Nature and scope of mental health nursing

A brief description of psychiatric nursing and its nature and scopes in nursing

1. NATURE AND SCOPE OF MENTAL HEALTH NURSING SRADHANJALI BISWAL TUTOR KALINGA INSTITUTE OF NURSING SCIENCES KIIT DEEMED TO BE UNIVERSITY BHUBANESWAR

2. INTRODUCTION Psychiatric–mental health nursing is a specialized area of nursing practice committed to promoting mental health through the assessment, diagnosis, and treatment of behavioral problems, psychiatric disorders and comorbid conditions. Psychiatric–mental health nursing intervention is an art and a science, employing a purposeful use of self and a wide range of nursing, psychosocial, and neurobiological research evidence to produce effective outcomes .

3. DEFINITION OF MENTAL HEALTH NURSING Psychiatric mental Health Nursing is an integral part of the continuum of nursing practice . The American Nurses’ Association (ANA) describes psychiatric mental health nursing as a specialized area of nursing practice committed to promoting mental health through the assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders (ANA, 2007). As a core mental health profession, psychiatric mental health nursing employs a purposeful use of self as its art and a wide range of nursing, psychosocial, and neurobiological theories and research evidence as its science (ANA, 2007).

4. GOALS The primary goal for psychiatric nurses is client mental health. Four major objectives for achieving those goals are: Promotion of mental health Prevention of mental disorders Treatment for clients with mental disorders Restoration of health .

5. SCOPES IN PSYCHIATRIC MENTAL HEEALTH NURSING Psychiatric Mental Health registered nurses practice in a variety of clinical settings across the continuum of care and engage in broad array of clinical activities including health promotion and health maintenance, intake screening, evaluation and triage, case management, provision of therapeutic and safe environment, promotion of self care activities, administration of psychobiological treatment regimens and monitoring response and effects, crisis intervention and stabilization, and psychiatric rehabilitation.

6. CONT… The scope of practice in psychiatric mental health nursing is continually expanding as the context of practice, the need for patient access to holistic care, and the various scientific and nursing bases evolve. It is within the scope of practice of the psychiatric mental health nurse to provide primary mental health care to patients seeking mental health services in a wide range of delivery setting.

7. Primary Mental Health Nursing : Psychiatric nurses are moving into the domain of primary care and working with other nurses and physicians to diagnose and treat psychiatric illness in patients with somatic complains. Cardiovascular, gynaecological, respiratory, and gastrointestinal, and family practice settings are appropriate for assessing patients for anxiety, depression, and substance abuse disorders.

8. Registered Psychiatric Mental Health Nursing : A registered Psychiatric Mental Health Nurse provides psychiatric mental health care to individuals, families, and groups to enable them to enable them to function at an optimal level of psychological wellness through more effective adaptive behaviours and increased resilience to stress. She must be able to provide safe, basic physical care, have a wide understanding of psychological and developmental problems and their treatment and have a highly developed level of communication skills. She works children, adolescents, adults, and elderly with dysfunctional behaviour patterns, and developmental handicaps.

9. CONT….  Nurse Generalist : a licensed nurse providing primary mental health care. Holistic approach, prevention programmes, community and day care centers , psychiatric rehabilitation facilities, homeless shelters etc.  Nurse Specialist: Psychiatric Clinical Nurse Specialist (CNS): have a master degree in mental health nursing. Autonomous functioning, prescription privileges, manages overall care of emotional and psychiatric problems. Eg . Crisis Interventio0n specialists, Milieu Specialists, Psychotherapists etc .

10. CONT.. Community Mental Health Nurse (CMHN): Diagnosis, appropriate referrals, care and rehabilitation of mentally ill people in the community. Psychiatric Home Care Nurse: direct patient care, behavioral management, crisis intervention, psycho education, detoxification, medication etc. Forensic Psychiatric Nurse: works with individuals who have entered the legal system

11. CONT…  Psychiatric Consultation - Liaison Nurse PCLN: Psychiatric nurse who work in non- psychiatric setting and provide necessary support, guidance and counselling for those affected with anxiety, depression and other psychological problems.  Case Manager: Nurse manager acts as advocates by coordinating care and linking patient with physician and other members of health care team. Works in community and helping in daily living of a mentally ill person such as transportation, managing money, buying things etc.

12. CONT…  Gero -Psychiatric Nurse  Parish Nurse: An RN with spiritual mature. Supports health education, social services, and carry out non-invasive nursing care. Common in US .  Tele health / Tele nurse: Nurses engaged in tele -nursing practice use technologies such as internet, computers, telephones, digital assessment tools & tele -monitoring equipment to deliver nursing care. In India around 10 hospitals are having telemedicine departments. Eg . Apollo hospitals, Narayana Hrudayalaya .

13. CONT….  Nurse Researcher: Nurse researchers design, conduct & disseminate findings of research at professional meets & in peer reviewed journals. They are doctorally or post- doctorally prepared persons who initiate or participate in all phases of the research process.  Psychiatric Nurse Educator:  Nurse Administrator/Manager  Nurse Pharmacologist: The psychiatric clinical nurse specialist with prescriptive authority.  Holistic Nurse : Integrates complementary and alternative modalities such as relaxation,

14. NATURE OF PSYCHIATRIC NURSING It is a profession possessing its unique history, ideology, knowledge and skills. I t is both an art (nurse – patient relationship) and a science (skills for the purpose of gaining insight, effective change, healing mental and emotional wounds and promoting growth). Understands the principles of nursing and remain current in knowledge and practice.

15.  Every individual has intrinsic worth and dignity and is worthy of respect.  Each person functions as holistic and react to environment as a whole.  All behaviour of an individual is meaningful. It can be understood from an internal frame of the patient.  Behaviour has perceptions, thoughts, feelings and actions.  Individuals vary in their coping capacities.  All are prone for health and illness.

16.   Nursing is aimed to promote wellness, maximize functioning and enhance self actualization .  IPR can produce change in growth of an individual.  Psychiatric nursing is based on psychosocial and biophysical sciences

17. Case management Using case management, a psychiatric mental health nurse is responsible for assessing needs, identifying services, and monitoring and evaluating client states. A case manager co- ordinates care through collaboration with all involved health professionals ensuring accessibility and availability of care. Case management for the psychiatric mental health nurses involves population specific nursing knowledge coupled with research, knowledge of the social and legal systems related to mental health and expertise to engage a wide range of services for the patient to engage a wide range of services for the patient, regardless of setting.