STANDARDS, CHALLENGES &

SCOPE OF PSYCHIATRIC
NURSING
MULTI-DISCIPLINARY TEAM &
ROLE OF NURSE
PRESENTED
PRESENTED BYBYJASLEEN
JASLEEN KAUR
KAUR BRAR
BRAR

THE STANDARDS OF PSYCHIATRIC

NURSING
The Standards of Psychiatric Nursing describes,
in broad terms, the expected level of performance
of all Registered Psychiatric Nurses.
The standards of Practice describe what the
psychiatric nurse does.
The
standards of Professional Performance
describe the context in which the psychiatric nurse
performs these activities.

The standards of practice are organized around the

nursing process and include six components:
assessment, diagnosis, outcome identification,
planning,
implementation
and
evaluation.
Validation is a part of each step and all phases may
overlap or occur simultaneously. The fifth standard,
implementation, has several subcategories that
specify standards for each intervention.
These standards of care represent the nursing
professions commitment to the general public. It is
important that nurses know their practice
standards and are able to practice at this level.

NURSING CONDITIONS

ASSESSMENT
NURSING BEHAVIORS

Self awareness

Establish nursing contract

Accurate observations

Obtain information from patient and family

Therapeutic communication

Validate data with patient

Responsive dimensions of care

Organize data

NURSING CONDITIONS

DIAGNOSIS
NURSING BEHAVIORS

Logical decision making

Identify patterns in data

Knowledge of normal parameters

Compare data with norms

Inductive and deductive reasoning

Analyze and synthesize data

Sociocultural senstivity

Problems and strengths identified

Validate problem with patient

Formulate nursing diagnosis

Set priorities of problems

OUTCOMES IDENTIFICATION
NURSING BEHAVIORS

NURSING CONDITIONS

Critical thinking skills

Hypothesizing

Partnership with patient and family

Specify expected outcomes

Validate goals with patient

NURSING CONDITIONS

PLANNING
NURSING BEHAVIORS

Application of theory

Prioritize goals

Respect of patient and family

Identify nursing activities

Validate plan with patient

IMLEMENTATION
NURSING BEHAVIORS

NURSING CONDITIONS

Past clinical experiences

Consider available resources

Knowledge of research

Implement nursing activities

Responsive and action dimensions of care

Generate alternatives

NURSING CONDITIONS

Coordinate with other team members

EVALUATION
NURSING BEHAVIORS

STANDARD 1: ASSESSMENT

The psychiatric mental health registered nurse

collects comprehensive health data that is
pertinent the patients health or situation.

Rationale
The psychiatric mental health registered nurse
uses linguistically and culturally effective
communication skills, interviewing, behavioural
observation, record review and collection of
collateral information to make sound clinical
assessments.

The Psychiatric-Mental Health Registered Nurse:

Collects data in a systematic and ongoing process.
Involves the patient, family, other healthcare providers, and
environment, as appropriate, in holistic data collection.
Demonstrates effective clinical interviewing skills that
facilitate development of a therapeutic alliance.
Prioritizes data collection activities based on the patients
immediate condition or anticipated needs of the patient or
situation. The data may include but is not limited to the
patients:
Central complaint, focus or concern and symptoms of
major psychiatric disorders.
History and presentation regarding suicidal, violent, and
self-mutilating behaviours to assess level of risk.

 History of reliability with regard to patients verbal

agreement to seek professional assistance prior to engaging
in behaviours dangerous to self or others.
Pertinent family history of psychiatric disorders, substance
abuse and other mental health issues.
Evidence of abuse or neglect.
Stressors, contributing factors and coping strategies.
Demographic profile and history of health patterns, illnesses
and past treatments and level of adherence and effectiveness.
Actual or potential barriers to adherence to recommended or
prescribed treatment.
Health beliefs and practices.
Religious and spiritual beliefs and practices.
Cultural, racial and ethnic identity and practices.
Physical, developmental, cognitive, mental status, emotional
health concerns and neurological assessment.

 Daily activities, personal hygiene, occupational functioning,

functional health status and social roles, including work,
sleep and sexual functioning.
Economic, political, legal, and environmental factors affecting
health.
Significant support systems and community resources
including what has been available and underutilized.
Knowledge, satisfaction, and motivation to change, related to
health.
Strengths and competencies that can be used to promote
health.
Current and past medications, both prescribed and over-thecounter inclusive of herbs, alternative medications, vitamins,
or nutritional supplements.
Medication interactions and history of side effects and past
efficacy.

