Psychiatric nursing or mental health nursing is the designated position of nurses specializing in mental health, and caring for people of all ages who have mental illness or distress. These include: schizophrenia, schizoaffective disorder, mood disorders, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.
Nurses in this area receive special training in psychological therapy, building therapeutic alliances, dealing with challenging behavior, and administration of psychiatric drugs.
In most countries, psychiatric nurses must achieve a nursing degree to become Registered Nurse (RN), and specialize in mental health. Degrees vary in different countries, and are governed by country-specific regulations.
Mental health nurses may work in a variety of services, including: Mental Health Services for Children and Adolescents (CAMHS), Acute Medical Unit (AMU), Intensive Psychiatric Nursing Unit (PICU), and Community Mental Health Services (CMHS).
Video Psychiatric and mental health nursing
History
The history of psychiatry and psychiatric nursing, though discontinuous, can be traced back to ancient philosophical thinkers. Marcus Tullius Cicero, in particular, was the first person known to create a psychiatric questionnaire using biographical information to determine the best psychological treatment and care. Some of the first psychiatric care centers were constructed in the Middle East during the 8th century. Medieval Muslim physicians and their aides rely on clinical observations for diagnosis and treatment.
In the 13th century of the European century, psychiatric hospitals were built for psychiatric hospitals, but no nurses took care of them and care was rarely provided. This facility is more functioning as a housing unit for crazy people. Throughout the high point of Christianity in Europe, hospitals for the mentally ill believe in using religious intervention. The madman partnered with "soul friends" to help them reconnect with society. Their main concern is to be friends with sadness and distractions, forming intimate spiritual relationships. Today, these soul friends are seen as the first modern psychiatric nurses.
In the colonial era of the United States, some settlers adapted the practice of community nursing. Individuals with mentally challenged disabilities are imprisoned or kept in cages, maintained and fully paid by community officials. The richer colonists take care of their crazy relatives either in the attic or basement and hire maids, or nurses, to care for them. In other communities, mentally ill people are sold at auction as manual laborers. Others were forced to leave town. As populations in the colony expand, informal care for communities fails and small institutions are established. In 1752, the first "crazy ward" opened in Pennsylvania Hospital trying to treat the mentally ill. Officers use the most modern care at present: cleaning, blowing out, blistering, and shock techniques. Overall, the officer who treated the patient believed in treating the institution with respect. They believe that if the patient is treated as a reasonable person, then they will act like that; if they give them confidence, then patients will rarely abuse it.
The 1790s saw the beginning of the moral treatment introduced to people with mental stress. The safe asylum concept, proposed by Philippe Pinel and William Tuke, offers protection and care at the institution for patients who have previously been abused or enslaved. In the United States, Dorothea Dix is ​​instrumental in opening 32 state hospitals to provide quality care for the sick. Dix was also responsible for the Union Army Nurses during the American Civil War, taking care of both Union and Confederate soldiers. Although the movement is promising, servants and nurses are often accused of abusing or ignoring the occupants and isolating them from their families.
Official recognition of psychiatry as a modern and legitimate profession occurred in 1808. In Europe, one of the main advocates of mental health care to assist psychiatrists was Dr. William Ellis. He proposed giving the "crazy guard" a better pay and training so that the more respectable and intelligent people would be interested in the profession. In his book, published in 1836 on the "Treatise on Insanity," he publicly stated that established nursing practice calms depressed patients and gives hope to desperate people. However, psychiatric nursing was not formalized in the United States until 1882 when Linda Richards opened Boston City College. This is the first school designed specifically to train nurses in psychiatric care.
The distinction between psychiatric establishment and the recognition of trained nurses in the field is largely associated with attitudes in the nineteenth century that oppose the training of women to work in the medical field.
