1. Psychiatric Mental Health Nurses: Who Are They? Spring 2011 Myers

2. Psychiatric-Mental Health Nurses What do they do? 2

3. Psychiatric-Mental Health Nurses - continued Psychiatric-mental health nursing promotes mental health through: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)Assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders (ANA, APNA, ISPN, 2007) 3

4. Standards Standards of Psychiatric-Mental Health Nursing Practice:Standards of Psychiatric-Mental Health Nursing Practice: Guidelines for providing quality careGuidelines for providing quality care 4

5. Standards - continued Psychiatric-Mental Health Nursing Standards of PracticePsychiatric-Mental Health Nursing Standards of Practice 1.Assessment 2.Diagnosis 3.Outcomes Identification 4.Planning 5

6. Standards - continued Psychiatric-Mental Health Nursing Standards of PracticePsychiatric-Mental Health Nursing Standards of Practice 5.Implementation A.Coordination of Care B.Health Teaching and Health Promotion C.Milieu Therapy D.Phamacological, Biological, and Integrative Therapies E.Prescriptive Authority and Treatment (APRN only) F.Psychotherapy (APRN only) G.Consultation (APRN only) 6.Evaluation 6

7. Standards - continued Standards of Professional PerformanceStandards of Professional Performance 7.Quality of Practice 8.Education 9.Professional Practice Evaluation 10.Collegiality 11.Collaboration 12.Ethics 13.Research 14.Resource Utilization 15.Leadership 7

8. Psychiatric-Mental Health Nurses Generalist levelGeneralist level Advanced practice levelAdvanced practice level Prescriptive authorityPrescriptive authority PsychotherapyPsychotherapy ConsultationConsultation 8

9. The Psychiatric-Mental Health Team Psychiatric-mental health nursePsychiatric-mental health nurse PsychiatristPsychiatrist Clinical psychologistClinical psychologist Psychiatric social workerPsychiatric social worker 9

10. The Psychiatric-Mental Health Team - continued Marriage and family therapistMarriage and family therapist Occupational therapistOccupational therapist Recreational therapistRecreational therapist Creative arts therapistCreative arts therapist Psychosocial rehabilitation workerPsychosocial rehabilitation worker 10

11. Effective Mental Health Services 11 Partnerships Client PMH TeamFamily

12. Health Care Team Members MaximizersMaximizers RivalistsRivalists CooperatorsCooperators 12

13. Lessons on Collaboration “Know thyself”“Know thyself” Value diversityValue diversity Know that conflict is naturalKnow that conflict is natural Share your power with othersShare your power with others Master communication skillsMaster communication skills 13

14. Lessons on Collaboration - continued Think life-long learning.Think life-long learning. Embrace interdisciplinary situations.Embrace interdisciplinary situations. Appreciate spontaneity.Appreciate spontaneity. Balance unity with autonomy.Balance unity with autonomy. 14

15. The Role of the Psychiatric- Mental Health Nurse 15 CustodialMultifaceted

16. Early Psychiatric-Mental Health Nursing (19 th century) First school of nursingFirst school of nursing Florence Nightingale’s thoughtsFlorence Nightingale’s thoughts American nursing schoolsAmerican nursing schools 16

17. Early Psychiatric-Mental Health Nursing (19 th century) - continued “First American psychiatric nurse”“First American psychiatric nurse” Single-focused training schoolsSingle-focused training schools Custodial, mechanistic, directed by psychiatristsCustodial, mechanistic, directed by psychiatrists 17

18. Psychiatric-Mental Health Nursing (1900-1940) Psychiatric nursing curriculaPsychiatric nursing curricula Psychiatric nursing textsPsychiatric nursing texts Single-focus psychiatric nursing schoolsSingle-focus psychiatric nursing schools 18

19. Psychiatric-Mental Health Nursing (1940-1990) Nurses begin to educate nurses.Nurses begin to educate nurses. Psychiatric theory includes interpersonal and emotional dimensions.Psychiatric theory includes interpersonal and emotional dimensions. National Mental Health Act of 1946National Mental Health Act of 1946 Elimination of single-focus psychiatric nursing schoolsElimination of single-focus psychiatric nursing schools 19

20. Psychiatric-Mental Health Nursing (1940-1990) - continued Period of role clarificationPeriod of role clarification Hildegard PeplauHildegard Peplau Gwen TudorGwen Tudor Frances SleeperFrances Sleeper Community Mental Health Centers Act of 1963Community Mental Health Centers Act of 1963 Psychiatric nursing journalsPsychiatric nursing journals 20

21. Psychiatric-Mental Health Nursing (1940-1990) - continued Birth of clinical nurse specialists and nurse therapist roleBirth of clinical nurse specialists and nurse therapist role First standards of psychiatric-mental health nursing practiceFirst standards of psychiatric-mental health nursing practice Increase role of nurses at national levelIncrease role of nurses at national level Shift in psychiatric nursing toward humanistic interactionismShift in psychiatric nursing toward humanistic interactionism 21

22. Psychiatric-Mental Health Nursing (1940-1990) - continued Decrease in numbers of psychiatric nursesDecrease in numbers of psychiatric nurses Decreased funding for trainingDecreased funding for training Psychiatric nursing diagnosesPsychiatric nursing diagnoses 22

23. Psychiatric-Mental Health Nursing (1990s) - Decade of the Brain Psychobiologic conceptsPsychobiologic concepts Nursing Psychopharmacology ProjectNursing Psychopharmacology Project Health care delivery reformHealth care delivery reform Outcome-based researchOutcome-based research Cultural diversityCultural diversity Integration of theoretical perspectivesIntegration of theoretical perspectives 23

24. Psychiatric-Mental Health Nursing (2000s) - The New Millennium Standards of practice – revisionsStandards of practice – revisions Knowledge explosionKnowledge explosion Renewed focus on physical healthRenewed focus on physical health Single point of entrySingle point of entry Advanced practice nursesAdvanced practice nurses Expansion of practice settingsExpansion of practice settings 24

25. Nursing Theories Assist nurses to:Assist nurses to: Organize assessment dataOrganize assessment data Identify problemsIdentify problems Plan interventionsPlan interventions Generate goals and actionsGenerate goals and actions Evaluate outcomesEvaluate outcomes 25

26. Nursing Theories Impacting Psychiatric Nursing Hildegard PeplauHildegard Peplau Dorothea OremDorothea Orem Martha RogersMartha Rogers Sister Callista RoySister Callista Roy Ida Jean OrlandoIda Jean Orlando 26

27. Nursing Theories Impacting Psychiatric Nursing - continued Ernestine WiedenbachErnestine Wiedenbach Joyce TravelbeeJoyce Travelbee Paterson and ZderadPaterson and Zderad Jean WatsonJean Watson Patricia BennerPatricia Benner 27

28. Nursing Theories - Value Nursing practice vs. medical practiceNursing practice vs. medical practice Caring vs. curingCaring vs. curing Interpretation of meaningInterpretation of meaning Nurse-client relationshipNurse-client relationship Advocacy of client dignityAdvocacy of client dignity Advocacy of nurse authenticityAdvocacy of nurse authenticity 28

29. Application of Theoretical Frameworks Application of various theoretical frameworks leads to:Application of various theoretical frameworks leads to: Quality client-centered care.Quality client-centered care. Efficient use of resources.Efficient use of resources. Practice-oriented research.Practice-oriented research. Clinical judgments and actions that can be articulated and taught to others.Clinical judgments and actions that can be articulated and taught to others. 29