 History and patterns of alcohol and substance abuse including

type, amount, most recent use and withdrawal symptoms.
Complementary therapies used to treat health and mental
illness and outcomes.
Uses appropriate evidence-based assessment techniques and
instruments in collecting pertinent data.
Uses analytical modes and problem-solving techniques.
Ensures that appropriate consents, as determined by regulations
and policies, are obtained to protect patient confidentiality and
support the patients rights in the process of data gathering.
Synthesizes available data, information, and knowledge relevant
to the situation to identify patterns and variances.
Uses therapeutic principles to understand and interpret the
patients emotion, thoughts and behaviors.
Documents relevant data in a retrievable format.

STANDARD 2. DIAGNOSIS
The psychiatric-mental health registered nurse
analyzes the assessment data in determining
diagnoses or problems including level of risk.
Rationale
Through comprehensive and focused assessment
and data analysis the psychiatric mental health
registered nurse identifies patient needs related to
actual or potential psychiatric disorders, mental
health problems, and potential co-morbid physical
illnesses.

The psychiatric mental health registered nurse:

Derives the diagnosis or problems from the assessment
data.
Identifies actual or potential risks to the patients health
and safety and/or barriers to mental and physical health
which may include but is not limited to interpersonal,
systematic, or environmental circumstances.
Develops diagnoses or problem statements that conform, or
are congruent with, available and accepted classifications
systems.
Validates the diagnosis or problems with the patient,
significant others and other health care clinicians.
Documents diagnoses or problems in a manner that
facilitates the determination of the expected outcomes and
plan.

STANDARD 3. OUTCOMES
IDENTIFICATION
The psychiatric mental health registered nurse
identifies
expected outcomes
for
a
plan
individualized to the patient or to the situation.
Rationale
Psychiatric
mental health registered nurses
provide nursing care to influence positive patient
outcomes
including
the
achievement
of
individualized mental and physical health.

The psychiatric mental health registered nurse:

Derives culturally appropriate expected outcomes from the diagnosis.
Involves the patient, family, and other healthcare providers in
formulating expected outcomes when possible and appropriate.
Considers associated risks, benefits, costs, current scientific evidence,
and clinical expertise when formulating expected outcomes.
Defines expected outcomes in terms of the patient, patient values,
ethical considerations, environment or situation with such
consideration as associated risks, benefits and costs, and current
scientific evidence.
Develops expected outcomes that provide direction for continuity of
care.
Documents expected outcomes as measurable goals.
Includes a time estimate for attainment of expected outcomes.
Modifies expected outcomes based on changes in the status of the
patient or evaluation of the situation.

STANDARD 4. PLANNING
The psychiatric mental health registered nurse
develops a plan that prescribes strategies and
alternatives to attain expected outcomes.
Rationale
A plan of care is used to systematically guide
therapeutic
interventions
and
document
progress.

The psychiatric mental health registered nurse:

Develops the plan in collaboration with the patient,
family, and other health care providers when
appropriate.
Prioritizes elements of the plan based on the
assessment of the patients level of risk for potential
harm to self or others and safety needs
Includes strategies within the plan that address
each of the identified diagnoses or issues, which
may include strategies for promotion and
restoration of health and prevention of illness,
injury, and disease.
Assists patients in securing treatment or services in
the least restrictive environment.

Includes an implementation pathway or timeline

within the plan.
Provides for continuity within the plan.
Utilizes the plan to provide direction to other
members of the health care team.
Documents the plan using standardized language or
recognized terminology.
Defines the plan to reflect current statutes, rules and
regulations, and standards.
Develops the plan to reflect the use of available
research evidence.
Considers the economic impact of the plan.
Modifies the plan based on ongoing assessment of the
patients response and other outcome indicators.

STANDARD 5. IMPLEMENTATION

The psychiatric mental health registered nurse

implements the identified plan.

The psychiatric mental health

nurse:
Implements the plan in a safe
manner.
Documents
implementation
modifications, including changes or
the identified plan.

registered
and timely
and
any
omissions of

Utilizes
evidence
based
interventions
and
treatments specific to the diagnosis or problem.
Utilizes community resources and systems to
implement the plan.
Collaborates with nursing colleagues and others to
implement the plan.
Manages psychiatric emergencies by determining
the level of risk and initiating and coordinating
effective emergency care.

