introduction to psychiatric-mental health nursing

Introduction to

Psychiatric-Mental

Health NursingChapter 1

Lecturer: Jomar D. Devano, R.N.

BASIC CONCEPTS OF PSYCHIATRIC-MENTAL HEALTH NURSING

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7TH Edition

Author:LOUISE REBRACA SHIVES

PSYCHIATRIC-MENTAL HEALTH NURSING

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4TH Edition

Author:SHEILA L. VIDEBECK

Psychiatric Nursing it is a specialized area of nursing practice that uses

theories of human behavior as its scientific framework and requires the purposeful use of self as its art of expression.

involves the diagnosis and treatment of human responses to actual or potential mental health problems.

it is concerned with promoting optimum health for society – focusing on prevention of mental illness, health maintenance, manangement of or referral of mental and physical health problems, diagnosis and treatment of mental disorders, and rehabilitation.

Historical Development of Psychiatric-Mental Health Nursing

Primitive Era people believed spirits possesed the body and had to be driven away to effect a cure.

sickness indicated displeasure of the gods and was punishment for sins and wrongdoings.

Before Christ (B.C.) the Greeks, Romans, and Arabs believed emotional disorders were an organic dysfunction of the brain.

Hippocrates: proposed that mental illness was a disturbance of four body fluids, or “humors” – heat, cold, dryness and moisture.

Before Christ (B.C.)

Galen: emotional or mental disorders were associated with the brain.

Aristotle: concluded that the mind was associated with the heart.

Middle ages mentally ill people

were excluded and confined away from society – lunatics, witches, or demons possessed by evil spirits.

Before 1773

Bethlehem Royal Hospital, England (1403) – 1st mental hospital

Historical Development of Psychiatric Nursing (Peplau, 1956) Phase 1: The Emergence of Psychiatric-Mental Health Nursing

(1773-1881)

Phase 2: Development of the Work Role of the Nurse in Psychiatric-Mental Health Facilities (1882-1914)

Phase 3: Development of Undergraduate Psychiatric-Mental Health Nursing Education (1915-1935)

Phase 4: Development of Graduate Psychiatric-Mental health Nursing Education (1936-1945)

Phase 5: Develpoment of Consultation and Research in Psychaitric-Mental Health Practice (1946-1956)

Phase 1: The Emergence of Psychiatric-Mental Health Nursing (1773-1881)

identification of special institutions for individuals with psychiatric disorders – Eastern Lunatic Hospital, Williamsburg, Virginia.

Benjamin Rush: the father of American Psychiatry, wrote the 1st textbook on psychiatry.

Johann Weyer: first psychiatrist.

Phase 1: The Emergence of Psychiatric-Mental Health Nursing (1773-1881)

Dorothea Lynde Dix: devoted her life to the cause of building state mental hospitals and helped improved the humane treatment of mentally ill people.

Emil Kraepelin (1856 to 1929) differentiated manic-depression psychosis from schizophrenia and stated that schizophrenia was incurable.

Sigmund Freud (1856 to 1939) introduced psychoanalytic theory and therapy.

Phase 1: The Emergence of Psychiatric-Mental Health Nursing (1773-1881)

Eugene Bleuler (1857 to 1939) described the psychotic disorder of schizophrenia.

Alfred Adler (1870 to 1937) focused on the area of psychosomatic medicine, referring to organ inferiority as the causative factor.

Carl Jung (1875 to 1961) described the human psyche as consisting of a social mask (persona), hidden personal characteristics (shadow), feminine identification in men (anima), masculine identification in women (animus), and the innermost center of the personality (self).

Phase 2: Development of the Work Role of the Nurse in Psychiatric-Mental Health

Facilities (1882-1914) McLean Hospital, Belmont Massachusetts (1882) –

established the first training school for nurses in the psychiatric setting.

(1890) trained nurses were employed on nursing staff of state mental hospitals.

Annie Payson Call (1891) wrote the first psychiatric literature by a psychiatric nurse.

Mary E. May (1899) wrote the first paper about the work of a nurse in a psychiatric facility: The Work of Nursing the Insane.

Phase 2: Development of the Work Role of the Nurse in Psychiatric-Mental Health

Facilities (1882-1914)

Effie Jayne Taylor: first professor of psychiatric nursing and outlined the curriculum of the undergraduate psychiatric nursing program at Johns Hopkin’s Phipps Psychiatric Clinic.

Phase 3: Development of Undergraduate Psychiatric-

Mental Health Nursing Education (1915-1935)

Linda Richards (1915) first graduate nurse in the US - “first American psychiatric nurse”.

Journals published and textbooks focusing on psychiatric nursing were written.

Harriet Bailey (1920) – wrote the first textbook of psychiatric nursing: Nursing Mental Diseases.

new treatment approaches were introduced: electroconvulsive therapy (ECT).

