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Introduction to mental health nursing part 2



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Introduction to mental health nursing part 2

  1. 1. Introduction to mental Health Nursing
  2. 2. Mental Health Team Multidisciplinary approach to provide service to mentally ill persons.  A psychiatrist  A psychiatric Nurse  A clinical Psychologist  A psychiatric social worker  An occupational therapist/activity therapist  A pharmacist and a dietician.  A counselor.
  3. 3. Mental Health Team  A psychiatrist: MD/DNB Psychiatry. Medical diagnosis and treatment.  Admission/discharge  Psychopharmacology  Administer ECT  Psychotherapy  Team meetings  Legal responsibilities.
  4. 4. Mental Health Team  A psychiatric Nurse: RN with specialized training.  Administer and monitor medications.  Assist in physical and psychiatric treatment  Interdisciplinary team meeting.  Health Education  Patients Records  Advocate of patient.  Relationship with patient’s family.
  5. 5. Mental Health Team  A Clinical Psychologist: Masters/ Doctorate in human psychology.  Accountable of psychological assessments/testing.  Individual, family and marital therapy.  A Psychiatric Social worker: Masters/ Doctorate.  Family case work and community placement of patients.  Group therapy sessions.  Social intervention at patient social environment.
  6. 6. Mental Health Team  An Occupational Therapist: Concerned training.  Accountable for recreational, occupational and activity programmes.  Assist the patients in gaining skills that help them cope more effectively, retain employment and use their leisure time.  A Counselor: Concerned training.  Provides basic supportive counseling and assists in psycho educational and recreational activities.
  7. 7. Nature of Mental Health  It is a profession possessing its unique history, ideology, knowledge and skills.  It is both an art (nurse – patient relationship) and a science (skills for the purpose of gaining insight, effective change, healing mental and emotional wounds and promoting growth).  Understands the principles of nursing and remain current in knowledge and practice.
  8. 8. The Philosophy of Psychiatric Nursing Practice  Every individual has intrinsic worth and dignity and is worthy of respect.  Each person functions as holistic and react to environment as a whole.  All behaviour of an individual is meaningful. It can be understood from an internal frame of the patient.  Behaviour has perceptions, thoughts, feelings and actions.  Individuals vary in their coping capacities.  All are prone for health and illness.
  9. 9. The Philosophy of Psychiatric Nursing Practice  Nursing is aimed to promote wellness, maximize functioning and enhance self actualization.  IPR can produce change in growth of an individual.  Psychiatric nursing is based on psychosocial and biophysical sciences.
  10. 10. Scope of Mental Health Nursing  Nurse Generalist: a licensed nurse providing primary mental health care. Holistic approach, prevention programmes, community and day care centers, psychiatric rehabilitation facilities, homeless shelters etc.  Nurse Specialist: Psychiatric Clinical Nurse Specialist (CNS): have a master degree in mental health nursing. Autonomous functioning, prescription privileges, manages overall care of emotional and psychiatric problems. Eg. Crisis interventio0n specialists, Milieu Specialists, Psychotherapists etc.
  11. 11. Scope of Mental Health Nursing  Community Mental Health Nurse (CMHN): Diagnosis, appropriate referrals, care and rehabilitation of mentally ill people in the community.  Psychiatric Home Care Nurse: direct patient care, behavioral management, crisis intervention, psycho education, detoxification, medication etc.  Forensic Psychiatric Nurse: works with individuals who have entered the legal system.
  12. 12. Scope of Mental Health Nursing  Psychiatric Consultation - Liaison Nurse PCLN: Psychiatric nurse who work in non- psychiatric setting and provide necessary support, guidance and counseling for those affected with anxiety, depression and other psychological problems.  Case Manager: Nurse manager acts as advocates by coordinating care and linking patient with physician and other members of health care team. Works in community and helping in daily living of a mentally ill person such as transportation, managing money, buying things etc.
  13. 13. Scope of Mental Health Nursing  Gero Psychiatric Nurse;  Parish Nurse: An RN with spiritual mature. Supports health education, social services, and carry out non-invasive nursing care. Common in US.  Tele health / Tele nurse: Nurses engaged in tele-nursing practice use technologies such as internet, computers, telephones, digital assessment tools & tele-monitoring equipment to deliver nursing care. In India around 10 hospitals are having telemedicine departments. Eg. Apollo hospitals, Narayana Hrudayalaya.