In 1913, Johns Hopkins University was the first nursing college in the United States to offer psychiatric nursing as part of its general curriculum. The first psychiatric nursing lesson, Mental Illness by Harriet Bailey, was not published until 1920. Only in 1950, the National League for Nursing required all nursing schools to incorporate clinical experience in psychiatry to receive national accreditation. The first psychiatric nurse faces tough working conditions. Density, lack of staff and bad resources require continuation of custodial care. They were suppressed by a dramatically rising patient population in the late 19th century. As a result, labor organizations are formed to fight for better pay and less hours of work. In addition, major hospitals were established to accommodate a large number of mental illnesses, including the renowned Kings Park Psychiatric Center on Long Island, New York. At its peak in the 1950s, the center housed more than 33,000 patients and needed its own power plant. Nurses are often called "officers" to imply a more humane approach to care. During this time, the officers keep the facility clean and maintain order among the patients. They also do orders from doctors.
In 1963, President John F. Kennedy accelerated the trend toward deinitutionalization with the Community Mental Health Act. Also, as psychiatric drugs become more available that allow patients to live alone and psychiatric hospitals are too expensive, institutions begin to close. Nursing care becomes more intimate and holistic. An expanded role was also developed in the 1960s that enabled nurses to provide outpatient services such as counseling, psychotherapy, consultation, prescribing medications, along with diagnosis and treatment of mental illness.
The first developed standard of care was prepared by the psychiatric division of the American Nurses Association (ANA) in 1973. This standard outlines the responsibility and quality of care expected of the nurse.
In 1975, the government published a document called "Better Service for Mental Illness" that reviewed current psychiatric nursing standards worldwide and devised a better plan for future mental health care.
Global health care experienced a major expansion in the 1980s, due to the government's reaction to the rapidly increasing demand for health care services. The expansion continued until the economic crisis of the 1970s.
In 1982, the Area Health Authority was terminated.
In 1983, a better hospital structure was implemented. General managers are introduced to make decisions, thus creating a better operating system. 1983 also saw many staff cuts that are greatly felt by all mental health nurses. However a new training syllabus was introduced in 1982, which offered the appropriate knowledgeable nurse.
The year 2000 has seen major educational improvements for nurses to specialize in mental health as well as various financial opportunities.
Maps Psychiatric and mental health nursing
Assessment
The term mental health includes many things about one person, including how we feel, how we behave, and how well we function. This single aspect of the person can not be measured or easily reported but it is possible to obtain a global picture by collecting subjective and objective information to investigate the actual mental health and well-being of a person. When identifying mental health and planning interventions, here are some things that were gathered from the Mental Health Association in Southern Pennsylvania to be remembered when completing a thorough mental health assessment in the nursing profession:
- Is the patient asleep in sufficient time on regular sleep cycles?
- Does the patient have an interest in communicating with others?
- Does the patient eat and maintain adequate nutritional status?
- Is the ability to perform daily living activities present (bathing, dressing, spraying one's self)?
- Can patients contribute to society and keep jobs?
- What is the ability to present the reason?
- Is security a recurring problem?
- Do patients often make decisions regardless of their own safety or the safety of others?
- Does the patient show difficulties with memory or recognition?
Interventions
Nursing orders can be divided into the following categories:
Physical and biological interventions
Psychiatric drugs
Psychiatric drugs are commonly used interventions and many psychiatric mental health nurses are involved in the administration of drugs, either in oral form (eg tablets or liquids) or by intramuscular injection. Nurse practitioners can prescribe medications. The nurse will monitor the side effects and responses to these medical treatments by appraisal. The nurse will also offer information about the drug so that, where possible, the person being treated can make informed choices, using the best evidence available.
Electroconvulsive Therapy
Psychiatric mental health nurses are also involved in the administration of electroconvulsive therapy treatments and assist with the preparation and recovery of treatments, which involve anesthesia. This treatment is only used in a small number of cases and only after all other treatments that may have run out.
A patient agreeing to receive care should be established and defended by the nurse.
Physical care
Together with other nurses, psychiatric psychiatric nurses will intervene in the areas of physical needs to ensure that people have personal hygiene, nutrition, sleep, etc., and treat concurrent physical illness.
