overview of psychiatric nursing

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Centre for Psychiatric Nursing

Psychiatric Mental HealthPsychiatric Mental Health

NursingNursing


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Overview ofOverview of

Psychiatric/Mental HealthPsychiatric/Mental HealthNursingNursing

OutlineSimilarities & differences between

psychiatric nursing and other fields of

nursingSkills & knowledge of the psychiatric nurse


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Overview ofOverview of

Psychiatric/mental HealthPsychiatric/mental HealthNursingNursing

T

he importance of psychiatric nursing sk

illsin all clinical settings

Career opportunities

Postgraduate study & endorsement

Professional affiliation


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The Psychiatric/mental HealthThe Psychiatric/mental Health

NurseNurse Mental Health Nursing is a specialised

field of nursing which focuses on meeting

the mental health needs of the consumer, in

partnership with family, significant others

and the community in any setting. It is a

specialised interpersonal processembodying a concept of caring. (p. 3)

ANZCMHN (1995)


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The Essence ofThe Essence of

Psychiatric/mental HealthPsychiatric/mental HealthNursingNursing

Lies not in tasks performed or with the presenting

illness but in the relationship that develops withclients and families and their responses to theillness, including the impact that the illness has ontheir lives.

The essence is in establishing a therapeuticpartnership, a connectedness, between the nurseand client which is based on empathy and trust.

Elsom (2001)


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Similarities & Differences


SIMILARITIES

Work in close contact with people from a wide

variety of backgrounds

Provide CARE for people with a wide variety of

illnesses

Involved in health promotion and illnessprevention

Nursing philosophy of benevolence


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SIMILARITIES

Education: must meet required level of

knowledge and skills to attainregistration/endorsement

Governed by the Nurses Codes

Professional Conduct & Ethics Structure of workhours, salary, benefits


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Similarities & DifferencesDIFFERENCES

Core focus of Psychiatric Mental Health Nursing

Therapeutic relationship

Use of self as a therapeutic tool

People-centred approach, engaging clients indiscourse, promoting change

Less taskorientated

Less technical environment

Professional autonomy

Moir & Abraham (1996)


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DIFFERENCES

Clinical competence based on interpersonal

techniques

Stuart & Laraia (2001)

Less repetition in process & procedures due to

client individualityMoir & Abraham (1996)


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Philosophy of the ProfessionPhilosophy of the Profession

Each individual:

Has intrinsic worth and dignity and eachperson is worthy of respect.

Has the potential to change.

Has common, basic human needs Varies in their coping capacities


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Philosophy of the professionPhilosophy of the profession

Each individual(s):

Behaviour is meaningful

Has a right to equal opportunity for

adequate health care.

Has the right to participate in decisionmaking regarding their care.

Has the right to self-determination


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Philosophy of the professionPhilosophy of the profession

The fundamental premise is:

The goal of nursing care is to promotewellness, maximise integratedfunctioning.nursing care is based onmutually determined needs and expectedtreatment outcomes..

An interpersonal relationship can producechange and growth within the individual.

Stuart & Laraia (2001, p. 7)


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The Knowledge, Skills &The Knowledge, Skills &

Attitudes of theAttitudes of thePsychiatric/mental Health NursePsychiatric/mental Health Nurse

The knowledge base of the

psychiatric/mental health nurse isgrounded in the integration of the

biological, psychological, spiritual, social

and environmental realms of the human

experience.

Stuart & Laraia (2001)


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Attitudes of theAttitudes of thePsychiatric/mental Health NursePsychiatric/mental Health Nurse

Broad context of care

Requires purposeful use of self as a therapeutictool

Knowing you, Knowing me (Awareness ofself) Barker, Jackson & Stevenson (1999)

Requires great sensitivity to the socialenvironment & advocacy needs of clients/families

Requires careful consideration of legal & ethicalissues


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Attitudes of theAttitudes of thePsychiatric/mental Health NursePsychiatric/mental Health NurseTHERAPEUTIC NURSE-CLIENT RELATIONSHIP

Physical dimension

Safety dimension Social dimension

Spiritual dimension

Provision of treatment modalities

Encouraging self-determination

Provision of information

Cowman, Farrelly & Gilheany (2001)


