Psychiatric Mental Health Psychiatric Mental Health Nurses: Who Are They?Nurses: Who Are They?

Spring 2011Spring 2011

MyersMyers

Psychiatric-Mental Health Psychiatric-Mental Health NursesNurses

What do they do? What do they do?

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Psychiatric-Mental Health Psychiatric-Mental Health Nurses - continuedNurses - continued

• Psychiatric-mental health nursing Psychiatric-mental health nursing promotes mental health through:promotes mental health through:• Assessment, diagnosis, and treatment Assessment, diagnosis, and treatment

of human responses to mental health of human responses to mental health problems and psychiatric disorders problems and psychiatric disorders (ANA, APNA, ISPN, 2007)(ANA, APNA, ISPN, 2007)

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StandardsStandards

• Standards of Psychiatric-Mental Standards of Psychiatric-Mental Health Nursing Practice:Health Nursing Practice:• Guidelines for providing quality careGuidelines for providing quality care

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Standards - continuedStandards - continued

• Psychiatric-Mental Health Nursing Psychiatric-Mental Health Nursing Standards of PracticeStandards of Practice1.1. AssessmentAssessment

2.2. DiagnosisDiagnosis

3.3. Outcomes IdentificationOutcomes Identification

4.4. PlanningPlanning

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Standards - continuedStandards - continued

• Psychiatric-Mental Health Nursing Psychiatric-Mental Health Nursing Standards of PracticeStandards of Practice5.5. ImplementationImplementation

A.A. Coordination of CareCoordination of CareB.B. Health Teaching and Health PromotionHealth Teaching and Health PromotionC.C. Milieu TherapyMilieu TherapyD.D. Phamacological, Biological, and Integrative Phamacological, Biological, and Integrative

TherapiesTherapiesE.E. Prescriptive Authority and Treatment (APRN only)Prescriptive Authority and Treatment (APRN only)F.F. Psychotherapy (APRN only)Psychotherapy (APRN only)G.G. Consultation (APRN only)Consultation (APRN only)

6.6. EvaluationEvaluation

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Standards - continuedStandards - continued

• Standards of Professional Standards of Professional PerformancePerformance7.7. Quality of PracticeQuality of Practice8.8. EducationEducation9.9. Professional Practice EvaluationProfessional Practice Evaluation10.10.CollegialityCollegiality11.11.CollaborationCollaboration12.12.EthicsEthics13.13.ResearchResearch14.14.Resource UtilizationResource Utilization15.15.LeadershipLeadership

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Psychiatric-Mental Health Psychiatric-Mental Health NursesNurses

• Generalist levelGeneralist level• Advanced practice levelAdvanced practice level

• Prescriptive authorityPrescriptive authority• PsychotherapyPsychotherapy• ConsultationConsultation

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The Psychiatric-Mental The Psychiatric-Mental Health TeamHealth Team

• Psychiatric-mental health nursePsychiatric-mental health nurse• PsychiatristPsychiatrist• Clinical psychologistClinical psychologist• Psychiatric social workerPsychiatric social worker

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The Psychiatric-Mental Health The Psychiatric-Mental Health Team - continuedTeam - continued

• Marriage and family therapistMarriage and family therapist• Occupational therapistOccupational therapist• Recreational therapistRecreational therapist• Creative arts therapistCreative arts therapist• Psychosocial rehabilitation workerPsychosocial rehabilitation worker

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Effective Mental Health Effective Mental Health ServicesServices

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Partnerships

Client

PMH Team Family

Health Care Team Health Care Team MembersMembers

• MaximizersMaximizers• RivalistsRivalists• CooperatorsCooperators

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Lessons on Lessons on CollaborationCollaboration

• ““Know thyself”Know thyself”• Value diversityValue diversity• Know that conflict is naturalKnow that conflict is natural• Share your power with othersShare your power with others• Master communication skillsMaster communication skills

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Lessons on Collaboration - Lessons on Collaboration - continuedcontinued

• Think life-long learning.Think life-long learning.• Embrace interdisciplinary Embrace interdisciplinary

situations.situations.• Appreciate spontaneity.Appreciate spontaneity.• Balance unity with autonomy.Balance unity with autonomy.

