unit_plan-psych_1_chapter_.pdf for nursing

Unit plan

1. UNIT PLAN
ON
UNIT - I

2. NAME OF THE FACULTY :MRS.K.SIVAKALA
DESIGNATION :HOD IN MENTAL HEALTH NURSING
NAME OF THE SUBJECT : CLINICAL SPECALITY-II
UNIT NO : UNIT – I
UNIT TITLE : REVIEW PRINCIPLES AND PRACTICE OF PSYCHIATRIC NURSING
COURSE PLACEMENT : M.Sc (N) II YEAR
PRESCRIBED HOURS : 4HRS.
PLANNED HOURS : 3HRS.
METHODS OF TEACHING : LECTURE CUM DISCUSSION
AV AIDS : BLACK BOARD , LCD PROJECTOR .,

3. GENERAL OBJECTIVE :
The students are able to develop the knowledge about principles and practice of psychiatric nursing , and study related psychiatric nursing principles
and develop desirable attitude and skill practice in teaching and clinical setting.
SPECIFIC OBJECTIVE :
At the end of the class the students will be able to,
1. define the psychiatry and the psychiatric nursing
2. explain in details about the principles of psychiatric nursing
3. describe briefly about the practices in mental health nursing
4. explain in details about the nature and scope of mental health nursing
5. explain in details about the role and functions of mental health nurses in various settings
6. discuss in detail about the new trends in role of a psychiatric nurse

4. TIME
(HOUR)
LEARNING
OBJECTIVE

CONTENT
METHODS OF
TEACHING
TEACHER’S
ACTIVITY
LEARNER’S
ACTIVITY
EVALUATION
METHOD
1hr define the
psychiatry and
the psychiatric
nursing
PSYCHIATRY
It is a branch of medicine that deals with the
diagnosis, treatment and prevention of mental
illness.

PSYCHIATRIC NURSING
It is a specialized area of nursing practice,
employing theories of human behaviour as it is
a science, and the purposeful use of self as it is
an art, in the diagnosis and treatment of human
responses to actual or potential mental health
problems.
-American Nurses Association (1994)

Thus, 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.
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
Define
psychiatric
nursing?
1 hr explain in
details about
the principles
PRINCIPLES
The following principles are general in nature
and form guidelines for emotional care of a
patient. These principles are based on the
Lecture
Discussion
 Explaining,
 Discussing,
 Listening,
 Taking
notes,
List out the
principles of
psychiatric
nursing

5. of psychiatric
nursing
concept that each individual has an intrinsic
worth and dignity and has potentialities to
grow.
Patient is Accepted Exactly as He is
PRINCIPLE: 1
Accepting means being non-judgmental.
Acceptance conveys the feeling of being loved
and cared. Acceptance does not mean complete
permissiveness but setting of positive
behaviours to convey to him the respect as an
individual human being. A nurse should be able
to convey to the patient that she may not
approve everything what he does, but he will
not be judged or rejected because of his
behaviour. Acceptance is expressed in the
following ways:
Being non – judgmental and non – punitive:
The patient’s behaviour is not judged as right
or wrong, good or bad. Patient is not punished
for his undesirable behaviour. All direct
(chaining, restraining, putting him in a separate
room) and indirect (ignoring his presence or
withdrawing attention) methods of punishment
must be avoided. A nurse who shows
acceptance does not reject the patient even
when he behaves contrary to her expectations.
Being sincerely interested in the patient:
Being sincerely interested in another individual
means considering the other individual's
interest. This can be demonstrated by:
Studying patient's behaviour pattern.