Psychosocial interventions are increasingly delivered by nurses in mental health settings. These include psychotherapy interventions, such as cognitive behavioral therapy, family therapy, and other less common interventions, such as environmental therapy or psychodynamic approaches. This intervention can be applied to a variety of issues including psychosis, depression, and anxiety. Nurses will work with people over a period of time and use psychological methods to teach people the psychological techniques they can then use to aid recovery and help manage future crises in their mental health. In practice, this intervention will often be used, along with psychiatric drugs. Psychosocial interventions are based on evidence-based practice, and hence techniques tend to follow established guidelines based on what has been shown to be effective by nursing research. There are some critics that evidence-based practice is focused primarily on quantitative research and should reflect also a more qualitative research approach that seeks to understand the meaning of people's experiences.
Spiritual intervention
The basis of this approach is to look at mental illness or stress from a spiritual crisis perspective. Spiritual interventions focus on developing a sense of meaning, purpose, and hope for people in their current life experience. Spiritual interventions include listening to people's stories and facilitating people to connect with God, greater or greater strength, perhaps by means of meditation or prayer. This may be a religious or non-religious experience depending on the individual's own spirituality. Spiritual intervention, along with psychosocial intervention, emphasizes the importance of engagement; however, spiritual intervention focuses more on caring and 'being with' people during their crisis times, rather than intervening and trying and 'fixing' problems. Spiritual intervention tends to be based on qualitative research and shares some similarities with the humanistic approach to psychotherapy.
Therapeutic relationship
As with other nursing practice areas, mental health psychiatric nursing works in nursing models, utilizes nursing care plans, and seeks to care for all people. However, the emphasis of mental health nursing is on the development of therapeutic alliances. In practice, this means that nurses should strive to engage with people in care in a positive and collaborative way that will empower patients to utilize their inner resources in addition to other treatments they may receive.
aspects of the therapeutic relationship of psychiatric nursing
The most important task of a psychiatric nurse is to maintain a positive therapeutic relationship with the patient in a clinical setting. The basic elements of mental health care revolve around the interpersonal relationships and interactions that exist between professionals and clients. Caring for people with mental illness requires a more intensive presence and a strong desire to support. Dziopa and Ahern emphasize that there are nine critical mental health aspects of psychiatric nursing practice: understanding and empathy, individuality, providing support, being there and available, being sincere, promoting equality, showing respect, showing clear boundaries, and demonstrating. awareness for the patient.
Understand and empathize
The understanding and empathy of the psychiatric nurse strengthens a positive psychological balance for the patient. Giving understanding is important because it provides patients with a sense of importance. Expressions of thoughts and feelings should be encouraged without blame, judgment, or belittling. Feeling important is important to the lives of people living in a structured society, often stigmatizing people who are mentally ill because of their disorders. Empowering patients with important feelings will bring them closer to the normality they have before the onset of their disorder. When suffering a fierce personal attack, psychiatric nurses maintain the desire and ability to understand the patient. The ability to quickly empathize with unfavorable situations proves very important. Involvement is also required when patients expect nursing staff to understand even when they can not express their needs verbally. When a psychiatric nurse gets an understanding of the patient, the opportunity to improve overall care will increase.
Individuality
Individual care becomes important when the nurse needs to know the patient. To undergo this knowledge psychiatric nurses should view patients as individuals with life outside of their mental illness. Seeing people as individuals with life outside their mental illness is a necessity in making patients feel respected and respected. To accept patients as individuals, psychiatric nurses should not be controlled by their own values, or by ideas, and pre-understanding of mental health patients. The individual patient's needs are met by bending the rules of standard intervention and assessment. Psychiatric nurses talk about the potential for 'bending rules', which require interpretation of unit rules, and the ability to evaluate the risks associated with bending them.