STANDARD 5A. COORDINATION OF

CARE

The psychiatric mental health registered nurse

coordinates care delivery.

The psychiatric mental health registered

nurse:
Coordinates implementation of the plan.
Documents the coordination of care.

STANDARD 5 B. HEALTH TEACHING

AND HEALTH PROMOTION
The psychiatric mental health registered nurse
employs strategies to promote health and a safe
environment.
Rationale
The psychiatric mental health registered nurse,
through health teaching, promotes the patients
personal and social integration and assists the
patient in achieving satisfying, productive, and
health patterns of living.

The psychiatric mental health registered nurse:

Uses health promotion and health teaching methods
appropriate
to
the
situation,
patients
developmental level, learning needs, readiness,
ability to learn, language preference and culture.
Provides health teaching related to the patients
needs and situation that may include, but is not
limited to, mental health problems and psychiatric
disorders, treatment regimen, coping skills, relapse
prevention, self-care activities, resources, conflict
management,
problem-solving
skills,
stress
management and relaxation techniques, and crisis
management.

Integrates current knowledge and research

regarding psychotherapeutic educational strategies
and content.
Engages consumer alliances and advocacy groups,
as appropriate, in health teaching and health
promotion
activities.
Identifies
community
resources to assist consumers in using prevention
and mental health care services appropriately.
Seeks opportunities for feedback and evaluation of
the effectiveness of strategies utilized.
Provides anticipatory guidance to individuals and
families to promote mental health and to prevent or
reduce the risk of psychiatric disorders.

STANDARD 5C. MILIEU THERAPY

The psychiatric mental health registered nurse
provides, structures, and maintains a safe and
therapeutic environment in collaboration with the
patients, families and other health care clinicians.
Rationale
The therapeutic environment consists of the
physical environment, social structures, and the
philosophy of care and treatment that provides
safety at points of crisis and supports the patients
ability to use new adaptive coping strategies and
available resources.

The psychiatric mental health registered nurse:

Orients
the patient and family to the care
environment including the physical environment, the
roles of different health care team providers in their
care, how to be involved in the treatment and care
delivery processes, schedules of events pertinent to
their care and treatment, and expectations regarding
behaviors.
Orients the patient to their rights and responsibilities
particular to the treatment or care environment.
Conducts ongoing assessments of the patient in
relationship to the environment to guide nursing
interventions in maintaining a safe environment and
patient safety.

Selects specific activities that meet the patients

physical and mental health needs for meaningful
participation in the milieu and promoting personal
growth.
Ensures that the patient is treated in the least
restrictive environment necessary to maintain the
safety of the patient and others.
Informs the patient in a culturally competent
manner about the need for the limits and the
conditions necessary to remove the restrictions.
Provides the patient with the opportunity to discuss
their illness experience with The psychiatric mental
health nurse to promote support, validation and
prevention of complications.

STANDARD 5 D. PHARMACOLOGICAL,
BIOLOGICAL AND COMPLEMENTARY
INTERVENTIONS

The psychiatric-mental registered nurse uses

knowledge of pharmacological, biological and
complementary interventions and applies clinical
skills to restore the patients health and prevent
further disability.

The psychiatric mental health registered nurse:

Applies current research findings to guide nursing
actions related to pharmacology, other biological
therapies, and complementary therapies.
Assesses patients response to biological interventions
based on current knowledge of pharmacological
agents intended actions, interactive effects, potential
untoward effects and therapeutic doses.
Includes health teaching for medication management
to support patients in managing their own
medications, and adherence to prescribed regimen.

Educates on information about mechanism of

action, intended effects, potential adverse effects
of the proposed prescription, ways to cope with
transitional side effects and other treatment
options, including no treatment.
Directs interventions toward alleviating untoward
effects of biological interventions.
Communicates observations about the patients
response to biological interventions are to other
health clinicians.