6. 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.
Recognizing and reflecting on feelings which
patient may express:
When patient talks, it is not the content that is
important to note, but the feeling behind the
conversation, which has to be recognized and
reflected.
Talking with a purpose:
The nurse's conversation with a patient must
revolve around his needs, wants and interests.
Indirect approaches like reflection, open-ended
questions, focusing on a point, presenting
reality are more effective when the problems
are not obvious.
Avoid evaluative, hostile, probing questions
and use understanding responses, which may
help the patient to explore his feelings.
Listening:
Listening is an active process. The nurse should
take time and energy to listen to what the
patient is saying. She must be a sympathetic
listener and show genuine interest.
Permitting patient to express strongly-held
feelings:
Strong emotions bottled up are potentially
explosive and dangerous. It is better to permit

7. the patient to express his strong feelings
without disapproval or punishment. Expression
of negative feelings (anxiety, tear, hostility and
anger) may be encouraged in a verbal or
symbolic manner. The nurse must accept the
expression of patient’s strong negative feelings
quietly and calmly.
Use Self -understanding as a Therapeutic Tool
PRINCIPLE: 2
A psychiatric nurse should have a realistic self-
concept and should be able to recognize one’s
own feelings, attitudes and responses. Her
ability to be aware and to accept her own
strengths and Limitations should help her to see
the strengths and limitations in other people
too. Self-understanding helps his/her to be
assertive in life situations without being
aggressive and feeling guilty.
Consistency is used to contribute to Patient’s
Security
PRINCIPLE: 3
This means that there should be consistency in
the attitude of the staff, ward routine and in
defining the limitations placed on the patient.
Reassurance should be given in a Subtle and
Acceptable Manner
PRINCIPLE: 4
Reassurance is building patient’s confidence.
To give reassurance, the nurse needs to
understand and analyse the situation as to how
it appears to the patient. False reassurance can
also reflect a lack of interest and understanding

8. or unwillingness on the part of the nurse to
empathize with the patient’s life situation.
Patient’s Behaviour is changed through
Emotional Experience and not by Rational
Interpretation
PRINCIPLE: 5
Major focus in psychiatry is on feelings and not
on the intellectual aspect. Advising or
rationalizing with patients is not effective in
changing behaviour. Roleplay and sociodrama
are a few avenues of providing corrective
emotional experiences to a patient and
facilitating insight into his own behaviour.
Such experiences can truly bring about the
desired behavioural changes.
Unnecessary Increase in Patient's Anxiety
should be avoided
PRINCIPLE: 6
The following approaches may increase the
patient’s anxiety and should, therefore, be
avoided:
Showing nurse’s own anxiety
Showing attention to the patient’s deficits
Making the patient face repeated failures
Placing demands on patient which he obviously
cannot meet
Direct contradiction of patient's psychotic ideas
Passing sharp comments and showing
indifference
Objective Observation of Patient to Understand
his Behaviour

9. PRINCIPLE: 7
Objectivity is an ability to evaluate exactly
what the patient wants to say and not mix up
one’s own feelings, opinion or judgment. To be
objective, the nurse should indulge in
introspection and make sure that her own
emotional needs do not take precedence over
patient’s needs.
Maintain Realistic Nurse –Patient Relationship
PRINCIPLE: 8
Realistic or professional relationship focuses
upon the personal and emotional needs of the
patient and not on nurse’s needs. To maintain
professional relationship the nurse should have
a realistic self-concept and should be able to
empathize and understand the feelings of the
patient and the meaning of his behaviour.
Avoid Physical and Verbal Force as Much as
Possible
PRINCIPLE: 9
All methods of punishment must be avoided. If
the nurse is an expert in predicting patient
behaviour, she can mostly prevent an onset of
undesirable behaviour.
Nursing Care is centered on the Patient as a
Person and not on the control of symptoms
PRINCIPLE: 10
Analysis and study of symptoms is necessary to
reveal their meaning and their significance to
the patient. Two patients showing the same
symptoms may be expressing two different
needs.

10. All Explanations of Procedures and other
Routines are given According to the Patient’s
Level of Understanding
PRINCIPLE: 11
The extent of explanation that can be given to a
patient depends on his span of attention, level
of anxiety and level of ability to decide. But
explanation should never be withheld on the
basis that psychiatric patients are not having
any contact with reality or have no ability to
understand.
Many Procedures are modified but Basic
Principles Remain Unaltered
PRINCIPLE: 12
In psychiatric nursing field, many methods are
adapted to individual needs of the patients, but
the underlying nursing scientific principles
remain the same. Some nursing principles to be
kept in mind are: safety, comfort, and privacy,
maintaining therapeutic effectiveness, economy
of time, energy and material.

