Professional Documents
Culture Documents
Intro To Psychiatric Mental Health
Intro To Psychiatric Mental Health
Neurosis
The Psychiatric/mental Health
Nursing
“Mental Health Nursing is a specialized field of
nursing which focuses on meeting the mental
health needs of the consumer, in partnership with
family, significant others and the community in
any setting. It is a specialized interpersonal process
embodying a concept of caring….”
PSYCHIATRIC NURSING
– is an interpersonal process that promotes and
maintains pt behavior that contributes to integrated
functioning.
- a specialized area of nsg practice, employing the
wide range of explanatory theories of human
behavior as its science and purposeful use of self
as its art (ANA 2000)
HISTORICAL PERSPECTIVE OF THE TREATMENT OF
MENTAL ILLNESS
Ancient times
- Cause: Punishment of wrongdoing
- divine or demonic
- (Aristotle 382-322 BC) amounts of blood
water, and yellow and black bile control
emotions
- aimed at resorting balance through
bloodletting, starving, and purging
EARLY CHRISTIAN (1-1000AD)
Primitive beliefs and superstitions were strong
Priest performed exorcisms to rid evil spirits;
incarceration, flogging & starving.
RENAISSANCE (1300-1600)
St Mary of Bethlem Hospital in England (1547)
Schizophrenia
Benchmark 3:
PERIOD OF PSYCHOTROPIC DRUGS ( 1950)
Chlorpromazine ( Thorazine); Lithium
Imipramine (Tofranil)
MAOI ( Monoamine oxidase inhibitor)
Haloperidol ( Haldol)
Tricyclic antidepressants, were introduced 10 years after
Benzodiazepines
Advantages:
1. Shorter hospital confinement
2. Noise and chaos diminished
3. Reduced agitation, psychotic thinking, depression
Benchmark IV:
PERIOD OF COMMUNITY MENTAL HEALTH
( 1960s)
theenactment of the Community Mental Health
Center Act.
DEINSTITUTIONALIZATION
CENTURY
Due to revolving door effect.
A. Community based care
> Cost Containment Managed Care
B. Managed Care
> people receive care based on need rather
than on request
C. Case Management
SIGNIFICANT PERSON IN PSYCHIATRIC
NURSING PRACTICE
LINDA RICHARDS
- The first american Psychiatric Nurse
1st Psychiatric Nursing Textbook (1920) by Harriet Bailey
“Nursing Mental Disease”
1st Psychiatric Nursing Theorist:
Hildegard Peplau “Interpersonal Relations in Nursing” (1952),
Interpersonal Techniques : The Crux of Psychiatric Nursing
( 1962); NPI
June Mellow “Nursing Therapy” 1968
- focusing on clients psychosocial needs and strengths.
SIGNIFICANT HOSPITALS IN PSYCHIATRIC
NUSING
Mc LEAN HOSPITAL, Belmont Massachussetts
- FIRST TRAINING Hospital for nurses in 1882
- Insulin Shock Therapy( 1935)
- Psychotherapy ( 1936)
- ECT ( 1937)
6. Hardiness
- Ability to resist illness
Components:
1. Commitment : active involvement in life activities
2. Control : ability to make approachabel decisions in life
activities
3. Challenge : ability to perceive change as benefecial rather
than just stressful
Factors Influencing
7. Resilience and resourcefulness
Mental Health
- healthy response to stressful circumstances or risky
situations
Resourcefulness - Involves using problem- solving abilities
and believing that one can cope with adverse or novel
situations
8. Spirituality
- Involves the essence of a persons being and his or her
belief about the meaning of life and the purpose for living
- Include belief in God or a higher power, the practice of
religion, cultural beliefs and practices and a relationship
with the environment
Factors Influencing Mental Health
8. Spirituality
- Involves the essence of a persons being and his or her
belief about the meaning of life and the purpose for
living
- Include belief in God or a higher power, the practice of
religion, cultural beliefs and practices and a relaitonship
with the environment
Interpersonal or relationship
1. Sense of belonging
2. Value
3. Fit
4. Social Networks and Social Support
1. Biologic make up
2. Intolerable or unrealistic worries or fears
3. Inability to distinguish reality from fantasy
4. Intolerance of life's uncertainties
5. Sense of disharmony in life
Interpersonal;
1. Ineffective communication
2. Excessive dependency
3. No sense of belonging
4. Inadequate social support
5. Loss of emotional control
Socio-culutral
Lack or resources
Violence
Homelessness
Poverty
Unwarranted negative view of the world
Discrimination ( stigma, racism, classism, ageism.
Sexism)
What IS Psychiatric and/or Mental
Health Nursing, Anyway??
Help!! This is NOT something I want to do!
I did NOT go into nursing to baby-sit “crazies”…
It’s ridiculous to spend my day just passing out
pills to keep these people quiet!
What good does it do, ANYWAY??!
Well……
We are so glad you asked!!
First of all… WHAT do psychiatric nurses do, anyway??
Isn’t it a “cushie” job??! (Noooo…, not really)
You need to know how to interact therapeutically
You need to have skill interpersonally
You need to know how medications work
You need to think on your feet – sometimes pretty fast. Not to
perform a physical skill, necessarily. But your words have never
been so important as they will be in this area of nursing.
Students' Concern about Psychiatric Nursing
Exposure
What If I say the wrong thing?
What will I be doing?
What if no one will talk to me?
Am I prying when I ask questions?
How will I handle bizarre or inappropriate behavior?
What happens if a client ask me for a date?
Is my physical safety in jeopardy?
What if I encounter someone I know being treated?
What if I recognized that I share similar problems or back
ground with the clients?
Myths of Mental Illness
Mental illness is caused by bad parenting.
Fact: Most diagnosed individuals come from supportive
homes.
Prescribe
Consult
Evaluate
Nurse and Therapist
Empathetic
Warm
Genuine
Respectful
Concrete
Immediate
Confrontive
Able to disclose self appropriately.
The Essence of Psychiatric/mental Health
Nursing
Lies not in tasks performed or with the presenting
illness but in the relationship that develops with
clients and families and their responses to the illness,
including the impact that the illness has on their lives.
The essence is in establishing a ‘therapeutic
partnership’, a connectedness, between the nurse and
client which is based on empathy and trust.
Similarities & Differences
SIMILARITIES
Work in close contact with people from a wide variety of
backgrounds
Provide CARE for people with a wide variety of illnesses
Involved in health promotion and illness prevention
Nursing philosophy of benevolence
Similarities & Differences
SIMILARITIES
Education: must meet required level of knowledge and
skills to attain registration/endorsement
Governed by the Nurses Codes –