This document outlines standards of practice for psychiatric nursing. It discusses key elements of the nursing process like assessment, diagnosis, planning, implementation, and evaluation of care. It emphasizes collecting comprehensive patient data, analyzing it to determine diagnoses, developing a care plan with interventions and expected outcomes, implementing interventions safely and ethically, and evaluating progress. The standards also address maintaining competency, evaluating one's own practice, collaborating with others, contributing to research, and considering safety, cost-effectiveness and impact on practice. Overall it provides a framework for delivering quality mental health nursing care.

1. Ms. RUPPA MERCY. R
M.Sc NURSING FIRST YEAR

3.  The word “psychiatry” is derived from Greek
word, ‘psyche’ means “soul or mind” and
“iatros means ‘healer’.
 It is a branch of medicine which deals with
the diagnosis, treatment and prevention of
mental illnesses.

4.  Specialized area of nursing practice,
combination of science and art by employing
theories of human behavior applied in the
diagnosis and treatment of human response
to actual or potential mental health
problems. It deals with promotion of mental
health prevention of mental illness, care of
the client with mental illness, care of mental
illness, rehabilitation of mentally ill patients
in the hospital or in the community
- American nurses association

6.  Acceptance does not mean complete
permissiveness but acceptance means setting
of positive behavior to convey the respect as
an individual human being.
 Acceptance conveys the feelings of being
loved and cared.
 Acceptance means being non judgmental

7. A. Being non judgmental & non punitive:
 The patient behavior is not judged as right or
wrong or bad.
 The patient is not punished for his
undesirable behavior.
 All direct & indirect methods of
punishment must be avoided.
 A nurse who shows acceptance does not
reject the patient even when he behaves
contrary to her expectations.

8.  This can be demonstrated by :
 Studying patient's behavior
 Allowing him to make his own choices &
decision as far as possible.
 Being aware of his likes & dislikes
 Being honest with him
 Taking time & energy to listen what he Is
saying
 ·Avoiding sensitive subjects & Issues.

9. When the patient talks it Is not the
content Is Important to note, but the
feeling behind the conversation which has
to be recognized & reflected.

10.  The nurse's conversation with a patient must
resolves around his needs, wants and
interests.

11.  The nurse should take time & energy to
listen to what the patient is saying.
 she must be a sympathetic listener & show
genuine interest.

12.  Strong emotions bottled up are potentially
explosive & dangerous.
 It is better to permit the patient to express
his strong feelings without disapproval or
punishment .

13.  A psychiatric nurses should have a realistic
self concept & should be able to recognize
one's own feelings.
 Her ability to aware & to accept her own
strengths & limitations should help her to see
the strengths & limitations in other people.

14.  This means that there should be consistency
in the attitude of the staff, ward routine and
in defining the limitations placed on the
patient.

15.  Reassurance is building patient's confidence.
 To give reassurance, the nurse needs to
understand and analyze the situation as to
how it appears to the patient.
 False reassurance can also reflect a lack of
interest and understanding or unwillingness
on the part of the nurse to empathize with
the patient's life situation

16.  Major focus in psychiatry is on feelings and
not on the intellectual aspect.
 Advising or rationalizing with patients is not
effective in changing behavior.
 Role-play and socio-drama are a few avenues
of providing corrective emotional
experiences to a patient and facilitating
insight into his own behavior.
 Such experiences can truly bring about the
desired behavioral changes.

17.  The following approaches may increase the
 patient's anxiety and should, therefore, be
avoided:
 Showing nurse's own anxiety.
 Showing attention to the patient's deficits.
 Making the patient to face repeated
failures.
 Placing demands on patient which he
obviously cannot meet.

18.  Direct contradiction of patient's psychotic
ideas.
 Passing sharp comments and showing
indifference.

19.  Objectivity is an ability to evaluate exactly
what the patient wants to say and not mix up
one's own feelings, opinion or judgment.
 To be objective, the nurse should indulge in
introspection and make sure that her own
emotional needs do not take a precedence
over patient's needs.

20.  Realistic or professional relationship focuses
upon the personal and emotional needs of the
patient and not on nurse's needs.
 To maintain professional relationship the nurse
should have a realistic self-concept and should
be able to empathize and understand the
feelings of the patient and the meaning of
behavior.

21.  All methods of punishment must be avoided.
 If the nurse is an expert in predicting patient
behavior, she can mostly prevent an onset of
undesirable behavior.

22.  Analysis and study of symptoms is necessary
to reveal their meaning and their
significance to the patient.
 Two patients showing the same symptoms
may be expressing two different needs.

23.  The extent of explanation that can be given
to a patient depends on his span of
attention, level of anxiety and level of
ability to decide.
 But explanation should never be withheld on
the basis that psychiatric patients are not
having any contact with reality or have no
ability to understand.

