Nursing 305

1. Nursing 305 The Role of the Psychiatric Nurse

2. 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.

3. 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?”

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

5. Role cont. • Answer: “use of oneself”

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

7. 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?”

8. 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

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

10. Historical perspectives • 1800’s-The mentally ill were no longer treated as “less than human.” Treatment was provided in asylums. • 1880- Linda Richards, the first American psychiatric nurse. Director of first school of psychiatric nursing; McLean Hospital in Massachusetts.

11. Historical perspectives cont. • 1935- emergence of somatic therapies • 1937- ECT • After WWII major growth in psych nursing • 1950’s –emergence of the role of the psych nurse & use of psychotropic drugs • 1952- Hildegard Peplau defined nursing as an interpersonal process, nurse role as counselor

12. History cont. • 1960- 1980 - Deinstitutionalization Movement Community Mental Health Centers Act Founding of the American Psychiatric Nurses Assoc and the ANA published standards of mental health & nursing practice. 1980 to present -significant changes in mental health treatment; focus on mental illness prevention

13. 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.

14. Competent Caring3 domains of psych nursing • Direct care • Communication • Management overlapped with teaching, delegating, and collaborating

15. Competent Caringcont. • 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

16. 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

17. 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.

18. 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.