11. TIME
(HOUR)
LEARNING
OBJECTIVE

CONTENT
METHODS OF
TEACHING
TEACHER’S
ACTIVITY
LEARNER’S
ACTIVITY
EVALUATION
METHOD
1 hr
describe
briefly about
the practices in
mental health
nursing
PRACTICES IN MENTAL HEALTH
NURSING
INTRODUCTION :
Mental ill health represents not only an
immense psychological, social and economic
burden to society, but also increases the risk
and complexity of physical illnesses.
Recognizing that neuropsychiatric conditions
account for 13% of total Disability Adjusted
Life Years lost globally, and are estimated to
increase to 15% by 2020 (WHO 2004), this
book addresses the dynamic nature of
professional mental health nursing across the
lifespan.
Effective mental health care delivery is brought
into sharp focus with the release of the
Australian Senate Select Committee Report on
Mental Health in March 2006. This specially
commissioned issue of Contemporary Nurse
considers mental health nursing from
consumer, nursing practice and community
health perspectives. It concludes with
recommendations for nurse education,
workplace training, and delivery of community
care.
Violence, 'difficult to treat' disorders, cultural
sensitivity, safety of psychotropic medications
and application of mental health services in
non-mental health settings are addressed from
North American, Australian and New Zealand
perspectives, which work to build evidence-
based research to inform effective mental
health practice.

Lecture
Discussion
 Asking
questions,
 Clarifying
doubts
 Involves in
discussion,
 Answering
the
questions
Discuss about
the practices in
mental health
nursing

12. 1hr explain in
details about
the nature and
scope of
mental health
nursing
NATURE & SCOPE OF MENTAL
HEALTH NURSING
The American Nurses Association
(2000) defines Psychiatric Nursing as “A
specialized area of nursing practice, employing
the wide range of explanatory theories of
human behavior as its science and purposeful
use of self as its art and diagnosis and treatment
of human responses to actual or potential health
problems”.
NATURE OF MENTAL HEALTH
NURSING

Hildegard Peplau, called as the mother
of psychiatric nursing, identified the heart of
psychiatric nursing as the role of counselor or
psychotherapist.
The practice of mental health nursing is
based on certain philosophical beliefs:
 The individual has intrinsic worth and
dignity and is worthy of respect.
 The goal of all individuals is growth,
health, autonomy and self-actualization.
 Every individual has the potential to
change.
 Each person functions as a holistic
being that acts on, interact with and
reacts to the environment as a whole
person.
 All people have common, basic needs
such as physical requirements, safety,
love, belonging, esteem and self-
actualization.
 All behavior of the individual is
meaningful.
 Individuals vary in their coping
capacities.
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
Discuss about
the nature and
scope of mental
health nursing?

13.  All people have a right to equal
opportunity for adequate health care.
 Each individual has a right to
participate in decision-making
regarding his/her health.
 The goal of nursing care is to promote
wellness.
 An interpersonal relationship can
produce change and growth.

1 hr explain in
details about
the continuum
of mental
health nursing
CONTINUUM OF MENTAL HEALTH
NURSING CARE
The traditional settings for mental health nurses
include psychiatric facilities, community
mental health centers and psychiatric units in
general hospitals, residential facilities and
private practice. The mental health nurse can
also work in other clinical systems such a day
care centers, residential care, home care and
ambulatory care centres.
Community based treatment settings have
expanded to include foster care, hospices, home
health agencies, visiting nurse associations,
emergency departments, nursing homes,
shelters, primary care clinics, schools, prisons,
industrial settings, managed care facilities and
health maintenance organizations.

Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
What is the
continuum of
nursing care?
1hr explain in
details about
the role and
functions of
mental health
nurses in
ROLE AND FUNCTIONS OF MENTAL
HEALTH NURSES IN VARIOUS
SETTINGS AND FACTORS AFFECTING
THE LEVEL OF NURSING PRACTICE
I. Preventive Psychiatry
There are three levels of preventive
intervention.
 Primary Prevention
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
Write about the
roles and
functions of
mental health
nursing ?

