Download presentation
Presentation is loading. Please wait.
1
Introduction to Psychiatric Mental Health Nursing Chapter 1 & 2
West Coast University NURS 204
2
Caring for Psychiatric Mental Health Clients
Feelings, Concerns, Questions—What Are They?
3
Factors Influencing Expectations
Media Other? Upbringing Expectations Life experiences Culture
4
Psychiatric Mental Health Clients
Psychiatric mental health clients are everyday, ordinary people.
5
Factors Impacting Mental Health and Mental Illness
Biological Mental Illness or Mental Health Social Cultural
6
Mental Disorder Characteristics
Distress Disability Risk
7
DSM-IV-TR Identifies Standardizes Categorizes
8
Deviance Is it bad? Bizarre in one cultural context; acceptable in another? Deviant political, religious, or sexual behavior Mental disorder- yes or no?
9
What do these terms mean?
Crazy? Berserk? Wacky? Insane? Weird? Lunacy? Nervous Breakdown? Melancholy?
10
History Understanding and approaches to “madness” throughout history were influenced by: Social attitudes Philosophic viewpoints
11
Historical Approaches
Era of Magico-Religious Explanations Superhuman forces Violation of taboos Neglect of rituals Loss of soul Witchcraft Era of Organic Explanations Imbalance in the body’s humors (Hippocrates, 4th century BCE) Era of Alienation Social exclusion Imprisonment “Ships of fools” “Lunacy” The exception: Arab belief was that the insane were divinely inspired.
12
A ward in Bethlehem Hospital about 1745
A ward in Bethlehem Hospital about A patient is being chained in the foreground, and in the background are two Sunday visitors on an entertainment outing. Source: Philosophical Library.
13
Historical Approaches - continued
Era of Confinement Confined Beaten and tortured Enormous asylums: Hôpital Général St. Mary of Bethlehem Era of Moral Treatment Emergence of reform Reform leaders: William Cullen Philippe Pinel William Tuke Benjamin Franklin Benjamin Rush “Father of American Psychiatry”
14
Historical Approaches - continued
Era of Psychoanalysis Sigmund Freud Contemporary Developments Social dimensions Brain dysfunction Neurochemical Medication therapy
15
21st Century Research Bases for mental disorders
Psychotropic medications Role of nutrients, biology, and genetics
16
Mental Disorder Statistics
High incidence with physical illness Account for 47% of all disability in economically developed countries Account for 28% of all disability worldwide
17
Prevalence Rates for Various Mental Disorders
18
Leading Causes of Mental Disability Worldwide
19
Mental Health Studies Epidemiologic Catchment Area (ECA)
Global Burden of Disease (WHO) U.S. Surgeon General’s Report Healthy People 2010
20
Healthy People 2010 Adolescent suicide rate
Homeless adults with serious mental illness (SMI) Relapse with eating disorders Mental health screening Treatment issues: Children and adults
21
Healthy People 2010 - continued
Screening in juvenile justice Jail diversion programs for SMI Cultural competence issues Services for older adults: crisis intervention, screening, treatment Employee stress in the workplace
22
Psychiatric-Mental Health Nurses
What do they do? Chapter 2
23
Psychiatric-Mental Health Nurses - continued
Psychiatric-mental health nursing promotes mental health through: Assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders (ANA, APNA, ISPN, 2007)
24
Standards Standards of Psychiatric-Mental Health Nursing Practice:
Guidelines for providing quality care Psychiatric-Mental Health Nursing Standards of Practice Assessment Diagnosis Outcomes Identification Planning
25
Standards - continued Psychiatric-Mental Health Nursing Standards of Practice Implementation Coordination of Care Health Teaching and Health Promotion Milieu Therapy Phamacological, Biological, and Integrative Therapies Prescriptive Authority and Treatment (APRN only) Psychotherapy (APRN only) Consultation (APRN only) Evaluation
26
Psychiatric–Mental Health Nursing Standards of Practice
27
Standards - continued Standards of Professional Performance
Quality of Practice Education Professional Practice Evaluation Collegiality Collaboration Ethics Research Resource Utilization Leadership
28
Psychiatric–Mental Health Nursing Standards of Professional Performance
29
Psychiatric-Mental Health Nurses
Generalist level Advanced practice level Prescriptive authority Psychotherapy Consultation
30
The Psychiatric-Mental Health Team
Psychiatric-mental health nurse Psychiatrist Clinical psychologist Psychiatric social worker Marriage and family therapist Occupational therapist Recreational therapist Creative arts therapist Psychosocial rehabilitation worker
31
Estimated Number of Mental Health Workers in the United States
32
The Mental Health Team
33
Effective Mental Health Services
Client Partnerships PMH Team Family
34
Lessons on Collaboration
“Know thyself” Value diversity Know that conflict is natural Share your power with others Master communication skills Think life-long learning. Embrace interdisciplinary situations. Appreciate spontaneity. Balance unity with autonomy.
35
The Role of the Psychiatric-Mental Health Nurse
Custodial Multifaceted
36
Early Psychiatric-Mental Health Nursing (19th century)
First school of nursing Florence Nightingale’s thoughts American nursing schools “First American psychiatric nurse” Single-focused training schools Custodial, mechanistic, directed by psychiatrists
37
Psychiatric-Mental Health Nursing (1900-1940)
Psychiatric nursing curricula Psychiatric nursing texts Single-focus psychiatric nursing schools
38
Psychiatric-Mental Health Nursing (1940-1990)
Nurses begin to educate nurses. Psychiatric theory includes interpersonal and emotional dimensions. National Mental Health Act of 1946 Elimination of single-focus psychiatric nursing schools Period of role clarification Hildegard Peplau Gwen Tudor Frances Sleeper Community Mental Health Centers Act of 1963 Psychiatric nursing journals
39
Psychiatric-Mental Health Nursing (1940-1990) - continued
Birth of clinical nurse specialists and nurse therapist role First standards of psychiatric-mental health nursing practice Increase role of nurses at national level Shift in psychiatric nursing toward humanistic interactionism Decrease in numbers of psychiatric nurses Decreased funding for training Psychiatric nursing diagnoses
40
Psychiatric-Mental Health Nursing (1990s) - Decade of the Brain
Psychobiologic concepts Nursing Psychopharmacology Project Health care delivery reform Outcome-based research Cultural diversity Integration of theoretical perspectives
41
Psychiatric-Mental Health Nursing (2000s) - The New Millennium
Standards of practice – revisions Knowledge explosion Renewed focus on physical health Single point of entry Advanced practice nurses Expansion of practice settings
42
Nursing Theories Assist nurses to: Organize assessment data
Identify problems Plan interventions Generate goals and actions Evaluate outcomes
43
Nursing Theories Impacting Psychiatric Nursing
Hildegard Peplau Dorothea Orem Martha Rogers Sister Callista Roy Ida Jean Orlando Ernestine Wiedenbach Joyce Travelbee Paterson and Zderad Jean Watson Patricia Benner
44
Nursing Theories - Value
Nursing practice vs. medical practice Caring vs. curing Interpretation of meaning Nurse-client relationship Advocacy of client dignity Advocacy of nurse authenticity
45
Application of Theoretical Frameworks
Application of various theoretical frameworks leads to: Quality client-centered care. Efficient use of resources. Practice-oriented research. Clinical judgments and actions that can be articulated and taught to others.
Similar presentations
