role of psychiatric nurse

1. MR. marudhar

2. • Trends& issuesin the health care systemaffect
the roles of the psychiatric – mental health
nurse.
• Psychiatric nurses have traditionally worked on
inpatient psychiatric units, they have continued
to expand their role into the community.
• There are two levels of psychiatric-mentalhealth
nurses: Thegeneralist (registered psychiatric
nurse) & the specialist(CNS).
• Thescope& roles of bothare guided by nurse
practice acts & by standards ofcare.

3. • Thepsychiatric mental health generalist nurse is
alicensed registered nurse for deliveringprimary
mental health care.
• It incorporates both physical & mental health
care.
• Generalist exerciseaholistic approach to practice
& performs psychiatric nursing in prevention
programs, community & day treatment centers,
psychiatric rehabilitation facilities, homeless,
shelters & many othersettings.

4. • Psychiatric Clinical Nurse Specialist (CNS)holds amasters
degree in psychiatric mental healthnursing.
• CNSis an advanced practice nurse who is usually a
primary health care provider, functions autonomously,
often works in asemi-isolated situation, hasmedications
prescription privileges (depending upon individual state
laws), managesthe overall care of people withemotional
& psychiatric problem , & usually hasaconsultative
arrangement with apsychiatrist.
• For example, aadvanced practice nurse in Minnesota are
psychotherapists, consultants, milieu specialists, role
models, teachers, administrators, crisis intervention
specialists co-ordinators.

5. • Community mental health nursing is the
application of knowledge of psychiatricnursing
in preventing mental illness, promoting &
maintaining mental health of thepeople.
• It includes early diagnosis, appropriate
referrals, care &rehabilitation of mentally ill
people.

6. • Home health care is one aspect of community
health nursing.
• Psychiatric home care nurses provide holistic
psychiatric nursing care on a visiting basis to
people needing assistance.
• Thesenurse provide comprehensive care,
including psychiatric & physical assessment,direct
nursing care, behavioral management, crisis
intervention, psychoeducation, in-home
detoxification, medication management, case
management & consultation withcolleagues.

7. • Forensic nursing is agrowing specialty in other
countries around the globe, especially in theUK,
Australia, Germany,Japan& Canada,& it is an
expanded scopeof practice.
• Theforensic psychiatric nurse works with
individuals who havemental health needs&
who haveentered the legalsystem.
• Nursesin this role perform physical &psychiatric
assessment & develop plans of care for the
patients entrusted to theircare.

8. • PCLNhasarisen in response to the increased
recognition of the importance of psycho-physiological
inter-relationships & their impact on physical illness,
recovery & wellness.
• It is an advanced practice nurse who practices
psychiatric & mental health nursing in medical
setting/non-psychiatric setting providingconsultation
& education to patients, families, & health careteam
& thecommunity.
• PCLNmay provide assessment, recommendations &
supportive therapy to patients who are anxious,
depressed or experiencing other psychological
problems or emotionaldistress.

9. • Nurse casemanagersact asadvocates for
patients & their families by coordinatingcare &
linking the patient with the physician, other
members of the health-care-team, resources&
payers.
• In the community, the casemanager workswith
patients on abroad range of issuesfrom
accessingneeded medical & psychiatricservices
to carrying out tasksof daily livingsuchasusing
public transportation, managing money &
buying groceries.

10. NURSECASEMANAGER
Assesses,plans, implements,
coordinates, monitor, & evaluates
patient care options & servicesto
meet health needs through
communication & promotes high
quality, cost-effective outcomes &
decreases the duplication &
fragmentation of care
Collaborates with
patient & family
Resolution of
illnessOnset of illness
Collaborates with Nursing,
psychiatrist, psychologists,
social worker, occupational
therapists & ancillaryservices
Co-ordinates services:
Home care & rehabilatory
services

11. • Geronursing is expanding the psychiatric
nursing practice to agedpeople whohave
been affected by emotional & behavioral
disorders suchasdementia, chronic
schizophrenia, delirium, etc.

12. • Parishnursing is another area of expansionof
psychiatric nurserole.
• Parishnursing is aprogram that promotes health&
wellness of body, mind & spirit.
• Theparish nurse is apastorally called, spiritually
mature, licensed registered nurse with desire to
serve the members & friends of his or her
congregation.
• In 1998 the APArecognized parish nursing asa
specialty focusing on diseaseprevention & health
promotion.
• It is anon-invasive type of nursing in which no
hands-on nursing care isprovided

13. • Nursesengagedin telenursing practice use
technologies suchasinternet, computers,
telephones, digital assessment tools &
telemonitoring equipment to delivernursing
care.
• In India around 10 hospitals are havingtele-
medicine departments.
• Forexample, at Apollo hospitals, Narayana
Hrudayalaya & Hosmat hospital atBengaluru.

14. • Nurse researchers are scientists who seekto
find answers to questions throughmethodical
observations & experimentation.
• Thedesign studies, conduct research &
disseminate findings at professional meets & in
peer reviewedjournals.
• They are doctorally or post-doctorally prepared
persons who initiate or participate in all phases
of the researchprocess.
• Theywork in avariety ofsetting.

15.  Thepsychiatric nurse educators works in
educational institutions, staff development
department of health care agencies, patient
education department (teach the mentally ill
patients & their families about care to provide at
hone).
 Another function of nurse educator in planning &
changing the curriculum planning accordingto
the needs of the society &learner.

16. • Anurse manager works lessdirectly with patients,
but hasthe responsibility to provide nursing
leadership to ensure that an appropriatetherapeutic
milieu ismaintained.
• Akeyresponsibility is the support & developmentof
nurses, representing nursing views to senior
managers.
• Nurse Manager plays an important role in
negotiating & allocating nursing resourceswithin
clinical directorates.
• Individuals, who assumeanurse executive role,
typically hold amaster’sdegree.

17. • Collaboration implies acommitment to common
goals, withshared responsibility for the outcome of
care.
• It also implies helping to facilitate the mental health
of the patient, family or community within the
context of the treatmentteam.
• Nursesbring their own specialized knowledge tothe
treatment process.
• Sevencharacteristics of effective collaboration
includes: trust, respect, commitment,co-operation,
co-ordination, communication & flexibility.

18. • Oneof the latest roles is that of the nurse
psychopharmacologist – the psychiatricclinical
nurse specialist with prescriptiveauthority.
• Thenew opportunities for psychiatric nursing
practice that are emerging throughout the
continuum of mental health care exciting forthe
specialty.
• Theyallow psychiatric nursesto demonstrate
their flexibility, accountability, &self direction as
they move forwards into these expanding areas
of practice.