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- 1. Copyright © 2014. F.A. Davis Company
Ethical and Legal Issues in Psychiatric/
Mental Health Nursing
Chapter 5
- 2. Copyright © 2014. F.A. Davis Company
Introduction
• Holistic patient care recognizes the
interconnectedness of physical, mental,
emotional, and social well-being.
• Essential in psychiatry due to the complex
nature of mental illnesses.
- 3. Copyright © 2014. F.A. Davis Company
Definition of Holistic Patient Care
• In psychiatry, holistic care considers biological,
psychological, social, and spiritual aspects.
• Offers a deeper understanding of mental
health conditions and personalized treatment.
• Acknowledges that mental health is
influenced by multiple dimensions.
- 4. Copyright © 2014. F.A. Davis Company
The Biopsychosocial Model
• The biopsychosocial model considers biology,
psychology, and social factors.
• Mental health issues result from a
combination of these factors.
• Helps in understanding and treating
underlying causes effectively.
- 5. Copyright © 2014. F.A. Davis Company
Components of Holistic Patient Care
Biological Dimension
• Focuses on physical health, medication, and
lifestyle's impact on mental health.
• Includes medical assessments, monitoring for drug
interactions, and lifestyle considerations.
- 6. Copyright © 2014. F.A. Davis Company
Ethical Considerations
Psychological Dimension
• Addresses mental health conditions and emotional
well-being.
• Involves assessments, psychotherapy, and
evidence-based treatments for mental health
disorders.
- 7. Copyright © 2014. F.A. Davis Company
Ethical Considerations (cont.)
Social Dimension:
• Impact of social factors on mental health
Assessment of social support systems and family
dynamics
• Consideration of cultural influences on well-
being
• Tailored treatment plans based on social
context
- 8. Copyright © 2014. F.A. Davis Company
Ethical Considerations (cont.)
Spiritual Dimension:
• Acknowledgment of beliefs and values in mental
health
• Incorporation of spirituality as a coping
mechanism
• Integration of mindfulness or meditation
• Supportive discussions on existential questions
- 9. Copyright © 2014. F.A. Davis Company
Benefits of Holistic Patient Care in
Psychiatry
• Improved treatment outcomes and patient
satisfaction
• Enhanced overall well-being and quality of
life
• Increased engagement and empowerment
in the treatment process
• Comprehensive understanding of patients'
needs and personalized care
- 10. Copyright © 2014. F.A. Davis Company
• Holistic patient care considers the social and
spiritual dimensions
• Tailored treatments lead to improved
outcomes and patient satisfaction
• Active patient engagement fosters
empowerment and adherence
• Comprehensive understanding allows for
personalized care based on individual
circumstances.
- 11. Copyright © 2014. F.A. Davis Company
Implementing Holistic Patient Care
1.Collaborative and Interdisciplinary Approach
Objective: Ensure a comprehensive approach to
patient care.
Strategy:
• Foster collaboration among healthcare professionals.
• Include psychiatrists, psychologists, nurses, social workers, and
specialists.
• Develop comprehensive treatment plans leveraging diverse
expertise.
- 12. Copyright © 2014. F.A. Davis Company
A Model for Making Ethical Decisions
2.Comprehensive Assessments
Objective: Establish a foundation for holistic
understanding.
Strategy:
• Conduct thorough medical and psychiatric evaluations.
• Perform psychosocial assessments for social context.
• Consider cultural factors for culturally competent care.
• Address individual needs across various dimensions.
- 13. Copyright © 2014. F.A. Davis Company
Ethical Issues in Psychiatric Mental
Health Nursing
3. Tailoring Treatment Plans
Objective: Provide personalized care.
Strategy :
• Integrate information from comprehensive
assessments.
• Develop personalized plans considering lifestyle
modifications, psychotherapy, pharmacology, and
social support services.
- 14. Copyright © 2014. F.A. Davis Company
Legal Considerations
4. Incorporating Evidence-Based
Interventions
Objective : Ground holistic care in proven
practices.
Strategy :
• Integrate interventions scientifically
validated for physical and mental health.
• Focus on improving patient outcomes.
- 15. Copyright © 2014. F.A. Davis Company
Challenges and Considerations
1. Limited Time and Resources
• Challenge: Time constraints in clinical
settings.
• Mitigation:
• Prioritize essential dimensions through
effective time management.
• Streamline processes to optimize
resources.
- 16. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing
2. Collaborative Efforts Across Disciplines
• Challenge: Coordination among diverse
healthcare professionals.
• Mitigation:
• Conduct regular interdisciplinary meetings.
• Provide training for clear communication and
shared understanding.
- 17. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
3. Overcoming Stigma and Cultural Barriers
Challenge:Mental health stigma and cultural
beliefs.
Mitigation:
• Address stigma through education and training.
• Promote cultural competence within healthcare
settings.
• Engage patients and families in culturally sensitive
ways.
- 18. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
4. Ongoing Professional Development and
Education
Challenge: Staying updated on holistic care
practices.
Mitigation:
• Provide continuous professional development
opportunities.
• Ensure access to the latest research and evidence-
based practices.
- 19. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
Nursing Liability (cont.)
• Invasion of privacy
• Assault and battery
• False imprisonment
- 20. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
2. As a last resort, an agitated, physically aggressive
client is placed in four-point restraints. The client
yells, “I’ll sue you for assault and battery.” The unit
manager determines that the nurses are protected
under which condition?
A. The client is voluntarily committed and poses a
danger to others on the unit.
B. The client is voluntarily committed and has a history
of being a danger to others.
C. The client is involuntarily committed because of a
history of violent behavior.
D. The client is involuntarily committed and is refusing
treatment.
- 21. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
• Correct answer: A
– As a threat to others, the client can be restrained
despite objections and voluntary commitment.
- 22. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
3. A nurse gave a client 5 mg of haloperidol
(Haldol) for agitation. The client’s chart was
clearly stamped “Allergic HALDOL.” The client
suffered anaphylactic shock and died. How
would the nurse’s actions be labeled?
A. Intentional tort
B. Negligence
C. Battery
D. Assault
- 23. Copyright © 2014. F.A. Davis Company
Legal Issues in Psychiatric Mental
Health Nursing (cont.)
• Correct answer: B
– The nursing action was an unreasonable and
careless act. The nurse was negligent and could
be held liable for the client’s death.
- 24. Copyright © 2014. F.A. Davis Company
Avoiding Liability
• Respond to the client.
• Educate the client.
• Comply with the standard of care.
• Supervise care.
• Adhere to the nursing process.
• Document carefully.
• Follow up as required.
• Develop and maintain a good interpersonal
relationship with client and family.