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The Knowledge, Skills & AttitudesThe Knowledge, Skills & Attitudes

of the Psychiatric/mental Healthof the Psychiatric/mental Health

NurseNurse Milieu management

Assessing, planning, implementing & evaluating

care

Pharmacological interventions

Documentation/Administration

Legal requirements Educating/supervision

Coordination/Multidisciplinary team member


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The Importance ofThe Importance of

Psychiatric/mental Health NursingPsychiatric/mental Health NursingKnowledge, Skills & AttitudesKnowledge, Skills & Attitudes

In Australia, one in five persons will at

some stage in their lives, experience a

major mental illness.

Commonwealth Department of Health and Aged Care Services (1997)


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Exposure to clients with mental health problems

or illness in any area of practice

Skills will assist the nurse to provide comfort to

clients who may be experiencing a myriad ofemotions. I.e. grief, anxiety, anger, cognitive

deficits and subsequent behaviour, and diagnosed

mental illness


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Mental state assessment skills

Early intervention - reduced stays, improved

recovery rates. Improved client outcomes

Nurse more comfortable, confident in working

with clients with mental illness


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Career

Opportunities

Career

Opportunities

Diversity within the profession

Attractive transferable skills

Consultation

Management

Education Independent Practitioner


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Career

Opportunities

Career

Opportunities

DIVERSITY

Public & Private Mental Health Services

In-Patient Facilities

Out-patient or Day-patient Programs

Crisis Assessment & Treatment Teams

Community TeamsConsultation-Liaison Mental Health Nurse


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CareerOpportunitiesCareerOpportunities

DIVERSITY

Adult Acute

Community

Adult Rehabilitation

Child & Adolescent

Aged Mental Health

ForensicSpecialty Programs: I.e. Eating Disorders, Substance

Abuse Treatment, Cognitive Behavioural Programs,

Parent-Infant.


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Career

Opportunities

Career

Opportunities

Career structure

Professional development

Clinical supervision

Scholarships

Graduate nurse Programs

Postgraduate StudyPaid study leave


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Postgraduate Study &Postgraduate Study &

EndorsementEndorsement Postgraduate studies in Psychiatric/Mental Health

Nursing

Graduate Diploma

Graduate Certificate

Endorsement by the NBV (Where relevant)

Highly attractive to prospective employers


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Professional AffiliationProfessional Affiliation Australian Collage ofMental Health Nurses

ACMHN.

Standards of Practice

Centre for Psychiatric Nursing (CPN)


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ReflectionR

eflectionNurses are traveling companions with

patients, not travel agents the heart

(of nursing) is the skills and values

needed by nurses to establish and

maintain human contact with patients.

Peck& Norman (1999)


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ReferencesReferences Australian and New Zealand Collage ofMental Health Nurses Inc.

(ANZCMHN) (1995). Standards of Practice for Mental HealthNursing in Australia Adelaide: ANZCMHN Inc.

Barker, P., Jackson, S. & Stevenson, C. (1999). What are psychiatricnurses needed for? Developing a theory of essential nursing

practiceJ

ournal of Psychiatric and Mental Health Nursing 6,273-282.

Commonwealth Department of Health and Aged Care Services.(1997).National Mental Health Report 1996: Fourth Annual Report,Changes in Australias Mental Health Services under the National

Mental Health Strategy 1995-6. Canberra: Australian GovernmentPrinting Services


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ReferencesR

eferences Cowman, S., Farrelly, M. & Gilheany, P. (2001). An examination ofthe role and function of psychiatric nurses in clinical practice inIreland Journal of Advanced Nursing 34(6), 745-753.

Elsom, S. (2001). The active participants in Mental Health Services.

In Meadows, G. & Singh, B. (Ed.),Mental Health in Australia,Collaborative Community Practice (pp. 136-162). Melbourne:Oxford University Press.

Grigg, M. (2001) The role of the psychiatric nurse.AustralasianPsychiatry 9(2), 143-145.

Peck, E. & Norman, I. (1999). Working together in adult communitymental health services: exploring inter-professional role relations.Journal of Mental Health 8, 231-242

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