Transcript Psychiatric Mental Health Nursing

Psychiatric Mental Health
Nursing
Centre for Psychiatric Nursing
Overview of
Psychiatric/Mental Health
Nursing
Outline
 Similarities
& differences between
psychiatric nursing and other fields of
nursing
 Skills & knowledge of the psychiatric nurse
Centre for Psychiatric Nursing
Overview of
Psychiatric/mental Health
Nursing
 The
importance of psychiatric nursing skills
in all clinical settings
 Career opportunities
 Postgraduate study & endorsement
 Professional affiliation
Centre for Psychiatric Nursing
The Psychiatric/mental Health
Nurse
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“Mental Health Nursing is a specialised
field of nursing which focuses on meeting
the mental health needs of the consumer, in
partnership with family, significant others
and the community in any setting. It is a
specialised interpersonal process
embodying a concept of caring….” (p. 3)
ANZCMHN (1995)
Centre for Psychiatric Nursing
The Essence of
Psychiatric/mental Health
Nursing
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Lies not in tasks performed or with the presenting
illness but in the relationship that develops with
clients and families and their responses to the
illness, including the impact that the illness has on
their lives.
 The essence is in establishing a ‘therapeutic
partnership’, a connectedness, between the nurse
and client which is based on empathy and trust.
Elsom (2001)
Centre for Psychiatric Nursing
Similarities & Differences
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SIMILARITIES
Work in close contact with people from a wide
variety of backgrounds
Provide CARE for people with a wide variety of
illnesses
Involved in health promotion and illness
prevention
Nursing philosophy of benevolence
Centre for Psychiatric Nursing
Similarities & Differences
SIMILARITIES
 Education: must meet required level of
knowledge and skills to attain
registration/endorsement
 Governed by the Nurses Codes –
Professional Conduct & Ethics
 Structure of work hours, salary, benefits
Centre for Psychiatric Nursing
Similarities & Differences
DIFFERENCES
Core focus of Psychiatric Mental Health Nursing
 Therapeutic relationship
 Use of self as a therapeutic tool
 People-centred approach, engaging clients in
discourse, promoting change
 Less task orientated
 Less technical environment
 Professional autonomy
Moir & Abraham (1996)
Centre for Psychiatric Nursing
Similarities & Differences
DIFFERENCES
 Clinical competence based on interpersonal
techniques
Stuart & Laraia (2001)
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Less repetition in process & procedures due to
client individuality
Moir & Abraham (1996)
Centre for Psychiatric Nursing
Philosophy of the Profession
Each individual:
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Has intrinsic worth and dignity and each
person is worthy of respect.
 Has the potential to change.
 Has common, basic human needs…
 Varies in their coping capacities
Centre for Psychiatric Nursing
Philosophy of the profession
Each individual(s):
Behaviour is meaningful…
 Has a right to equal opportunity for
adequate health care.
 Has the right to participate in decision
making regarding their care.
 Has the right to self-determination…
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Centre for Psychiatric Nursing
Philosophy of the profession
The fundamental premise is:
The goal of nursing care is to promote
wellness, maximise integrated
functioning….nursing care is based on
mutually determined needs and expected
treatment outcomes..
An interpersonal relationship can produce
change and growth within the individual….
Stuart & Laraia (2001, p. 7)
Centre for Psychiatric Nursing
The Knowledge, Skills & Attitudes
of the Psychiatric/mental Health
Nurse
The knowledge base of the
psychiatric/mental health nurse is
grounded in the integration of the
biological, psychological, spiritual, social
and environmental realms of the human
experience.
Stuart & Laraia (2001)
Centre for Psychiatric Nursing
The Knowledge, Skills & Attitudes
of the Psychiatric/mental Health
Nurse
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Broad context of care
 Requires purposeful use of self as a therapeutic
tool
 “Knowing you, Knowing me” (Awareness of self)
Barker, Jackson & Stevenson (1999)
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Requires great sensitivity to the social
environment & advocacy needs of clients/families
 Requires careful consideration of legal & ethical
issues
Centre for Psychiatric Nursing
The Knowledge, Skills & Attitudes
of the Psychiatric/mental Health
Nurse
THERAPEUTIC NURSE-CLIENT RELATIONSHIP
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Physical dimension
Safety dimension
Social dimension
Spiritual dimension
Provision of treatment modalities
Encouraging self-determination
Provision of information
Cowman, Farrelly & Gilheany (2001)
Centre for Psychiatric Nursing
The Knowledge, Skills & Attitudes
of the Psychiatric/mental Health
Nurse
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Milieu management
Assessing, planning, implementing & evaluating
care
Pharmacological interventions
Documentation/Administration
Legal requirements
Educating/supervision
Coordination/Multidisciplinary team member
Centre for Psychiatric Nursing
The Importance of
Psychiatric/mental Health Nursing
Knowledge, Skills & Attitudes
In Australia, one in five persons will at
some stage in their lives, experience a
major mental illness.
