Nursing 305 The Role of the Psychiatric Nurse

Pre-requisites for the Role:  Self awareness is a key part of the psychiatric nursing experience.  You must be able to examine personal feelings, actions, and reactions.

Questions to ask yourself “Why do I want to help others?” “Who am I?” “What do I value?” “Am I open to my feelings and can I express them?”

Role cont.  “What is the key therapeutic tool of the psychiatric nurse?”

Role cont.  Answer: “use of oneself”

Some indicators of mental health  Positive attitudes toward self, growth, and development  Self-actualized  Integrated self  Autonomous  Reality-perception  Environmental mastery

Indicators cont.  Can a person adapt to changing needs throughout the life cycle?  How much resilience does a person have?  How does a person handle stress and adapt?  What kind of coping mechanisms are used?”

Mental health as a process  Mental health is ….a lifetime process that includes a sense of harmony and balance for the individual, friends, family, and community; it is more than the mere absence of a mental disorder

FACT  Nearly 50% of all people ages 15 to 54 have had a psychiatric or substance abuse disorder in their lifetime.

Historical perspectives  1800’s-The mentally ill were no longer treated as “less than human.” Treatment was provided in asylums.  Linda Richards, the first American psychiatric nurse. Director of first school of psychiatric nursing; McLean Hospital in Massachusetts.

Historical perspectives cont.  emergence of somatic therapies  ECT  After WWII major growth in psych nursing  1950’s –emergence of the role of the psych nurse & use of psychotropic drugs  Hildegard Peplau defined nursing as an interpersonal process, nurse role as counselor

History cont.  Deinstitutionalization Movement Community Mental Health Centers Act Founding of the American Psychiatric Nurses Assoc and the ANA published standards of mental health & nursing practice to present -significant changes in mental health treatment; focus on mental illness prevention

Contemporary psychiatric nursing practice  Reflects an interpersonal process  Is a specialized area of nursing practice utilizing theories of human behavior and the purposeful use of self.  The nurse-pt. partnership expands the nursing role to include: pt-family advocacy, clinical competence, collaboration, fiscal responsibility, and legal-ethical parameters.

Competent Caring 3 domains of psych nursing  Direct care  Communication  Management overlapped with teaching, delegating, and collaborating

Competent Caring cont.  Additional activities: Make culturally sensitive health assessments Engage in case management services Provide a health care map for families to guide them to community services Provide teaching and counseling

Levels of Performance  Laws: each state has its own nursing practice act, which regulates entry into the profession.  Qualifications include education, work experience, and certification.  2 levels: Basic-Psychiatric Mental Health RN  Advanced- Advanced Practice RN Psych Mental Health Nurse

Practice Settings  Vary widely for the psych nurse.  The role depends on the philosophy, mission, values of the setting, needs of the consumers, # of clinical staff available, resources, and presence of strong nursing leadership.

Focus for the future  Psych nurses focus on : -outcomes of care quality and cost -leadership skills-acting as change agents to advocate for the mental health needs of pts and families. Join organizations such as the American Psych. Nurses Assoc. (APNA) located in Washington DC -political action-increase political awareness to bring about changes in the MH delivery system.