Unit One: Role of the Psychiatric/Mental Health Nurse
Scope of the Problem
How many people ages 15 – 54 had a psychiatric or substance abuse disorder in their lifetime?
Name the top three medical morbidities in the developed world:
How many of the 15 leading causes of disability in developed countries are mental problems?
25% affected in a year
1 in 5 children in U.S.
18 million in U.S. have problem with etoh
23 million in U.S. use illicit drugs
2/3 of nursing home residents
30% jails hold people but not charged with crime
4 Major Depression
6 Angioplasty: 41 %
Objective 1: Discuss the historical evolution of role of the psychiatric/mental health nurse as a member of the nursing profession.
Psychiatric Nursing A Historical Evolution (pg 2-4) – see timeline pg 3
1873 - Linda Richards
1950 - Accreditation to include psychiatric nursing in curriculum
1973 - ANA publishes “Standards of Psychiatric-Mental Health Nursing”
Evolution of multiple roles for nursing in various aspects of psychiatric nursing
Evolving Functions & Roles (pg 5-6)
1950’s - Hildegard Peplau – Mother of Psychiatric Nursing
Nursing as a therapeutic process
1 Attitudes, mood & reality testing
2 Explore disturbing thoughts & emotion
3 Provide support & use of self to improve therapeutic homeostasis
Driving Factors in Psychiatric Nursing
4 Imaging technologies
5 Genetic decoding of neurotransmitter & receptor mechanics
6 Psychobiology of emotion
7 Consumer demand
Psychiatric Nursing Challenges
2 Realignment of care and caring
4 Refocus the balance on
6 Caring while integrating biological and behavioral concepts into practice
Contemporary Practice (pg 6-10)
Definition of psychiatric nursing: (from book): pg 6
4 An interpersonal process that promotes and maintains patient behavior that contributes to integrated functioning
6 ANA Scope & Standards of Psychiatric-Mental Health Nursing Practice defines psychiatric nursing as “a specialized are of nursing practice, employing the wide range of explanatory theories of human behavior as its science and purposeful use of self as its art”
8 The Center for Mental Health Services officially recognizes psychiatric nursing as “One of five core mental health disciplines “
9 Philosophical beliefs of nursing practice – see box 1-3 page 7
11 Nurse – patient partnership
Continuum of Care (pg 8)
2 Psychiatric facilities & Forensic Units
3 Community mental health centers
4 Psychiatric units in general hospitals
5 Residential facilities
6 Private practice
7 Primary care, Ob /Gyn, ED . . .
Objective 3: Identify how nursing knowledge of cultural diversity affects the role of the nurse as provider and manager of care.
- Describe the term “competent caring”.
Competent Caring (see box 1-4 page 9)
Three domains of practice of psychiatric nurses
4 Direct care
Other types of psychiatric nurse activities:
▪ Biopsychosocial assessments
▪ Treatment plans
▪ Integration of services
▪ Health Care Map
Qualifications (pg 10-11)
Entry level – RN & certification
Advanced Level – MSN, APRN, Ph.D
Cultural Competency (pg 121 – Ch 8)
Attitudes & behaviors about others...
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