14. various
settings
 Secondary Prevention
 Tertiary Prevention
1. Nurses Role in Primary Prevention
Nurses play a major role in identifying high-
risk groups and preventing the occurrence of
mental illness in them. Some of them are:
i) Providing antenatal care and
educating the mother-to-be
regarding the adverse effects
of irradiation, certain drugs
and pre-maturity
ii) Ensuring timely obstetrical
assistance to safeguard
against the ill-effects of
anoxia and injury to the
newborn at birth.
iii) Providing dietary correction
to infant suffering from
metabolic disorders.
iv) Correcting endocrinal
disorders.
v) Planning and implementing
training programs for the
mentally and physically
handicapped children like
the blind, deaf, mute, etc.
vi) Crisis counseling for the
parents of the physically and
mentally handicapped
children.
vii) Identifying the problems of
scholastic performance and
emotional disturbances
among school-going
children and giving timely
intervention.
 Answering
the
questions.

15. viii) Teaching the family
members adaptive coping
techniques.

ix) Extending mental health
education services at the
child guidance clinic
regarding healthy child
rearing practices, at parent-
teachers associations
regarding the ‘triad’
relationship among the
teacher, child and parents
and at various extra-mural
health agencies regarding
integration of mental health
into general health practice.
x) Counseling adolescents and
retired persons passing
through transitional crises;
bereaved families to accept
the loss, etc.


2. Nurses Role in Secondary Prevention

i) Early diagnosis and case
finding
ii) Early referral
iii) Screening programs
iv) Early and effective treatment
for the patient and if
necessary, family members.
v) Mental health education
vi) Crisis intervention
vii) Consultation services.
3. Nurses Role in Tertiary Prevention

16. Nurses are involved in rehabilitation services.
These are:
i) Social reintegration of the
discharged chronic mentally
ill back into the community.
ii) Vocational rehabilitation and
job placement for the
mentally restored.
iii) Re-equipping the mentally
restored with daily living
care abilities.
iv) Administration of
medication at the doorstep of
the mentally ill.
v) Utilizing the resources of the
family and community for
the long-term rehabilitation
of the mentally restore
1hr explain in
details about
the role of a
nurse in the
mental hospital
II. Role of a Nurse in the Mental Hospital
Earlier, the role of a nurse in the mental
hospital was characterized by custodial care,
which ranged from humanistic to neglectful
and cruel approach.
Nurse’s functions and responsibilities
can be categorized into:
1. Patient Care
 Assesses the patient’s needs and
gives individualized nursing
care according to their needs.
 Develops care plans to meet
long term goals
 Assists multidisciplinary team
members in diagnostic and
therapeutic measures.
 Provides therapeutic
environment
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
What are the
roles of a nurse
in the mental
hospital ?

17.  Assists in personal hygiene and
provides facilities for those who
can take care of themselves.
 Distributes food to patients and
feeds those who are unable to
feed themselves.
 Carries out mental status
examination, reports and
records.
 Sets limit for patient’s behavior
 Provides activities to channelise
the patient’s energy with
constructive work to improve
their self-esteem.
2. Education and Supervision
 Makes use of opportunities to
give group and individual
mental health education.
 Assists nursing students to learn
to take care of mentally ill
patients.
 Supervises the work of
subordinates.
 Changes the misconception of
Group D officials and family
members of patients regarding
mental illness through health
education.
3. Ward Management
 Writes daily report of acutely ill
patients.
 Periodically evaluates the
chronic patient’s progress and
records it.
 Assesses the ward cleanliness
and takes steps to improve it
(e.g. Slippery watery floor could

18. cause fracture to manic running
around patients).
 Hands over and takes over
patients, briefing with emphasis
on the behavioral changes that
are seen in them and the kind of
attitude to be displayed. This
helps in consistency in nursing
care.
 Accompanies the
multidisciplinary team for
clinical rounds and gives report
based on her observation.
4. Interpersonal Relationship and
Communication
 Establishes and maintains
cordial relationship with
patients, their families and team
members.
 Co-ordinates the nursing
services with psychosocial
therapies.
 Communicates the patient
behavior to the concerned
personnel. Eg. Escaping of the
patient from the mental hospital
is intimated to the police, unit
consultants and family
members.
 Shares the knowledge about
community resources with
patients and their families for
future rehabilitation.
5. Role in Other Therapies
The nurse plays an interdependent role in
various therapies such as chemo, psycho, socio
and physical therapies. The nurse has a key

19. role in milieu therapy and therapeutic
community. The nurse’s role in these therapies
is dealt with in-depth in the respective chapter.