Providing support
A successful therapeutic relationship between nurse and patient should be supported positively. Different methods to provide support to patients include many active responses. Small activities, such as shopping, reading a newspaper together, or having lunch or dinner with a patient can improve the quality of support provided. Physical support can also be used and manifested through the use of touch. The patient describes a feeling of connection when the nurse hugs them or puts a hand on their shoulders. Psychiatric nurses in the Berg and Hallberg studies described an element of employment as an entertainer through holding a patient's hand. Patients with depression describe relief when nurses hug them. Physical touch is meant to entertain and entertain patients who are willing to accept this sensation and share the same feelings with nurses.
Be there and available
To make patients feel more comfortable, patient care providers make themselves more approachable, therefore more easily open to different levels of personal connections. Such personal connections have the ability to uplift the patient and maintain confidentiality. The utilization of the quality of time spent with the patient proved to be beneficial. Available in the right amount of time, the patient opens and reveals personal stories, allowing the nurse to understand the meaning behind each story. The result produces nurses who try their best to achieve an unbiased viewpoint. Combinations are there and available allowing empirical connections to quell negative feelings in patients.
Being original
The act of being sincere must come from within and expressed by the nurse without reluctance. Authenticity requires nurses to be natural or authentic in their interactions with patients. In his article on important moments in therapeutic relationships, Welch finds that nurses must fit their values ​​and beliefs. Along with the previous concept, O'Brien concluded that being consistent and reliable both in timeliness and character makes genuitas. Schafer and Peternelj-Taylor believe that nurses' authenticity is determined through the level of consistency displayed between their verbal and non-verbal behaviors. Similarly, Scanlon discovers that authenticity is expressed by fulfilling the intended task. Self-disclosure proves to be the key to being open and honest. It involves nurses sharing life experiences and is essential for the development of therapeutic relationships, because as the relationship grows patients are reluctant to provide more information if they feel the relationship is too one-sided. Many authors find original emotions, such as weeping, blunt feedback, and direct talk facilitate therapeutic relationships in an effort to be open and honest. The friendship of the therapeutic relationship is different from the friendly friendship because the friendship of the therapeutic relationship is not symmetrical. The basic concept of authenticity centers on the truth of one's words. Patients will not believe nurses who fail to fulfill what they say or promise.
Promote equality
In order for a successful therapeutic relationship to form, a favorable reliance between nurse and patient must be established. The insulting views of the patient's role in the clinical setting deteriorate the therapeutic alliance. While patients need nurses to support their recovery, psychiatric nurses require patients to develop skills and experience. Psychiatric nurses declare themselves as team members or relationship facilitators, rather than leaders. By empowering patients with a sense of control and involvement, nurses encourage patient independence. The single control of a particular situation should not be implanted on the nurse. The same interaction occurs when the nurse speaks to the patient one-on-one. Participating in activities that do not make one person more dominant than others, such as talking about mutual interests or luncheon together strengthen the level of commonality shared between professionals and patients. It can also create "the illusion of choice"; provide patient choice, even if limited or limited in structure.
Demonstrating respect
To develop a quality therapeutic relationship, the nurse needs to make the patient feel respected and important. Accepting mistakes and patient problems is essential to convey respect - helping patients see themselves worthy and valuable.
Demonstrate clear limits
Limits are vital to protect patients and nurses, and maintain functional therapeutic relationships. Boundary arrangements help protect patients from embarrassing behavior, and instill patients with feelings of security and detention. Border arrangements also protect nurses from "fatigue", maintaining personal stability - thus enhancing quality relationships.
Demonstrate self-awareness
Psychiatric nurses recognize personal vulnerability to develop professionally. Humanistic insights, basic human values, and self-knowledge increase the depth of self-understanding. Different personalities affect the way psychiatric nurses respond to their patients. The more self-conscious, the more knowledgeable about how to approach the interaction with the patient nurse. The interpersonal skills necessary to form a relationship with the patient are obtained through learning about oneself. Clinical monitoring was found to provide an opportunity for nurses to reflect on patient relationships, to improve clinical skills, and to help repair difficult relationships. Reflections articulated by nurses through clinical supervision help foster self-awareness.
