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Introduction to Psychiatric Mental Health Nursing Chapter 1

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Psychiatric / Mental Health Nursing Introduction to Psychiatric Mental Health Nursing Chapter 1 & 2 West Coast University NURS 204 – PowerPoint PPT presentation

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Title: Introduction to Psychiatric Mental Health Nursing Chapter 1


1
Introduction to Psychiatric Mental Health
Nursing Chapter 1 2
Psychiatric / Mental Health Nursing
  • West Coast University
  • NURS 204

2
Caring for Psychiatric Mental Health Clients
  • Feelings, Concerns, QuestionsWhat Are
    They?

3
Factors Influencing Expectations
Media
Other?
Upbringing
Expectations
Life experiences
Culture
4
Psychiatric Mental Health Clients
  • Psychiatric mental health clients are everyday,
    ordinary people.

5
Factors Impacting Mental Health and Mental Illness
Biological
Mental Illness
or
Mental
Health
Social
Cultural
6
Mental Disorder Characteristics
  • Distress
  • Disability
  • Risk

7
DSM-IV-TR
  • Identifies
  • Standardizes
  • Categorizes

8
Deviance
  • Is it bad?
  • Bizarre in one cultural context acceptable in
    another?
  • Deviant political, religious, or sexual behavior
  • Mental disorder- yes or no?

9
What do these terms mean?
Crazy?
Berserk?
Wacky?
Insane?
Weird?
Lunacy?
Nervous Breakdown?
Melancholy?
10
History
  • Understanding and approaches to madness
    throughout history were influenced by
  • Social attitudes
  • Philosophic viewpoints

11
Historical Approaches
  • Era of Magico-Religious Explanations
  • Superhuman forces
  • Violation of taboos
  • Neglect of rituals
  • Loss of soul
  • Witchcraft
  • Era of Organic Explanations
  • Imbalance in the bodys humors (Hippocrates, 4th
    century BCE)
  • Era of Alienation
  • Social exclusion
  • Imprisonment
  • Ships of fools
  • Lunacy
  • The exception Arab belief was that the insane
    were divinely inspired.

12
A ward in Bethlehem Hospital about 1745. A
patient is being chained in the foreground, and
in the background are two Sunday visitors on an
entertainment outing. Source Philosophical
Library.
13
Historical Approaches - continued
  • Era of Confinement
  • Confined
  • Beaten and tortured
  • Enormous asylums
  • Hôpital Général
  • St. Mary of Bethlehem
  • Era of Moral Treatment
  • Emergence of reform
  • Reform leaders
  • William Cullen
  • Philippe Pinel
  • William Tuke
  • Benjamin Franklin
  • Benjamin Rush Father of American Psychiatry

14
Historical Approaches - continued
  • Era of Psychoanalysis
  • Sigmund Freud
  • Contemporary Developments
  • Social dimensions
  • Brain dysfunction
  • Neurochemical
  • Medication therapy

15
21st Century Research
  • Bases for mental disorders
  • Psychotropic medications
  • Role of nutrients, biology, and genetics

16
Mental Disorder Statistics
  • High incidence with physical illness
  • Account for 47 of all disability in economically
    developed countries
  • Account for 28 of all disability worldwide

17
Prevalence Rates for Various Mental Disorders
18
Leading Causes of Mental Disability Worldwide
19
Mental Health Studies
  • Epidemiologic Catchment Area (ECA)
  • Global Burden of Disease (WHO)
  • U.S. Surgeon Generals Report
  • Healthy People 2010

20
Healthy People 2010
  • Adolescent suicide rate
  • Homeless adults with serious mental illness (SMI)
  • Relapse with eating disorders
  • Mental health screening
  • Treatment issues Children and adults

21
Healthy People 2010 - continued
  • Screening in juvenile justice
  • Jail diversion programs for SMI
  • Cultural competence issues
  • Services for older adults crisis intervention,
    screening, treatment
  • Employee stress in the workplace

22
Psychiatric-Mental Health Nurses
  • What do they do?

Chapter 2
23
Psychiatric-Mental Health Nurses - continued
  • Psychiatric-mental health nursing promotes mental
    health through
  • Assessment, diagnosis, and treatment of human
    responses to mental health problems and
    psychiatric disorders (ANA, APNA, ISPN, 2007)

24
Standards
  • Standards of Psychiatric-Mental Health Nursing
    Practice
  • Guidelines for providing quality care
  • Psychiatric-Mental Health Nursing Standards of
    Practice
  • Assessment
  • Diagnosis
  • Outcomes Identification
  • Planning