1 hr explain in
details about
the current
trends and
issues in care
CURRENT ISSUES AND TRENDS IN
CARE
A psychiatric nurse faces various challenges
because of changes in patient care approach.
Some of these changes that affect her role are
as follows:

Demographic Changes
Type of family (increased number of nuclear
families )
 Increasing number of the elderly group
Social Changes
 The need for maintaining intergroup
and intragroup loyalties
 Peer pressure
Economic Changes
 Industrialization
 Urbanization
 Raised standard of living
Technological Changes
 Mass media
 Electronic systems
 Information Technology
Mental Health Care Changes
 Increased awareness in the public
regarding mental health
 Need to maintain mental stability
 Increased mental health problems

Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
Discuss about
the current
trends in nursing
care?
1 hr explain in
details about
the educational
EDUCATIONAL PROGRAMS FOR THE
PSYCHIATRIC NURSE
Lecture
Discussion
 Explaining,
 Discussing,
 Listening,
 Taking
notes,
List out the
educational
programmes of

20. programs for
the psychiatric
nurse
 Diploma in Psychiatric Nursing (The
first program was offered in 1956at
NIMHANS, Bangalore)
 M.Sc in Psychiatric Nursing (The first
program was offered in 1976at
Rajkumari Amrit Kaur College of
Nursing, New Delhi)
 M.Phil in Psychiatric Nursing (1990,
M.G. University, Kottayam)
 Doctorate in Psychiatric Nursing
(offered at MAHE, Manipal; RAK
College of Nursing, Delhi; NIMHANS,
Bangalore)
 Short-term training programs for both
the degree and diploma holders in
nursing

 Asking
questions,
 Clarifying
doubts
Involves in
discussion,
 Answering
the
questions.
the psychiatric
nursing ?
1 hr discuss in
details about
the standards
of mental
health nursing
STANDARDS OF MENTAL HEALTH
NURSING
The purpose of Standards of Psychiatric
and Mental Health Nursing practice is to fulfill
the profession’s obligation to provide a means
of improving the quality of care. The standards
presented here are a revision of the standards
enunciated by the Division on Psychiatric and
Mental Health Nursing Practice in 1973.
PROFESSIONAL PRACTICE
STANDARDS
Standard I: Theory
The nurse applies appropriate theory that is
scientifically sound as a basis for decisions
regarding nursing practice. Psychiatric and
mental health nursing is characterized by the
application of relevant theories to explain
phenomena of concern to nurses and to provide
a basis for intervention.
Standard II: Data Collection
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
What are the
standards of
mental health
nursing ?

21. The nurse continuously collects data that are
comprehensive, accurate and systematic.
Effective interviewing, behavioral observation,
physical and mental health assessment enable
the nurse to reach sound conclusions and plan
appropriate interventions with the client.
Standard III: Diagnosis
The nurse utilizes nursing diagnoses and /or
standard classification of mental disorders to
express conclusions supported by recorded
assessment data and current scientific premises.
Nursing’s logical basis for providing care rests
on the recognition and identification of those
actual or potential health problems that are
within the scope of nursing practice.
Standard IV: Planning
The nurse develops a nursing care plan with
specific goals and interventions delineating
nursing actions unique to each client’s needs.
The nursing care plan is used to guide
therapeutic intervention and effectively achieve
the desired outcomes.