  14. 14. Scope of Mental Health Nursing  Nurse Researcher: Nurse researchers design, conduct & disseminate findings of research at professional meets & in peer reviewed journals. They are doctorally or post-doctorally prepared persons who initiate or participate in all phases of the research process.  Psychiatric Nurse Educator:  Nurse Administrator/Manager  Nurse Pharmacologist: The psychiatric clinical nurse specialist with prescriptive authority.  Holistic Nurse: Integrates complementary and alternative modalities such as relaxation,
  15. 15. Functions of Mental Health Nurse INPATIENT PSYCHIATRIC WARD…  Provide for environment safety including protecting the patient & others from injury.  Perform psychosocial, high risk & physical assessment.  Promotion of self care activities.  Medication management.  Assisting for somatic therapies.  Accurately observing & documenting the patient’s behavior.  Providing opportunities for the patient to make his own decisions & to assume
  16. 16. Functions of Mental Health Nurse INPATIENT PSYCHIATRIC WARD  Provide safe environment and protect from injury.  Perform psychosocial, high risk & physical assessment.  Promotion of self care activities.  Medication management.  Documentation of behaviour.  Providing opportunities for the patient to make his own decisions & to assume responsibility for his life.
  17. 17. Functions of Mental Health Nurse INPATIENT PSYCHIATRIC WARD  Participation in various therapies, individual interactions, formal & informal group situations, role play, advocating on behalf of the patient & so forth.  Delivering psycho-education, social skill and stress management strategies.  Counseling the patient & family members.  Interdisciplinary approach to care.  Discharge planning & community referral & follow up care.
  18. 18. Functions of Mental Health Nurse PSYCHIATRIC OUTPATIEBT DEPARTMENT  Performing clinical assessment.  Assisting for psychometric assessment.  Assisting or providing psychotherapy or behavior therapy.  Counseling the patient & family members.  Conducting group therapy.  Delivering psycho education.
  19. 19. Functions of Mental Health Nurse ECT TREATMENT SETTING  Preparing the patient for ECT.  Providing care during the procedure.  Assisting with post treatment.  Providing reassurance to reduce anxiety.  Delivering psycho education regarding ECT.
  20. 20. Functions of Mental Health Nurse PSYCHOTHERAPY UNIT  Establishing a therapeutic relationship with the patient.  Providing an opportunity for the patient to release tension as problem are discussed.  Assisting the patient in gaining insight about the problem.  Providing opportunity to practice new skills.  Reinforcing appropriate behavior as it occurs.  Providing consistent emotional support.
  21. 21. Functions of Mental Health Nurse DAY CARE CENTERS OR DAY HOSPITALS  Performing clinical assessment /observation/ documentation.  Medication management.  Teaching social skills.  Counseling patient & family members.  Delivering psycho education.  Providing occupational or recreational therapy & vocational assistance.
  22. 22. Functions of Mental Health Nurse CHILD PSYCHIATRIC WARD  Assessing the child and understand his strengths and abilities.  Monitor the child’s developmental levels & initiate supportive interventions such as speech, language or occupational skills as needed.  Provide a safe therapeutic environment.  Interdisciplinary approach to care.  Teach the child adaptive skills such as eating, dressing, grooming & toileting.  Deliver psycho education and Medication management, participate in therapies.
  23. 23. Functions of Mental Health Nurse HOME SETTING  Assessment of symptoms.  Teaching the patient & family regarding nutrition, exercise, hygiene & the relationship between physical & emotional health.  Stress management and Daily living kills (bank accounts, rent, utility bills, use of the telephone, grocery shopping).  Medication management Oral/IV– monitoring blood levels, toxicity, side effects & purposes.  Acts as a case manager & coordinate an array of services such as therapies.
  24. 24. Functions of Mental Health Nurse COMMUNITY MENTAL HEALTH CENTERS  Identification and referral of patients to appropriate hospitals.  Home visiting & providing direct care to the patients in the community.  Follow up care with special emphasis on medication regimen, & side effects, patient’s occupational function.  Conducting public awareness programs to remove misconceptions regarding mental disorders.  Training of other care giving professionals in the community.
  25. 25. Functions of Mental Health Nurse HOSPICE CARE CENTERS  Helping cancer patients or terminally ill individuals through the grieving process.  Provide supportive psychotherapy and support their families. EMERGENCY DEPARTMENTS  Crisis intervention during natural disasters, accidents, unexpected illnesses causing increased anxiety.  Helping the mother in labor & to cope with stress.  Providing support to bereaved patients in the event of fetal demise, abortion, birth of an infant with congenital abnormalities.
  26. 26. Functions of Mental Health Nurse HOSPITALS FOR CRIMINAL INSANE, JAILS & PRISONS  Forensic psychiatric nurses assist patients with self care, administration of medications & monitor the effectiveness of the treatment.  Provide psychotherapy & act as consultants.  Assessment of potential for violence.  Parole / probation considerations.  Assessment of racial / cultural factors during crime.  Formal written reports to court.
  27. 27. Factors affecting Level of Mental Health Practice  Nurse Practice acts.  Professional Practice Standards  Nurse’s Qualification.  Philosophy of health Care Organization.  The person competence and initiatives of the individual nurse.
  28. 28. Concepts of Normal and Abnormal Behaviour Medical Model Statistical Model Socio-cultural Model Behaviour Model