Commonwealth Department of Health and Aged Care Services (1997)
Centre for Psychiatric Nursing
The Importance of
Psychiatric/mental Health Nursing
Knowledge, Skills & Attitudes
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Exposure to clients with mental health problems
or illness in any area of practice
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Skills will assist the nurse to provide comfort to
clients who may be experiencing a myriad of
emotions. I.e. grief, anxiety, anger, cognitive
deficits and subsequent behaviour, and diagnosed
mental illness
Centre for Psychiatric Nursing
The Importance of
Psychiatric/mental Health Nursing
Knowledge, Skills & Attitudes
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Mental state assessment skills
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Early intervention - reduced stays, improved
recovery rates. Improved client outcomes
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Nurse more comfortable, confident in working
with clients with mental illness
Centre for Psychiatric Nursing
Career Opportunities
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Diversity within the profession
 Attractive transferable skills
 Consultation
 Management
 Education
 Independent Practitioner
Centre for Psychiatric Nursing
Career Opportunities
DIVERSITY
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Public & Private Mental Health Services
In-Patient Facilities
Out-patient or Day-patient Programs
Crisis Assessment & Treatment Teams
Community Teams
Consultation-Liaison Mental Health Nurse
Centre for Psychiatric Nursing
Career Opportunities
DIVERSITY
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Adult Acute
Community
Adult Rehabilitation
Child & Adolescent
Aged Mental Health
Forensic
Specialty Programs: I.e. Eating Disorders, Substance
Abuse Treatment, Cognitive Behavioural Programs,
Parent-Infant.
Centre for Psychiatric Nursing
Career Opportunities
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Career structure
Professional development
Clinical supervision
Scholarships
Graduate nurse Programs
Postgraduate Study
Paid study leave
Centre for Psychiatric Nursing
Postgraduate Study &
Endorsement
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Postgraduate studies in Psychiatric/Mental Health
Nursing
Graduate Diploma
Graduate Certificate
Endorsement by the NBV (Where relevant)
Highly attractive to prospective employers
Centre for Psychiatric Nursing
Professional Affiliation
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Australian Collage of Mental Health Nurses
ACMHN.
Standards of Practice
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Centre for Psychiatric Nursing (CPN)
Centre for Psychiatric Nursing
Reflection
“Nurses are ‘traveling companions’ with
patients, not ‘travel agents’… the heart
(of nursing) is the skills and values
needed by nurses to establish and
maintain human contact with patients.”
Peck & Norman (1999)
Centre for Psychiatric Nursing
References
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Australian and New Zealand Collage of Mental Health Nurses Inc.
(ANZCMHN) (1995). Standards of Practice for Mental Health
Nursing in Australia Adelaide: ANZCMHN Inc.
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Barker, P., Jackson, S. & Stevenson, C. (1999). What are psychiatric
nurses needed for? Developing a theory of essential nursing
practice Journal of Psychiatric and Mental Health Nursing 6,
273-282.
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Commonwealth Department of Health and Aged Care Services.
(1997). National Mental Health Report 1996: Fourth Annual Report,
Changes in Australia’s Mental Health Services under the National
Mental Health Strategy 1995-6. Canberra: Australian Government
Printing Services
Centre for Psychiatric Nursing
References
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Cowman, S., Farrelly, M. & Gilheany, P. (2001). An examination of
the role and function of psychiatric nurses in clinical practice in
Ireland Journal of Advanced Nursing 34(6), 745-753.
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Elsom, S. (2001). The active participants in Mental Health Services.
In Meadows, G. & Singh, B. (Ed.), Mental Health in Australia,
Collaborative Community Practice (pp. 136-162). Melbourne:
Oxford University Press.
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Grigg, M. (2001) The role of the psychiatric nurse. Australasian
Psychiatry 9(2), 143-145.
Peck, E. & Norman, I. (1999). Working together in adult community
mental health services: exploring inter-professional role relations.
Journal of Mental Health 8, 231-242
Centre for Psychiatric Nursing