The document outlines 13 basic principles of psychiatric nursing: 1) Accepting patients unconditionally by showing non-judgment and understanding their feelings and behaviors. 2) Maintaining contact with reality by not encouraging unrealistic ideas and ensuring the patient is grounded in reality. 3) Seeking validation from the patient to understand their perspective and check the nurse's interpretations. 4) Using self-understanding as a tool to effectively respond to patient behaviors and attitudes. 5) Establishing consistency, security, and appropriate expectations to reduce patient anxiety.

1. Principles of Psychiatric Nursing

2. The basic principles in Psychiatric
Nursing are as follows:
1. Accepting patients as exactly
as they are
2. Maintaining contact with
reality
3. Seeking validation from
patient
4. Self-understanding used as a
therapeutic tool
5. Nurse’s personal contribution
6. Influence of expectations of
behavior
7. Consistency and patient
security
8. Reassurance
9. Changes in patient behavior
through emotional
experience
10. Avoiding increased patient
anxiety
11. Consideration of reason for
behavior
12. Necessity of Motor and
Sensory stimulation
13. Realistic nurse patient
relationship

3. 1. Accepting patients as exactly as they
are:
• The goal is to convey to the patient as a
respect for him/ her as an individual human
being who possesses worth and dignity.

4. Acceptance is conveyed through many
avenues of approach such as:
1. Non-judgmental and non-punitive
relationship with patient.
• A patient's behavior is no more right or wrong,
good or bad.
• You can feel shocked from his or her behavior
but do not make the patient feel that he has
insulted and must be punished.

5. A non-punitive approach:
do not punish neither directly nor indirectly for
his expressions of behavior.

6. The means of punishment consists of
measures such as:
a. Avoiding a patient except when something
must be done for him.
b. Telling him something un-pleasant
c. Calling attention to his defects by talking to
him.
d. Reducing him to a diagnosis.
e. Failing to explain what is being done to him.
f. Laughing at his fears.

7. g. Expecting him to know and behave as though
hospital routine were more important than him.
h. Demanding that he respects doctors and
nurses, and showing him annoyance and
disapproval face.

8. Showing interest in the patient as a
person and not as a case or clinical
problem.
• reading patient's chart by the nurse
• studying textbooks for increased
understanding of the development of the
behavior pattern
• using time spent with him on those things
which he is interested
• nurses awareness of patient's likes and dislikes

9. • Attain patient's requests and if not explain to
them the reason for not meeting it
• Listen carefully to client’s complaints and
expressions
• accept patient's fears as a real to him

10. Recognizing the feelings patients do
express:
• the nurse must focus his/her attention upon
understanding what the feeling means to the
patients
e.g: " I'd like to break someone's neck, means
that he is angry.
• use of open-end question. it does not direct
the patient's answer in any specific direction.
E.g "Would you care to tell me about it?"

11. Talking provides a means of keeping
acceptance of patients.
• The conversation should center on the
patient, on his needs, wants and on his
interests, not on the nurse's
• Nurse can use Understanding approach,
reflection and open-end questions

12. Listening to Patients
• Listening requires hearing, proper
interpretation and selective responsiveness.
• Nurse can encouraging patients to talk
through non-directive comments and through
interests in what the patient is saying.

13. Permitting patients to express
emotions.
• Anxiety, fear, hostility, hate and anger should
be expected, tolerated and allowed expression
but without physiologic or physical danger to
themselves and others.

14. 2. Maintaining contact with reality
• clients tend to see reality as they want it to be
rather than what it is.
• There must not be support for the unrealistic
ideas, assumptions or behavior. Reality must
be called to the patient's attention.

15. 3. Seeking Validation from patient
• It is the meaning of feelings and behavior from
the patients point of view thus the nurse has
to check against the nurse's interpretation of
how he sees things. ?

16. 4. Self- understanding used as a
therapeutic tool
• The nurse should feels some security about
her ability to respond appropriately to patient
behavior by understanding her behavior and
attitude towards mental illness first
• The nurse can participate in group
conferences about patient care.

17. 5. Nurse's personal contribution
• Self-understanding of how nurse really feels is
so important and stereotyped behavior
response to situations and patients is
potentially dangerous.
• The inconsistency between feelings and
actions lessens the nurse's effectiveness in a
relationship

18. 6. Influence of expectations of
behavior
• It is important to see the potential for growth
in every patient this makes the nurse to be
active as a resources person.

19. 7. Consistency and patient security
• The nurse has to be consistent in attitude,
behavior, feelings and routine in the
psychiatric hospital to help the patient to
reduce the number of decisions he is called
upon to make

20. 8. Reassurance
• Reassurance can best be given to patient by:
a. Attention to matters that are important to him/her.
b. Allowing patient to be as sick as he needs to be
c. Complete awareness and acceptance of how the
patient actually feels.
d. Doing things without asking anything of the patient in
return, such as improved behavior or a show of
appreciation.

21. 9. Changes in patient behavior through
emotional experience
• Help patient to go through experience and
develop their own feelings toward subject
• This involves the use of acceptance,
discriminating listening, focus of relationships
upon the patient, and involvement with the
patient.

22. 10. Avoiding increased patient anxiety
• Demands upon the patient that he obviously
cannot meet. e.g. to insist that a depressed
patient cheer-up, that an over active patient
sits down and keeps quiet. Failure causes
anxiety to patient
• Careless conversations
• Focusing attention on patient's defects, failing
abilities

23. • Insincerity
• Threats, by sharp commands
• Avoid topics/situations that increase patient's
anxiety
• Avoid exposing the patient's failing ability
• Avoid focusing attention on patient's
weaknesses

24. 11. Consideration of reason for
behavior
• Viewing patient's behavior objectively is
important in understanding why the patient
behaves in a specific way.
• Objectivity is the ability to evaluate a situation
of the patient's behavior, on the basis of what
is actually happening rather than on the basis
of one's personal feelings

25. 12. Necessity of Motor and Sensory
Stimulation
• Opportunity must be given to psychiatric
patients on exercises, games or mental tasks
to increase the sense of achievement

26. 13. Realistic nurse patient relationship
• It has to be therapeutic relationship and
limitations within the relationships
• It is to protect the patient from demanding
more than possibly he can receive
• It has a beginning, it develops once a
relationship is established and it has an end. A
relationship based on mutual respect and
trust will tolerate mistakes and the strains and
stresses of termination.

27. Thank You