STANDARD 5E. PRESCRIPTIVE

AUTHORITY AND TREATMENT
The psychiatric mental health registered nurse:
Conducts a thorough assessment of past medical trials,
side effects, efficacy and patient preference.
Prescribes or recommends pharmacological agents based
on research evidence and knowledge of psychopathology,
neurobiology, physiology, expected therapeutic actions,
anticipated side effects and courses of action.
Prescribes or recommends psychotropic and related
medications based on clinical indicators of patient status.
Assesses a reasoned balance of risk and benefits,
including results of diagnostic and lab tests as
appropriate, to treat symptoms of psychiatric disorders
and improve functional status

Provides health teaching about mechanism of

action, intended effects, potential adverse effects of
the proposed prescription, ways to cope with
transitional side effects and other treatment
options, including no treatment.
Educates and assists the patient in selecting the
appropriate use of complementary and alternative
therapies.
Evaluates therapeutic and potential adverse effects
of
pharmacological
and
non-pharmacological
treatments.
Evaluates pharmacological outcomes by utilizing
standard symptom measurements and patient
report to determine efficacy.

STANDARD 5F. PSYCHOTHERAPY

The Psychiatric Mental Health Advanced Practice
Registered Nurse conducts individual, couples, group,
and/or family psychotherapy using evidence-based
psychotherapeutic
frameworks,
interpersonal
transactions
and
nurse-patient
therapeutic
relationship.
The psychiatric mental health registered nurse:
Uses knowledge of personality theory, growth and
development,
psychology,
neurobiology,
psychopathology, social systems small-group and
family dynamics, stress and adaptation, and theories
and best available research evidence to select
therapeutic methods based on the patients needs.

Structures the therapeutic contract to include, but

not limited to:
Purpose, goals, and expected outcomes
Time, place and frequency of therapy
Participants involved in therapy
Confidentiality and appropriate written release of
information
Availability and means of contacting therapist
Responsibilities of both patient and therapist
Fees and payment schedule
Cancellations/alteration in schedule policy

Utilizes interventions that promote mutual trust to build

a therapeutic treatment alliance.
Empowers patients to be active participants in treatment.
Applies therapeutic communication strategies based on
theories and research evidence to reduce emotional
distress, facilitate cognitive and behavioral change and
foster personal growth.
Uses
self-awareness of emotional reactions and
behavioral responses to others to enhance the therapeutic
alliance.
Analyzes the impact of duty to report and other advocacy
actions on the therapeutic alliance.
Arranges for the provision of care in the therapists
absence.

Applies ethical and legal principles to the treatment of

patients with mental health problems and psychiatric
disorders.
Makes referrals when it is determined that the patient
will benefit from a transition of care or consultation due
to change in clinical condition.
Evaluates effectiveness of interventions is relation to
outcomes using standardized methods as appropriate.
Monitors outcomes of therapy and adjusts plan of care
when indicated.
Therapeutically
concludes
the
nurse-patient
relationship and transitions the patient to other levels
of care, when appropriate.
Identifies and maintains professional boundaries to
preserve the integrity of the therapeutic process.

STANDARD 5G. CONSULTATION

The psychiatric mental health

nurse provides consultation
identified plan, enhance the
clinicians to provide services for
change.

advanced practice
to influence the
abilities of other
patients and effect

The psychiatric mental health registered nurse:

Synthesizes clinical data, theoretical frameworks,
and evidence when providing consultation.
Initiates consultation at the request of the consultee

Establishes a working alliance with the patient or

consultee based on mutual respect and role
responsibilities.
Facilitates the effectiveness of a consultation by
involving the stakeholders in the decision-making
process.
Communicates consultation recommendations that
influence
the
identified
plan,
facilitate
understanding by involved stakeholders , enhance
the work of others, and effect change.
Clarifies that implementation of system changes or
changes to the plan of care remain the consultees
responsibility.

STANDARD 6. EVALUATION
The psychiatric mental health registered nurse evaluates progress
toward attaining expected outcomes.
The psychiatric mental health registered nurse:
Conducts a systematic, ongoing, and criterion-based evaluation of
the outcomes in relation to the structures and processes prescribed
by the plan and indicated timeline.
Involve the patient, family or significant others, and other health
care clinicians in the evaluation process.
Documents results of the evaluation.
Evaluates the effectiveness of the planned strategies in relation to
patient responses and the attainment of the expected outcomes.
Uses on going assessment data to revise the diagnoses, outcomes,
the plan and the implementation as needed.
Disseminates the results to the patient and others involved in the
care or situation, as appropriate, in accordance with state and
federal laws and regulations.