Standard V: Intervention
The nurse intervenes as guided by the nursing
care plan to implement nursing actions that
promote, maintain or restore physical and
mental health, prevent illness and effect
rehabilitation.
a) Psychotherapeutic interventions: The
nurse uses psychotherapeutic
interventions to assist clients in
regaining or improving their previous
coping abilities and to prevent further
disability.
b) Health teaching: The nurse assists
clients, families and groups to achieve

22. satisfying and productive patterns of
living through health teaching.
c) Activities of daily living: The nurse
uses the activities of daily living in a
goal directed way to foster adequate
self-care and physical and mental well
being of clients.
d) Somatic therapies: The nurse uses
knowledge of somatic therapies and
applies related clinical skills in working
with clients.
e) Therapeutic environment: The nurse
provides, structures and maintains a
therapeutic environment in
collaboration with the client and other
health care providers.
f) Psychotherapy: The nurse utilizes
advanced clinical expertise in
individual, group and family
psychotherapy, child psychotherapy and
other treatment modalities to function
as a psychotherapist and recognizes
professional accountability for nursing
practice.
Standard VI: Evaluation
The nurse evaluates client responses to nursing
actions in order to revise the database, nursing
diagnoses and nursing care plan.
PROFESSIONAL PERFORMANCE
STANDARDS
Standard VII: Peer Review
The nurse participates in peer review and other
means of evaluation to assure quality of
nursing care provided for clients.
Standard VIII: Continuing Education
The nurse assumes responsibility for
continuing education and professional

23. development and contributes to the
professional growth of others.
Standard IX: Interdisciplinary
Collaboration
The nurse collaborates with other health care
providers in assessing, planning, implementing
and evaluating programs and other mental
health activities.
Standard X: Utilization of Community
Health Systems
The nurse participates with other members of
the community in assessing; planning,
implementing and evaluating mental health
services and community systems that include
the promotion of the broad continuum of
primary, secondary and tertiary prevention of
mental illness.
Standard X: Research
The nurse contributes to nursing and the mental
health field through innovations in theory and
practice and participation in research.

1 hr explain in
detail about
development
of code of
ethics
DEVELOPMENT OF CODE OF ETHICS
This is very important for a psychiatric nurse as
she takes up independent roles in
psychotherapy, behavior therapy, cognitive
therapy, individual therapy, group therapy,
maintains patient’s confidentiality, protects his
rights and acts as patient’s advocate.
LEGAL ASPECTS IN PSYCHIATRIC
NURSING
Knowledge of the legal boundaries governing
psychiatric nursing practice is necessary to
protect the public, the patient, and the nurse.
The practice of psychiatric nursing is
influenced by law, particularly in its concern
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
What are the
development of
code of ethics ?

24. for the rights of patients and the quality of care
they receive.
The client’s right to refuse a particular
treatment, protection from confinement,
intentional torts, informed consent,
confidentiality and record keeping are a few
legal issues in which the nurse has to
participate and gain quality knowledge.
PROMOTION OF RESEARCH IN
MENTAL HEALTH NURSING
The nurse contributes to nursing and the mental
health field through innovations in theory and
practice and participation in research.
COST EFFECTIVE NURSING CARE
Studies need to be conducted to find out the
viability in terms of cost involved in training a
nurse and the quality of output in terms of
nursing care rendered by her.
FOCUS OF CARE
A psychiatric nurse has to focus care on certain
target groups like the elderly, children, women,
youth, mentally retarded and chronic mentally
ill.

1hr discuss in
detail about the
new trends in
role of a
psychiatric
nurse
NEW TRENDS IN ROLE OF A
PSYCHIATRIC NURSE
1. Role of the Generalist
The psychiatric mental health generalist
nurse is a licensed registered nurse for
delivering primary mental health care. It
incorporates both physical & mental
health care.Generalist exercise a holistic
approach to practice & performs
psychiatric nursing in prevention
programs, community & day treatment
centers, psychiatric rehabilitation
Lecture
Discussion
 Explaining,
 Discussing,
 Asking
questions,
 Clarifying
doubts
 Listening,
 Taking
notes,
Involves in
discussion,
 Answering
the
questions.
Tell about the
new trends in
role of
psychiatric
nurse ?