Phase 4: Development of Graduate Psychiatric-Mental Health Nursing

Education (1936-1945)

(1937) clinical experiences in psychiatric hospitals were standardized:

students were given the opportunity to care for patients with varying degrees of mental disorders including organic origin.

(1939) approximately half of the nursing schools

provided psychiatric nursing courses for students.

(1955) psychiatric nursing became a requirement for licensure.

Phase 4: Development of Graduate Psychiatric-Mental Health Nursing

Education (1936-1945)

National League of Nursing Education developed curriculum guidelines for graduate education: 60 to 80 hours of theoretical instruction,

and 12 to 16 weeks of clinical experience.

Phase 5: Development of Consultation and Research in Psychiatric-Mental

Health Practice (1946-1956)

passage of Mental Health Act of 1946.

Helen Render (1947) wrote Nurse-Patient Relationships in Psychiatry.

(1956) National League of Nursing Education formed a committee to review and revised a proposed guide for the development of an advanced clinical course in psychiatric nursing.

Brown Report: stressed that the interest in the field of psychiatry should be stimulated to facilitate research focusing on the prevention and cure of mental illness.

1956 and beyond. Phenothiazines and other major tranquilizers

were developed and used to treat the major symptoms of pyschoses.

(1963) the Community Mental Health Act authorized funding for the establishment of community health centers to provide services to the public.

20th Century - Psychiatric nursing began to evolve as a clinical specialty.

Standards of Psychiatric-Mental Health Clinical Nursing Practice

Standards authoritative statements used by the nursing

profession to describe the responsbilities for which nurses are accountable.

provides direction for professional nursing practice and a fremework for evaluation of practice.

defines the nursing profession’s accountability to the public and the client outcomes for which nurses are responsible.

Scope and Standards of Psychiatric-Mental Health Nursing Practice (ANA,

2000)

STANDARDS OF CAREStandard I. AssessmentStandard II. DiagnosisStandard III. Outcome IdentificationStandard IV. PlanningStandard V. Implementation

Standard Va. CounselingStandard Vb. Millieu TherapyStandard Vc. Promotion of Self-care ActivitiesStandard Vd. Psychobiologic Interventions

Scope and Standards of Psychiatric-Mental Health Nursing Practice (ANA,

2000)

Standard Ve. Health TeachingStandard Vf. Case ManagementStandard Vg. Health Promotion and Health

Maintenance

Advance Practice Intevention Vh-Vj: (APRN-PMH)Standard Vh. PsychotherapyStandard Vi. Prespective Authority and TreatmentStandard Vj. Consulation

Scope and Standards of Psychiatric-Mental Health Nursing Practice (ANA,

2000)

Standard VI. Evaluation

STANDARDS OF PROFESSIONAL PERFORMANCEStandard I. Quality of CareStandard II. Performance AppraisalStandard III. EducationStandard IV. CollegialityStandard V. EthicsStandard VI. CollaborationStandard VII. ResearchStandard VIII. Resource Utilization

Psychiatric-Mental Health Nursing Today

Use of Psychiatric-Mental Health Nursing Skills in Career Opportunities

Obstetric Nursing helping the mother in labor and support person

cope with anxiety or stress during labor and delivery.

providing support to bereaved parents in the event of fetal demise, inevitable abortion, or the birth of an infant with congenital anomalies.

providing support to a mother considering whether to keep her child or give the child up for adoption.

Use of Psychiatric-Mental Health Nursing Skills in Career Opportunities

Forensic Nursing providing services to incarcerated

clients. acting as a consultant to medical and

legal agencies. serving as an expert witness in court. providing support for victims of violent

crime.

Use of Psychiatric-Mental Health Nursing Skills in Career Opportunities

Oncologic Nursing helping cancer patients or other

terminally ill individuals on oncology units work through the grieving process.

providing support groups for families or terminally ill individuals on oncology units through the grieving process.

Use of Psychiatric-Mental Health Nursing Skills in Career Opportunities

Industrial (Occupational Health) Nursing implementing or participating in industrial substance

abuse programs for employees and thier families. providing crisis intervention during an industrial

accident or the acute onset of a physical or mental illness.

teaching stress management.

Public Health Nursing assessing the person both physically and

psychologically.

Use of Psychiatric-Mental Health Nursing Skills in Career Opportunities

Office Nursing assisting the client by explaining somatic or

emotional concerns during assessment. providing support with the problem-solving

process when people call the office and the physician is unavailable.

acting as a community resource person.

Emergency Room Nursing providing crisis intervention as the need arises.

Introduction to

Psychiatric-Mental

Health NursingChapter 1

Lecturer: Jomar D. Devano, R.N.