STANDARDS OF PROFESSIONAL PERFORMANCE

STANDARD 7. QUALITY OF PRACTICE

The psychiatric mental health registered nurse

systematically
enhances
the
quality
and
effectiveness of nursing practice.

The psychiatric-mental health registered nurse:

Demonstrates
quality
by
documenting
the
application of the nursing process in a responsible,
accountable, and ethical manner.
Uses the results of quality improvement activities to
initiate changes in nursing practice and in the
healthcare delivery system.

Uses creativity and innovation in nursing practice

to improve care delivery.
Incorporates new knowledge to initiate changes in
nursing practice if desired outcomes are not
achieved.
Obtains and maintains certification in psychiatric
mental health nursing.
Participates in quality improvement activities. Such
activities may include:
Identifying aspects of practice important for
quality monitoring.
Using indicators developed to monitor quality
and effectiveness of nursing practice.

Collecting data to monitor quality and effectiveness of nursing practice.

Analyzing quality data to identify opportunities for improving
nursing practice.
Formulating recommendations to improve nursing practice or
outcomes.
Implementing activities to enhance the quality of nursing practice.
Developing, implementing, and evaluating policies, procedures
and/or guidelines to improve the quality of practice.
Participating on interdisciplinary teams to evaluate clinical care or
health services.
Participating in efforts to minimize costs and unnecessary
duplication.
Analyzing factors related to safety, satisfaction, effectiveness, and
cost/benefit options.
Analyzing organizational systems for barriers
Implementing processes to remove or decrease barriers within
organizational systems.

STANDARD 8. EDUCATION

The psychiatric mental health registered nurse

attains knowledge and competency that reflects
current nursing practice.

The psychiatric mental health registered nurse:

Participates
in ongoing educational activities
related to appropriate knowledge bases and
professional issues.
Demonstrates a commitment to lifelong learning
through self-reflection and inquiry to identify
learning needs.

Seeks experiences that reflect current practice in

order to maintain skills and competence in
clinical practice or role performance.
Acquires knowledge and skills appropriate to the
specialty area, practice setting, role, or situation.
Maintains professional records that provide
evidence of competency and life long learning.
Seeks experiences and formal and independent
learning activities to maintain and develop
clinical and professional skills and knowledge.

STANDARD 9: PROFESSIONAL
PRACTICE EVALUATION

The psychiatric mental health registered nurse

evaluates his/her own practice in relation to the
professional practice standards and guidelines,
relevant statutes, rules, and regulations.

The psychiatric mental health registered nurse:

Demonstrates the application of knowledge of current
practice standards, guidelines, statutes, rules, and
regulations.
Provides age appropriate care in a culturally and
ethnically sensitive manner.

Engages in self-evaluation of practice on a regular

basis, identifying areas of strength as well as areas
in which professional development would be
beneficial.
Obtains informal feedback regarding ones own
practice
from
patients,
peers,
professional
colleagues, and others.
Participates
in systematic peer review as
appropriate.
Takes action to achieve goals identified during the
evaluation process.
Provides rationale for practice beliefs, decisions, and
actions as part of the informal and formal evaluation
processes.

STANDARD 10. COLLEGIALITY

The psychiatric mental health registered nurse interacts with and

contributes to the professional development of peers and colleagues.

The psychiatric-mental health registered nurse:

Shares knowledge and skills with peers and colleagues as evidenced
by such activities as patient care conferences or presentations at
formal or informal meetings.
Provides peers with feedback regarding their practice and/or role
performance.
Interacts with peers and colleagues to enhance ones own
professional nursing practice and/or role performance.
Maintains compassionate and caring relationships with peers and
colleagues.
Contributes to an environment that is conducive to the education of
healthcare professionals.
Contributes to a supportive and healthy work environment.

STANDARD 11: COLLABORATION

The psychiatric mental health registered nurse collaborates

with patients, family and others in the conduct of nursing
practice.

The psychiatric-mental health registered nurse:

Communicates with patient, family, and healthcare providers
regarding patient care and the nurses role in the provision of
that care.
Collaborates in creating a documented plan focused on
outcomes and decisions related to care and delivery of services
that indicates communication with patients, families, and
others.
Partners with others to effect change and generate positive
outcomes through knowledge of the patient or situation.
Documents referrals, including provisions for continuity of care.

STANDARD 12: ETHICS

The psychiatric mental health registered nurse

integrates ethical provisions in all areas of practice.

