Principles of mental health nursing

Appropriate for GNM, B.Sc. Nursing, P.B.B.Sc.Nursing & M.Sc. Nursing

1. Tejal D. Virola
M.Sc. Nursing
GHPSCN

2. Mental Health
It is a state of balance between the
individual and the surrounding world,
a state of harmony between oneself
and others, a co-existence between
the realities of the self and that of
other people and the environment.

3. Mental Illness
Mental and behavioral disorders are
understood as clinically significant
conditions characterized by
alterations in thinking, mood
(emotions) or behavior associated
with personal distress and/ or
impaired functioning

4. Learning Objectives
Enlist Principles of Mental Health / Psychiatric
Nursing
Describe each principle in detail
Apply principles in patient care

5. DEFINITION OF MENTAL HEALTH
NURSING
Itisaspecializedareaofnursingpractice,
employingtheoriesofhumanbehavioras
itisascience,andthepurposefuluseof
selfasitisanart,inthediagnosisand
treatmentofhumanresponsestoactual
orpotentialmentalhealthproblems.
(AmericanNursesAssociation,1994)

6. Psychiatric nursing deals with the
promotion of mental health,
prevention of mental illness,
care and rehabilitation of
mentally ill individuals both in
hospital and community

7. GENERAL PRINCIPLES OF
PSYCHIATRIC NURSING

8. 1. Patient is Accepted Exactly as He is

9. Being Non-judgmental and Non-punitive
Being Sincerely Interested in the Patient

10. How we can demonstrate that we
are sincerely interested in patient???
Studying patient's behavior pattern.
Allowing him to make his own choices and
decisions as far as possible.
Being aware of his likes and dislikes.
Being honest with him.
Taking time and energy to listen to what he is
saying.
Avoiding sensitive subjects and issues.
Listening to him

11. Recognizing and Reflecting onFeelings
which Patient may Express
Talking with a Purpose

12. Listening
Permitting Patient to Express Strongly-
held Feelings

13. 2. Use Self-understanding as a
Therapeutic Tool

14. We can understand ourselves better by:
Exchanging personal experience freely and
frankly with our colleagues
Discussing our personal reaction with an
experienced person
Participating in-group conference
regarding our patient care
Introspecting on why we feel or act the
way we do

15. 3. Consistency is used to Contribute to
Patient's Security

16. Consistency in our approach is needed to
develop a feeling in patient that we can
depend on the people working in the
ward.
Our consistency must reflect in our
attitudes, ward routine and in defining the
limitations placed on the patient.

17. 4. Reassurance should be given in a
Subtle and Acceptable Manner

18. Reassurance can be given in the
following manner:
Be truly interested in patient’s problem
Pay attention to the matters that are important
to the patient-matter however insignificant it
may be
Allow him to be as sick as he needs to be
Be aware and accept how the patient really feels
Do things for the patient without asking
anything of the patient in return such as
improved behaviour or show of appreciation

19. Sit beside patient even when he does not
want to talk. Accepting patient’s silence
and the physical presence of nurse can be
very reassuring to the patient
Listen to personal problem without
showing surprise or disapproval
Agree that patient has a problem and
think along with him to solve them
Provide patient with acceptable outlets of
anxiety

20. 5. Patient's Behavior is Changed
through Emotional Experience and not
by Rational Interpretation

21. 6. Unnecessary Increase in Patient's
Anxiety should be Avoided

22. Following approaches may
increase the patient's anxiety
Showing nurse's own anxiety.
Showing attention to the patient's deficits.
Making the patient to face repeated
failures.
Placing demands on patient which he
obviously cannot meet.
Direct contradiction of patient's psychotic
ideas.

23. Using big sentences, professional terms
while talking to him
Careless conversation within patient’s
hearing about his personal life
Being insincere
Giving no orientation about the words,
about his co-patients, about ward staff,
policies, routines and procedures
Passing sharp comments and showing
indifference.

24. 7. Objective Observation of Patient to
Understand his Behavior

25. 8. Maintain Realistic Nurse-Patient
Relationship

26. 9. Avoid Physical and Verbal Force as
Much as Possible

27. 10. Nursing Care is Centered on the
Patient as a Person and not on the
Control of Symptoms

28. 11. All Explanations of Procedures and
other Routines are Given According to
the Patient's Level of Understanding

29. 12. Many Procedures are Modified but
Basic Principles Remain Unaltered

30. The nursing principles to be kept in
mind are:
Safety
Comfort
Individuality and Privacy
Maintaining therapeutic environment,
very fine workmanship while doing
procedure and
Economy of time, energy and material