nursing as a profession began to emerge in the late nineteenth century, and by the twentieth century...
TRANSCRIPT
Nursing as a profession began to emerge
in the late nineteenth century, and by the
twentieth century it had evolved in to a
specialty with unique roles and functions.
The role of psychiatric nursing began to emerge in the early 1950s. In 1947 was published an article in the AJN that reemphasized the shortage of psychiatric nurses and outlined the difference between psychiatric and general duty nurses.
ROLE EMERGENCEROLE EMERGENCE ….
An article by Bennet and Eaton in the American Journal of Psychiatry in 1951 identified the following 3 problems affecting psychiatric nurses:
• The scarcity of qualified psychiatric nurses.
• The under use of their abilities
• The fact that “very little real psychiatric nursing is carried out.
In 1952 Peplau published a book, Interpersonal relationship in nursing, in which she described the skills, activities and role of psychiatric nurses.
StrangerStranger The role assumed by both nurse and patient when The role assumed by both nurse and patient when they first meet.they first meet.
Resource Resource personperson
Provides health information to a patient who has Provides health information to a patient who has assumed consumer role.assumed consumer role.
TeacherTeacher Helps the patient to grow and learn from experience Helps the patient to grow and learn from experience with the health care systemwith the health care system
LeaderLeader Helps the patient to participate in a democratically Helps the patient to participate in a democratically implemented nursing process.implemented nursing process.
SurrogateSurrogate Assumes roles that have been assigned by the Assumes roles that have been assigned by the patient, based on significant past relationship, as in patient, based on significant past relationship, as in the psychoanalytical phenomenon of transference.the psychoanalytical phenomenon of transference.
CounselorCounselor Helps the patient integrate the facts and feelings Helps the patient integrate the facts and feelings associated with an episode of illness.associated with an episode of illness.
ROLE EMERGENCEROLE EMERGENCE ….
Two significant developments in psychiatry in the 1950s also affected nursing’s role for years to come. The first was Jone’s publication of the therapeutic community. A new treatment method in psychiatry in 1953.
Therapeutic communities became the preferred
environmental for psychiatric patients.
The second significant development in psychiatry in the
early 1950s was the use of psychotropic drugs. With these
drugs more patients became treatable and fewer environmental
constraints such as locked doors and strait jackets were
required.
EVOLVING FUNCTIONS:
In 1958 the following functions of psychiatric nurses were described (Hays, 1975)
• Dealing with patient’s problems of attitude, mood and interpretation of reality.
• Exploring, disturbing and conflicting thoughts and feelings.
• Using the patient’s positive feelings toward the therapist to bring about psycho physiological homeostasis.
• Counseling patients in emergencies, including panic and fear.
• Strengthening the well part of patients.
EVOLVING FUNCTIONS….
In the 1960s the focus of psychiatric nursing began
to shift to primary prevention and implementation of
care and consultation in the community.
Representative of these changes was the shift in the
name of the field from psychiatric nursing to
psychiatric and mental health nursing. This focus
was stimulated by the community mental health
centers Act of 1963.
Poverty affects all the cultural groups and also other groups including the elderly, the disabled, the psychiatrically impaired and single – parent families. Families living in poverty are undergone tremendous financial and emotional stress that can often trigger or exacerbate mental problems.
GEOGRAPHIC LOCATION AND ACCESS TO MENTAL
HEALTH CARE
Most mental health services are located in urban areas
because the majority of the people live near cities. All age
groups in rural areas have limited access to health care. The lack
of resources is particularly problematic for children and the elderly
who have specialised needs. Study showed t hat t he rural areas
had a higher prevalence of alcohol and drug abuse or
dependence.
CHANGING FAMILY STRUCTURE :
Traditionally families have been a source of guidance security love and understanding.
The family has undergone some radical changes in the past half a century. Its structure has changes, its functions have been altered and its nature has been affected. In almost all the modern families there is a lack of trust between the husband and wife, also between the parent and children.
Women’s role has hanged drastically in the family structure over the past 25 years. Working women still bear the bulk of responsibility for child care and household duties and often feel guilty and stressed from trying to do everything be a good parent and be successful at a demanding job.
MOBILITY AND RELOCATION:
Families commonly relocate geographically
in search of better employment opportunities or
for life style changes. Such relocations are
stressful to families who must leave familiar
environments and readjust to new environments
and life style.
In the past one – parent families were usually the result of the death of a spouse. Now, one – parent families are mostly the result of divorce. Of all children in one parent homes, 88% live with their mother.
STEP FAMILIES:
In a step family, problems in relations between
step parents and children may generate tension and
the difficulties can be especially great in the marriage
of single parents when the c children of both parents
live with them as siblings.
ENVIRONMENTAL INFLUENCES:
Non genetic and non – biological factors also play important mediating roles in the transmission of risk and resilience to psychiatric diagnosis (Silverman 1989). Most notably, these include parenting behavior, martial or partner relationship and family functioning.
Such parenting styles may influence the development of maladaptive coping styles and interpersonal skills associated with depression and anxiety in children.
HEALTH CARE The delivery of a populations health care varies with the culture. The more developed nations of the world have complex systems for providing health care for their citizens.
MENTAL; HEALTH CARE IN CANADA:
By the late 1960s “comprehensive government administered health insurance plans were established in all provinces of Canada.” Today a “single payer arrangement” is used in the Canadean health care system, which is based on five guiding principles.
1. Universality
2. Portability
3. Accessibility
4. Comprehensiveness.
5. Public administration
MENTAL HEALTH CARE IN GREAT BRITAIN:
All British citizens are provided health care through a
government managed national health care system. T he secretary
for social services is responsible for setting fees for private e
physicians, budgets for hospitals and salaries for hospital
physicians.
MENTAL HEALTH CARE IN U.S.:
Health care in U.S. is based on the private insurance
model. By the late 1970s many employers provided insurance, w
which included coverage for mental health care, for t heir
employees.
DEVELOPMENT OF PSYCHIATRIC NURISNG IN INDIA
1. Health committee’s report in 1946 recommended preparation of nursing personnel in psychiatric nursing
In 1956 a one year post certificate course in psychiatric nursing started at NIMHN’S Bangalore
2. Based on recommendations of the Mudaliar’s committee (1964)
INC included psychiatric nursing as a compulsory course in B.Sc Nursing
3. In 1975 started MSc Nursing in Psychiatric nursing at RAK in New Delhi
COMMUNITY SUPPORT SYSTEM MODEL
For mentally ill people to function well within their communities, a wide range of support services is necessaryA typical programme may co-ordinate such services as health care, housing, food, income support, rehabilitation advocacy and crisis response.