The psychiatric mental health registered nurse:

Uses the Code of Ethics for Nurses with Interpretive
Statements (ANA, 2001) to guide practice.
Delivers care in a manner that preserves and
protects patient autonomy, dignity and rights.
Maintains patient confidentiality within legal and
regulatory parameters.
Serves as a patient advocate assisting patients in
developing skills for self advocacy.

Maintains a therapeutic and professional patient

nurse relationship with appropriate professional role
boundaries and does not promote or engage in
intimate, sexual, or business relationships with
current or former patients.
Monitors
and carefully manages self-disclosure
therapeutically.
Demonstrates a commitment to practicing self-care,
managing stress, and connecting with self and others.
Contributes to resolving ethical issues of patients,
colleagues, or systems as evidenced in such activities
as participating on ethics committees.
Reports illegal, incompetent, or impaired practices.

STANDARD 13: RESEARCH

The psychiatric mental health registered nurse

integrates research findings into practice.

The psychiatric-mental health registered nurse:

Utilizes the best available evidence, including
research findings, to guide practice decisions.
Actively participates in research activities at
various levels appropriate to the nurses level of
education and position. Such activities may include:

 Identifying clinical problems specific to psychiatricmental health

nursing research (patient care and
nursing practice).
Participating in data collection (surveys, pilot projects,
formal studies).
Participating in a formal committee or program.
Sharing research activities and/or findings with peers
and others
Conducting research.
Critically analyzing and interpreting research for
application to practice.
Using research findings in the development of policies,
procedures, and standards of practice in patient care.
Incorporating research as a basis for learning

STANDARD 14. RESOURCE UTILIZATION

The psychiatric mental health registered nurse

considers factors related to safety, effectiveness,
cost, and impact on practice in the planning and
delivery of nursing services.

The psychiatric-mental health registered nurse:

Evaluates factors such as safety, effectiveness,
availability, cost and benefits, efficiencies, and
impact on practice, when choosing practice options
that would result in the same expected outcome.

STANDARD 15. LEADERSHIP

The psychiatric mental health registered nurse provides

leadership in the professional practice setting and the
profession.

The psychiatric-mental health registered nurse:

Engages in teamwork as a team player and a team builder.
Works to create and maintain healthy work environments
in local, regional, national, or international communities.
Displays the ability to define a clear vision, the associated
goals, and a plan to implement and measure progress.
Demonstrates a commitment to continuous, life long
learning for self and others.

Teaches others to succeed by mentoring and other strategies.

Exhibits creativity and flexibility through times of change.
Demonstrates energy, excitement, and a passion for quality
work.
Willingly accepts mistakes by self and others thereby creating
a culture in which risk-taking is not only safe, but expected.
Inspires loyalty through valuing of people as the most precious
asset in an organization.
Directs the coordination of care across settings and among
caregivers, including oversight of licensed and unlicensed
personnel in any assigned or delegated tasks.
Serves in key roles in the work setting by participating on
committees, councils, and administrative teams.
Promotes advancement of the profession through participation
in professional organizations.

CHALLENGES OF PSYCHIATRIC
NURSING
The challenges of psychiatric nursing are increasing.
New knowledge is being generated, technology is
shaping health care into new dimension, and nursing
practice is becoming more specialized and
autonomous.
Knowledge Development, Dissemination and
Application: The challenge for psychiatric nurses
today is to stay abreast of the advances in total
health care in order to provide safe, competent care
to individuals with mental disorders. Additional
challenges for psychiatric nurses include updating
their knowledge so that significant results of studies
can be applied to the care of patients.

Overcoming Stigma: Nurses can play an important role in

dispelling myths of mental illnesses. Stigma often prevents
individuals from seeking help for mental health problems.
To reduce the burden of mental illness and improve access
to care, nurses can educate all of their patients about the
etiology, symptoms and treatment of mental illnesses.
Health Care Delivery System Challenges: Additional
continuing challenges for psychiatric nurses include
providing nursing care within integrated community based
services where culturally competent, high quality nursing
care is needed to meet the emerging mental health care
needs of the patients.
Impact of Technology: Nurses are challenged to continue
to develop their technical and computer skills and to use
this technology in improving care.