24.  In psychiatric nursing field, many methods
are adapted to individual needs of the
patients, but the underlying nursing
scientific principles remain the same.

25.  Following basic principles of nursing must be
followed:
 Providing safety
 Providing comfort
 Providing individual care
 Maintaining therapeutic effectiveness
 Maintaining economy of time, energy and
material.

28.  The development of standards for nursing
practice is a beginning step towards the
attainment of quality nursing care.
 The phases of the nursing process as
described by the Standards of Practice in
Psychiatric–Mental Health Nursing: Scope and
Standards of Practice are assessment,
diagnosis, outcomes identification, planning,
implementation, and evaluation.

29.  The nurse applies appropriate theory that is
scientifically strong and serves as a basis for
decision making regarding nursing practice.
 RATIONALE:
Provides basis for intervention and evaluation
 KEY ELEMENTS:
Ability to explain the possible cause behind
abnormal behavior if the patient.
Practice evidenced based nursing

30.  The psychiatric–mental health registered
nurse collects comprehensive health data
that are pertinent to the patient’s health or
situation.
 A Systematic, dynamic process by which the
nurse, through interaction with the client,
significant others, and health care provides
collectives & analyses data about the client.

31. It enables the psychiatric–mental health
nurse to make sound clinical judgments and
plan appropriate interventions with the
patient.
KEY ELEMENTS:
Patient’s immediate condition of needs
Focus on concern
Plan appropriate intervention

32.  The psychiatric–mental health registered
nurse analyzes the assessment data to
determine diagnoses or problems, including
level of risk.
 A nursing diagnosis provides the basis for
selection of nursing intervention to achieve
outcomes for which the nurse is
accountable” NANDA-2005

33.  The basis for providing psychiatric–mental
health nursing care is the recognition and
identification of patterns of response to
actual or potential psychiatric illnesses,
mental health problems, and potential co
morbid physical illnesses.
 Key elements:
 Diagnoses should reflect adaptive and
maladaptive coping responses based on
nursing frameworks and Diagnoses should
focus on the phenomena of concern to
psychiatric–mental health nurses

34.  Nurse develops a plan of care that prescribes
interventions to attain expected outcomes.
 RATIONALE:
Achieve the expected outcomes
Used to guide therapeutic interventions
 KEY ELEMENTS:
It identifies priorities of care
It identifies effective interventions to achieve
the outcomes

35.  Implementing the interventions identified in
the plan of care
 RATIONALE:
Takes basic nursing care like medication
administration, activity therapy, milieu
therapy, and can take psychotherapies,
consultation, counseling etc.
KEY ELEMENTS:
Interventions are performed in a safe, ethical
and appropriate manner.

36.  The psychiatric–mental health registered
nurse evaluates progress toward attainment
of expected outcomes.
 RATIONALE:
Continuous process of appraising and
treatment on the patient’s condition.
KEY ELEMENTS:
Evaluation is systematic and ongoing
The effectiveness of intervention is
documented.

37.  It enhances the quality and effectiveness of
mental health care.
 RATIONALE:
Advent of various research and technologies
Improvement in quality of care
KEY ELEMENTS:
Identification of aspects of care
Analysis of quality data to identify
opportunities
development of policies and procedures.

38.  The psychiatric–mental health registered
nurse attains knowledge and competency
that reflect current nursing practice.
 RATIONALE:
The rapid expansion of knowledge pertaining
to basic and behavioral sciences, technology,
information systems, and research requires a
commitment to learning throughout the
psychiatric–mental health nurse’s
professional career.

39.  The psychiatric–mental health registered
nurse evaluates one’s own practice in
relation to the professional practice
standards and guidelines and relevant
statutes, rules, and regulations.
 RATIONALE:
to evaluate the role and performance of
psychiatric– mental health nursing practice
according to standards established by the
profession.

40.  The psychiatric–mental health registered nurse
collaborates with patients, family, and others in the
conduct of nursing practice.
 RATIONALE:
Through the collaborative process, different abilities of
health care clinicians are used to identify problems,
communicate, plan and implement interventions, and
evaluate mental health services.
KEY ELEMENTS:
Collaboration involves the ability to negotiate and
formulate new solutions with others.

41.  Nurse contributes to nursing and mental
health through the use of research.
RATIONALE:
Every member of a profession has a
responsibility to aid in development of body
of knowledge.

42.  The psychiatric–mental health registered
nurse considers factors related to safety,
effectiveness, cost, and impact on practice
in the planning and delivery of nursing
services.
 RATIONALE:
The psychiatric–mental health nurse seeks to
provide cost-effective, quality care by using
the most appropriate resources and
delegating care to the most appropriate,
qualified health care clinician.

43.  The standard of leadership is one of the most
important, since it requires psychiatric
nurses to think beyond their immediate care
giving responsibilities to the way in which
they can impact the broader health care
environment.