25. facilities, homeless, shelters & many
other settings.
2. . Role of the specialist…
• Psychiatric Clinical Nurse Specialist
(CNS) holds a masters degree in
psychiatric mental health nursing. CNS
is an advanced practice nurse who is
usually a primary health care provider,
functions autonomously, often works in
a semi-isolated situation, has
medications prescription privileges
(depending upon individual state laws),
manages the overall care of people with
emotional & psychiatric problem , &
usually has a consultative arrangement
with a psychiatrist. For example, a
advanced practice nurse in Minnesota
are psychotherapists, consultants,
milieu specialists, role models, teachers,
administrators, crisis intervention
specialists co-ordinators.
3. Community Mental Health
Nurse(CMHN)…
Community mental health nursing is the
application of knowledge of psychiatric
nursing in preventing mental illness,
promoting & maintaining mental health
of the people.• It includes early
diagnosis, appropriate referrals, care &
rehabilitation of mentally ill people.
4. Psychiatric Home Care Nurse

26. 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.•
These nurse provide comprehensive
care, including psychiatric & physical
assessment, direct nursing care,
behavioral management, crisis
intervention, psychoeducation, in-home
detoxification, medication management,
case management & consultation with
colleagues.
5. Forensic Psychiatric Nurse
Forensic nursing is a growing specialty
in other countries around the globe,
especially in the UK, Australia,
Germany, Japan & Canada, & it is an
expanded scope of practice.• The
forensic psychiatric nurse works with
individuals who have mental health
needs & who have entered the legal
system.• Nurses in this role perform
physical & psychiatric assessment &
develop plans of care for the patients
entrusted to their care.
6. Psychiatric Consultation –
Liaison Nurse(PCLN
PCLN has arisen in response to the
increased recognition of the importance
of psycho-physiological inter-
relationships & their impact on physical

27. illness, recovery & wellness.• It is an
advanced practice nurse who practices
psychiatric & mental health nursing in
medical setting/non-psychiatric setting
providing consultation & education to
patients, families, & health care team &
the community.• PCLN may provide
assessment, recommendations &
supportive therapy to patients who are
anxious, depressed or experiencing
other psychological problems or
emotional distress.
7. Case Manager
Nurse case managers act as advocates
for patients & their families by
coordinating care & linking the patient
with the physician, other members of
the health-care-team, resources &
payers.• In the community, the case
manager works with patients on a broad
range of issues from accessing needed
medical & psychiatric services to
carrying out tasks of daily living such
as using public transportation,
managing money & buying groceries.
Collaborates with patient & family
Assesses, plans, implements,
coordinates, monitor, & evaluates
patient care options & services to
Resolution ofOnset of illness meet
health needs through illness
communication & promotes high

28. quality, cost-effective outcomes &
decreases the duplication &
fragmentation of care Collaborates with
Nursing, Co-ordinates services:
psychiatrist, psychologists, Home care
& rehabilatory social worker,
occupational services therapists &
ancillary services
8. Case management can be
provided by an individual or a
team.• It may include both face-
to-face & telephone contact with
the patient, as well as contact with
other service providers.• One of
the most valuable assets case
managers possess is their ability to
synthesize patient data & act as
conduits between patients & the
health care system.
9. Geropsychiatric Nurse
Geronursing is expanding the
psychiatric nursing practice to aged
people who have been affected by
emotional & behavioral disorders such
as dementia, chronic schizophrenia,
delirium, etc.
10. Parish Nurse
Parish nursing is another area of
expansion of psychiatric nurse role.•
Parish nursing is a program that
promotes health & wellness of body,
mind & spirit.• The parish nurse is a

29. pastorally called, spiritually mature,
licensed registered nurse with desire to
serve the members & friends of his or
her congregation.• In 1998 the APA
recognized parish nursing as a specialty
focusing on disease prevention & health
promotion.• It is a non-invasive type of
nursing in which no hands-on nursing
care is provided
11. . Telehealth / Telenurse…
Nurses engaged in telenursing practice
use technologies such as internet,
computers, telephones, digital
assessment tools & telemonitoring
equipment to deliver nursing care. In
India around 10 hospitals are having
tele- medicine departments. For
example, at Apollo hospitals, Narayana
Hrudayalaya & Hosmat hospital at
Bengaluru.
12. . Nurse Researcher…• Nurse
researchers are scientists who seek
to find answers to questions
through methodical observations
& experimentation.• The design
studies, conduct research &
disseminate findings at
professional meets & in peer
reviewed journals.• They are
doctorally or post-doctorally
prepared persons who initiate or
participate in all phases of the