25
Standards - continued
  • Psychiatric-Mental Health Nursing Standards of
    Practice
  • Implementation
  • Coordination of Care
  • Health Teaching and Health Promotion
  • Milieu Therapy
  • Phamacological, Biological, and Integrative
    Therapies
  • Prescriptive Authority and Treatment (APRN only)
  • Psychotherapy (APRN only)
  • Consultation (APRN only)
  • Evaluation

26
PsychiatricMental Health Nursing Standards of
Practice
27
Standards - continued
  • Standards of Professional Performance
  • Quality of Practice
  • Education
  • Professional Practice Evaluation
  • Collegiality
  • Collaboration
  • Ethics
  • Research
  • Resource Utilization
  • Leadership

28
PsychiatricMental Health Nursing Standards of
Professional Performance
29
Psychiatric-Mental Health Nurses
  • Generalist level
  • Advanced practice level
  • Prescriptive authority
  • Psychotherapy
  • Consultation

30
The Psychiatric-Mental Health Team
  • Psychiatric-mental health nurse
  • Psychiatrist
  • Clinical psychologist
  • Psychiatric social worker
  • Marriage and family therapist
  • Occupational therapist
  • Recreational therapist
  • Creative arts therapist
  • Psychosocial rehabilitation worker

31
Estimated Number of Mental Health Workers in the
United States
32
The Mental Health Team
33
Effective Mental Health Services
Client
Partnerships
PMH Team
Family
34
Lessons on Collaboration
  • Know thyself
  • Value diversity
  • Know that conflict is natural
  • Share your power with others
  • Master communication skills
  • Think life-long learning.
  • Embrace interdisciplinary situations.
  • Appreciate spontaneity.
  • Balance unity with autonomy.

35
The Role of the Psychiatric-Mental Health Nurse
Multifaceted
Custodial
36
Early Psychiatric-Mental Health Nursing (19th
century)
  • First school of nursing
  • Florence Nightingales thoughts
  • American nursing schools
  • First American psychiatric nurse
  • Single-focused training schools
  • Custodial, mechanistic, directed by psychiatrists

37
Psychiatric-Mental Health Nursing (1900-1940)
  • Psychiatric nursing curricula
  • Psychiatric nursing texts
  • Single-focus psychiatric nursing schools

38
Psychiatric-Mental Health Nursing (1940-1990)
  • Nurses begin to educate nurses.
  • Psychiatric theory includes interpersonal and
    emotional dimensions.
  • National Mental Health Act of 1946
  • Elimination of single-focus psychiatric nursing
    schools
  • Period of role clarification
  • Hildegard Peplau
  • Gwen Tudor
  • Frances Sleeper
  • Community Mental Health Centers Act of 1963
  • Psychiatric nursing journals

39
Psychiatric-Mental Health Nursing (1940-1990) -
continued
  • Birth of clinical nurse specialists and nurse
    therapist role
  • First standards of psychiatric-mental health
    nursing practice
  • Increase role of nurses at national level
  • Shift in psychiatric nursing toward humanistic
    interactionism
  • Decrease in numbers of psychiatric nurses
  • Decreased funding for training
  • Psychiatric nursing diagnoses

40
Psychiatric-Mental Health Nursing (1990s) -
Decade of the Brain
  • Psychobiologic concepts
  • Nursing Psychopharmacology Project
  • Health care delivery reform
  • Outcome-based research
  • Cultural diversity
  • Integration of theoretical perspectives

41
Psychiatric-Mental Health Nursing (2000s) - The
New Millennium
  • Standards of practice revisions
  • Knowledge explosion
  • Renewed focus on physical health
  • Single point of entry
  • Advanced practice nurses
  • Expansion of practice settings

42
Nursing Theories
  • Assist nurses to
  • Organize assessment data
  • Identify problems
  • Plan interventions
  • Generate goals and actions
  • Evaluate outcomes

43
Nursing Theories Impacting Psychiatric Nursing
  • Hildegard Peplau
  • Dorothea Orem
  • Martha Rogers
  • Sister Callista Roy
  • Ida Jean Orlando
  • Ernestine Wiedenbach
  • Joyce Travelbee
  • Paterson and Zderad
  • Jean Watson
  • Patricia Benner

44
Nursing Theories - Value
  • Nursing practice vs. medical practice
  • Caring vs. curing
  • Interpretation of meaning
  • Nurse-client relationship
  • Advocacy of client dignity
  • Advocacy of nurse authenticity

45
Application of Theoretical Frameworks
  • Application of various theoretical frameworks
    leads to
  • Quality client-centered care.
  • Efficient use of resources.
  • Practice-oriented research.
  • Clinical judgments and actions that can be
    articulated and taught to others.
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