Condition
Canada
The registered psychiatric nurse is a distinct nursing profession in all four western provinces. The nurse carries the designation of "RPN". In Eastern Canada, a psychiatric nursing system is followed. Registered Psychiatric Nurses can also work in all three areas of Canada; though, the registration process for work in the region varies as a psychiatric nurse should be licensed by one of the four provinces.
ireland
In Ireland, mental health nurses undergo a 4-year honors degree training program. Nurses trained under a diploma program in Ireland can undertake postgraduate courses to take their status from diploma to degree.
New Zealand
Mental Health Nursing in New Zealand requires a diploma or degree in nursing. All nurses are now trained in general and mental health, as part of their three-year degree training program. Mental health nurses are often required to complete a postgraduate diploma or post-graduate certificate in mental health, if they are employed by the District Health Board. It provides additional training specifically to work with people with mental health problems.
Swedish
In Sweden, to become a registered psychiatric nurse a person should be a registered nurse who needs a BSc. (Bachelor of Science) in Nursing (three years full-time study, 180 higher education credits). Then, one must complete one year of graduate study in psychiatry/mental health nursing (60 higher education credits), which also includes writing an MSc. (Master of Science) thesis. Registered psychiatric nurses are a growing profession in Sweden. However, unlike in countries like the United States, there are no psychiatric mental health nursing practitioners, so in Sweden, the profession can not for example prescribe pharmacological treatments. Studies show that nurses themselves look forward to such clinical ladder programs to recognize and motivate the continued professional development of their profession. English
In the United Kingdom and Ireland the term psychiatric nurses are now largely superseded by mental health nurses. The mental health nurse undergoes a 3-4 year training program at the undergraduate level, or a 2-year training program at the Masters level, the same as any other nurse. However, most of their training is specialized to care for clients with mental health problems.
RMN may continue to further training as an Advanced Nurse Practitioner (ANP): this requires completion of the 9 month Master's program. This role includes prescribing medicines, becoming a call to hospital wards and providing psychosocial intervention to clients.
AS
In North America, there are three levels of psychiatric nursing.
- The licensed vocational nurse ( practically licensed nurse in some states) and licensed psychiatric technician can take medications and help with collecting data on mental and mental health clients.
- Registered Nurses or registered psychiatric nurses have additional scope for assessment and may provide other therapies such as counseling and environmental therapy.
- Nurses who are enrolled in advanced practice (APRN) either practice as clinical nurse specialists or nursing practitioners after obtaining a master's degree in mental health psychiatric care. Psychiatric-mental health nursing (PMHN) is a nursing specialization. This course works in the master's degree program including specialized practice. APRN assesses, diagnoses, and treats individuals or families with mental problems/disorders or potential interference, as well as performing functions related to basic levels. They provide a range of key mental health care services to individuals, families, groups and communities, serving as psychotherapists, educators, consultants, advanced case managers, and administrators. In many countries, APRN has the authority to prescribe drugs. Qualified to practice independently, the mental health of the APRN offers direct care services in a variety of settings: mental health centers, community mental health programs, homes, offices, HMOs, etc.
Psychiatric nurses who get a doctorate (PhD, DNSc, EdD) are often found in practice settings, teaching, conducting research, or as administrators in hospitals, institutions or nursing schools.
Australia
In Australia, to become a psychiatric nurse, a nursing degree must be obtained to become a registered nurse (RN) and this degree takes 3 years full time. Then a diploma in mental health or something similar should also be obtained, this is an additional year of learning. Australian psychiatric nurses have tasks that may include assessing a mentally ill patient, observing, helping the patient take part in activities, providing medication, observing whether the drug is working, assisting in a behavior change program or visiting a patient at home. Australian nurses may work in public or private hospitals, institutes, prisons, mental care facilities and patient homes.
See also
- List of counseling topics
- Professional mental health
- Psychiatric and mental health Nurse Practitioners
- Hildegard Peplau - the psychiatrist nurse theorist
- Tidal Model - a model developed for mental health nursing
References
External links
Source of the article : Wikipedia
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