30. research process.• They work in a
variety of setting.
13. . Psychiatric Nurse Educator…•
The psychiatric 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 according
to the needs of the society &
learner.
14. Nurse Administrator /
Manager…• A nurse manager
works less directly with patients,
but has the responsibility to
provide nursing leadership to
ensure that an appropriate
therapeutic milieu is maintained.•
A key responsibility is the support
& development of nurses,
representing nursing views to
senior managers.• Nurse Manager
plays an important role in
negotiating & allocating nursing
resources within clinical
directorates.• Individuals, who
assume a nurse executive role,
typically hold a master’s degree.

31. 15. Psychiatric nurse as
collaborativemembers of the
interdisciplinary team
Collaboration implies a
commitment to common goals,
with shared 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 treatment team. • Nurses bring
their own specialized knowledge
to the treatment process. • Seven
characteristics of effective
collaboration includes: trust,
respect, commitment, co-
operation, co-ordination,
communication & flexibility.
16. Nurse Psychopharmacologist…
One of the latest roles is that of the
nurse psychopharmacologist – the
psychiatric clinical nurse specialist with
prescriptive authority.• The new
opportunities for psychiatric nursing
practice that are emerging throughout
the continuum of mental health care
exciting for the specialty.• They allow
psychiatric nurses to demonstrate their
flexibility, accountability, & self
direction as they move forwards into
these expanding areas of practice.
17. Primary Mental Health Nursing

32. 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 complaints.
Cardiovascular, gynecological,
respiratory and gastrointestinal and
family practice settings are appropriate
for assessing patients for anxiety,
depression and substance abuse
disorders.
18. Collaborative Psychiatric
Nursing Practice
Patients who are having difficulty being
stabilized on their medications or who
have co-morbid medical illnesses are
seen in a psychiatric nursing clinic
where nurses and physicians collaborate
to provide high quality patient care.
19. Registered Psychiatric Nurse
(RPN)
A Registered Psychiatric Nurse
provides psychiatric mental health
nursing care to individuals, families and
groups to enable them to function at an
optimal level of psychological wellness
through more effective adaptive
behaviors 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

33. treatment and have a highly developed
level of communication skills. She
works with children, adolescents, adults
and elderly with dysfunctional behavior
patterns, and developmental handicaps.
A registered psychiatric nurse works as
an independent entity. She works in
various kinds of inpatient facilities and
community settings.
20. Nurse Psychotherapist
The psychiatric nurse can take up
psychotherapy roles as in individual
therapy, group therapy, counseling, etc.
21. Psychiatric Nurse Educator
The main function of psychiatric nurse
educator is planning and changing the
curriculum according to the needs of the
society and learner. The Indian Nursing
Council included psychiatric nursing as
compulsory for the qualifying
examination in B.Sc Nursing program
in 1965, and from 1986 it became a
component in General Nursing and
Midwifery course as well.
The number of nurses in the field of
teaching psychiatric nursing needs to be
enhanced. This is a big challenge for
nursing curriculum planners.
22. Psychosocial Rehabilitation
Nursing
It is concerned with helping people with
chronic mental illness to lead more

34. independent and satisfactory lives in the
community.
23. Child Psychiatric Nursing
In child psychiatric nursing the nurse
identifies emotional and behavioral
problems of the children and provides
comprehensive care.
24. Deaddiction Nrusing
A psychiatric nurse in these units
identifies psychosocial problems and
maintaining factors in addicts. She also
provides various therapies to the addicts
and their family members.
Conclusion: Contemporary Nurse
considers mental health nursing from
consumer, nursing practice and
community health perspectives. It
concludes with recommendations for
nurse education, workplace training,
and delivery of community care.