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The Role of the The Role of the Psychiatric-Mental Health Psychiatric-Mental Health

NurseNurse

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CustodialMultifaceted

Early Psychiatric-Mental Health Early Psychiatric-Mental Health Nursing (19Nursing (19thth century) century)

• First school of nursingFirst school of nursing

• Florence Nightingale’s thoughtsFlorence Nightingale’s thoughts

• American nursing schoolsAmerican nursing schools

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Early Psychiatric-Mental Health Early Psychiatric-Mental Health Nursing (19Nursing (19thth century) - century) -

continuedcontinued• ““First American psychiatric nurse”First American psychiatric nurse”

• Single-focused training schoolsSingle-focused training schools

• Custodial, mechanistic, directed by Custodial, mechanistic, directed by psychiatristspsychiatrists

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (1900-1940)Nursing (1900-1940)

• Psychiatric nursing curriculaPsychiatric nursing curricula

• Psychiatric nursing textsPsychiatric nursing texts

• Single-focus psychiatric nursing Single-focus psychiatric nursing schoolsschools

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (1940-1990)Nursing (1940-1990)

• Nurses begin to educate nurses.Nurses begin to educate nurses.• Psychiatric theory includes Psychiatric theory includes

interpersonal and emotional interpersonal and emotional dimensions.dimensions.

• National Mental Health Act of 1946National Mental Health Act of 1946• Elimination of single-focus Elimination of single-focus

psychiatric nursing schoolspsychiatric nursing schools

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (1940-1990) - continuedNursing (1940-1990) - continued

• Period of role clarificationPeriod of role clarification• Hildegard PeplauHildegard Peplau• Gwen TudorGwen Tudor• Frances SleeperFrances Sleeper• Community Mental Health Centers Community Mental Health Centers

Act of 1963Act of 1963• Psychiatric nursing journalsPsychiatric nursing journals

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (1940-1990) - continuedNursing (1940-1990) - continued

• Birth of clinical nurse specialists Birth of clinical nurse specialists and nurse therapist roleand nurse therapist role

• First standards of psychiatric-First standards of psychiatric-mental health nursing practicemental health nursing practice

• Increase role of nurses at national Increase role of nurses at national levellevel

• Shift in psychiatric nursing toward Shift in psychiatric nursing toward humanistic interactionismhumanistic interactionism

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (1940-1990) - Nursing (1940-1990) -

continuedcontinued• Decrease in numbers of psychiatric Decrease in numbers of psychiatric

nursesnurses• Decreased funding for trainingDecreased funding for training• Psychiatric nursing diagnosesPsychiatric nursing diagnoses

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (1990s) - Decade of the Nursing (1990s) - Decade of the

BrainBrain• Psychobiologic conceptsPsychobiologic concepts• Nursing Psychopharmacology ProjectNursing Psychopharmacology Project• Health care delivery reformHealth care delivery reform• Outcome-based researchOutcome-based research• Cultural diversityCultural diversity• Integration of theoretical Integration of theoretical

perspectivesperspectives

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Psychiatric-Mental Health Psychiatric-Mental Health Nursing (2000s) - The New Nursing (2000s) - The New

MillenniumMillennium• Standards of practice – revisionsStandards of practice – revisions• Knowledge explosionKnowledge explosion• Renewed focus on physical healthRenewed focus on physical health• Single point of entrySingle point of entry• Advanced practice nursesAdvanced practice nurses• Expansion of practice settingsExpansion of practice settings

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Nursing TheoriesNursing Theories

• Assist nurses to: Assist nurses to: • Organize assessment dataOrganize assessment data• Identify problemsIdentify problems• Plan interventionsPlan interventions• Generate goals and actionsGenerate goals and actions• Evaluate outcomesEvaluate outcomes

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Nursing Theories Impacting Nursing Theories Impacting Psychiatric NursingPsychiatric Nursing

• Hildegard PeplauHildegard Peplau• Dorothea OremDorothea Orem• Martha RogersMartha Rogers• Sister Callista RoySister Callista Roy• Ida Jean OrlandoIda Jean Orlando

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Nursing Theories Impacting Nursing Theories Impacting Psychiatric Nursing - continuedPsychiatric Nursing - continued

• Ernestine WiedenbachErnestine Wiedenbach• Joyce TravelbeeJoyce Travelbee• Paterson and ZderadPaterson and Zderad• Jean WatsonJean Watson• Patricia BennerPatricia Benner

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Nursing Theories - Nursing Theories - ValueValue

• Nursing practice vs. medical Nursing practice vs. medical practicepractice

• Caring vs. curingCaring vs. curing• Interpretation of meaningInterpretation of meaning• Nurse-client relationshipNurse-client relationship• Advocacy of client dignityAdvocacy of client dignity• Advocacy of nurse authenticityAdvocacy of nurse authenticity

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Application of Theoretical Application of Theoretical FrameworksFrameworks

• Application of various theoretical Application of various theoretical frameworks leads to: frameworks leads to: • Quality client-centered care.Quality client-centered care.• Efficient use of resources.Efficient use of resources.• Practice-oriented research.Practice-oriented research.• Clinical judgments and actions that Clinical judgments and actions that

can be articulated and taught to can be articulated and taught to others. others.

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