SCOPE OF PSYCHIATRIC NURSING

Psychiatric mental health nursing is 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. It is within the
scope of Psychiatric Mental Health Practice to provide primary
mental health care to patients seeking mental health services in a
wide range of delivery setting.
The psychiatric mental health nurse works in child guidance
clinics, school health programmes, sheltered workshops, halfway
homes, de-addiction campus, suicidal prevention squads, old age
homes and in foster homes for destitute and mentally retarded.
He/she works as counsellor in adolescent clinics, AIDS clinics & as
psychiatric nurse consultant in general hospital.
He/she is a team leader for crisis intervention; his/her services can
be availed in all units of hospital.
He/she works as nurse educator, counsellor & clinic specialist,
consultant and conducts research.

MULTIDISCIPLINARY TEAM

PERSONNEL
Psychiatric

TRAINING
ROLE/FUNCTION
Registered nurse (RN) with specialized Biopsychosocial nursing

nurse

training in the care and treatment of patients and families and their

Psychiatrist

psychiatric patients.
milieu.
Medical doctor (MD) with internship and Medical diagnosis and treatment of

Social worker

residency training in psychiatry.

patients with psychiatric disorders.
May have a BS, MSW of PhD degree Family casework and community

care

of

with specialized training in mental placement of patients.

Psychologist

health settings.
Has a PhD or PsyD degree with research Psychological assessments, testing

Activity

and clinical training in mental health.

and treatments.
May have a BS degree with training in Recreational,
occupational

therapist
Case worker

mental health settings.

activity programs.
Has varying degrees of training and Helps patients to be maintained in
usually works under supervision.

community

and

receive

and

needed

Substance

services.
Has varying degrees of training in Evaluates and treats patients with

abuse

alcohol and substance use disorders.

substance use problems.

counsellor
Peer counsellor Self- identified as a consumer who is Helps consumers identify goals and
receiving or has received mental health receive

services

that

services and is well grounded in their recovery and resiliency.

promote

ROLE OF NURSE:
The nurse in psychiatric hospital setting:
The safe custody of patients.
Carrying out various modalities (physical and
psychological).
The administration of the ward.
The responsibility of health education to patients and
their relatives.
Patient centred and research minded responsibilities,
Maintaining
better
adjustment
and
cordial
relationships with her own professional colleagues.
Playing an active role in promoting mental health
services.

The nurse in general hospital setting:

Reducing the anxiety of normal patients suffering
from any type of disease.
Crisis intervention, that is short term therapeutic
intervention to resolve an immediate crisis or
emergency using all available resources.
Counselling that is directed toward resolution of a
health related problem.

The nurse in community mental health services:

Health promotion which includes- Participation in health education programmes.
- Working with special groups e.g. pregnant women,
elderly, adolescents.
- Helping the authorities in changing the attitude
towards mental illness.
Activity with the individual, the family or special
groups- preventive action and case finding.
Ensuring continuity and care.
Participation in studies with regard to community
needs.
Participation in rehabilitation programmes.

SUMMARIZATION

1.
2.
3.
4.
5.

Standards:
Assessment
Diagnosis
Outcomes identification
Planning
Implementation
a. coordination of care
b. health teaching and health promotion
c. milieu therapy
d. pharmacological, biological and complementary
interventions
e. prescriptive authority and treatment
f. psychotherapy
g. consultation

Challenges

Knowledge Development, Dissemination and Application

Overcoming Stigma
Health Care Delivery System Challenges
Impact of Technology

Scope

Multidisciplinary
Role

of nurse

team

6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Evaluation
Quality of practice
Education
Professional practice evaluation
Collegiality
Collaboration
Ethics
Research
Resource utilization
Leaership

BIBLIOGRAPHY:
Stuat W. Gail,Principals and Practice of Psychiatric
Nursing;(10);149-63
Boyd
Ann Mary,Psychiatric Nursing Contempory
Practice;(4);48-54
Jacob Alphonsa, Handbook of Psychiatric Nursing;161-63
Vyas
JN;Ahuja Niraj, Textbook of Postgraduate
Psychiatry;(2);994-97
http://www.ispn-psych.org/docs/standards/scope-standards
-draft.pdf
http://www.slideshare.net/bivinjose/scope-of-psyciatric-m
ental-health-nursing
http://www.austincc.edu/adnlev3/rnsg2213online/intro/s
tandards.htm
www.mhcirl.ie/documents/publications/DiscussionPaper M

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