The psychiatric nurse and the 'appropriate adult'

This paper identifies a role for the mental health nurse in the 'Appropriate Adult Scheme'. It discusses how the unique skills of the mental health nurse could be utilized in this role but also the problems and objections associated with this potential development.     

What is Good Mental Health Nursing? A Survey of Irish Nurses

The practice, theory, and preparation associated with nursing people with mental health issues has changed in profound ways in recent decades. This has in part been reflected by a shift in nurses identifying as being mental health rather than psychiatric nurses. Context, theory, and values shape what it means to be a mental health nurse. Thirty experienced mental health nurses in Ireland completed a survey on what good mental health nursing is and a definition induced from their responses. Mental health nursing is a professional, client-centered, goal-directed activity based on sound evidence, focused on the growth, development, and recovery of people with complex mental health needs. It involves caring, empathic, insightful, and respectful nurses using interpersonal skills to draw upon and develop the personal resources of individuals and to facilitate change in partnership with the individual and in collaboration with friends, family, and the health care team. This appears to encapsulate the best of what it meant to be a psychiatric nurse, but challenges remain regarding how to reconcile or whether to discard coercive practices incompatible with mental health nursing.     

The future of the psychiatric mental health clinical nurse specialist: evolution or extinction

The role of the psychiatric mental health clinical nurse specialist (PMHCNS) is now in a precarious position. At first glance, some may say it is on the verge of extinction. In this article, a brief history of the role of the PMHCNS is reviewed along with current education, practice, role, and American Nurses Credentialing Center certification of the PMHCNS. The future implications and considerations of the unique functions of the PMHCNS for an advanced practice registered nurse with a psychiatric mental health specialization are discussed.     

Insight: a mental health prevention intervention

Modern health care systems are grasping the financial benefit of illness prevention programs. In mental illness prevention, psychiatric and mental health nurses are challenged to demonstrate efficacy in meeting the needs of the public and maintaining its position as one of the core mental health professions. The Center of Advanced Nursing Practice's Evidence-Based Practice Model provided the framework for guiding a pilot study intervention program, Insight, that facilitated a depression prevention program for women by an advanced practice nurse. Preliminary findings support the efficacy of Insight in a community setting and with program modifications.     

The role of the psychiatric nurse in a community substance abuse prevention program

There is an increasing awareness of the need for prevention of substance abuse related problems. The psychiatric nurse is especially equipped to strengthen the bonds among citizens and parents, health agencies and schools, law enforcement and hospitals to assist the community in the design and implementation of its own prevention program. The nurse is able to facilitate the community's own vested interests in a manner congruent with its needs. The nature and scope of nursing practice have traditionally included responses to health-conducive behavior. The nurse emphasizes self-determination and choice in health matters; therefore, substance abuse prevention efforts are likely to be incorporated by the community. The nurse provides the knowledge of addiction and abuse and assists the community in its health enhancement by using addiction and nursing theory, interpersonal process, research competencies, and teaching skills.     

Mental Health Needs of Children in School Role of the Child Psychiatric Mental Health Nurse

This article addresses the mental health needs of children in the school system. Children are often exposed to situations in their lives that affect their ability to master developmental and academic tasks resulting in school difficulties. The school system has the opportunity to provide primary prevention and early intervention that will promote the mental health of children. The role of the child psychiatric mental health nurse in the school is described as one model for promoting the mental health of children.     

The role of the psychiatric consultation-liaison nurse in the general hospital.

The mainstreaming of psychiatric services has increased the amount of contact nurses have with clients experiencing mental health problems within the general hospital environment. A review of the literature suggests that general nurses find themselves lacking in the skills, confidence and knowledge to care adequately for these patients. The aim of this paper is to discuss the potential contribution of the psychiatric consultation-liaison nurse in addressing such problems in order to improve health outcomes for patients experiencing mental health problems. While a number of positions for Psychiatric Consultation-Liaison Nurses are being created throughout Australia, there is a paucity of literature relating to the development of this important role. This paper is intended to contribute to the advancement of a body of knowledge in this area.     

The role of the nurse practitioner in psychiatric/mental health nursing: exploring consumer satisfaction

There is a substantial body of literature pertaining to the role of the nurse practitioner. Research directed towards consumer satisfaction suggests that the care provided by nurse practitioners is perceived as at least equal to that provided by a medical practitioner. However, there is a paucity of literature examining the nurse practitioner role in the psychiatric/mental health field. An evaluation of a Nurse Practitioner demonstration model has recently been undertaken in the Crisis, Assessment and Treatment Team in Victoria, Australia. This article presents the findings of a qualitative, exploratory study. Individual interviews were conducted with consumers (n = 7) who had received care and treatment provided by the nurse practitioner candidate. Data analysis revealed two main themes: the quality of the service provided, and the unique role of the nurse. The findings supported the available literature in articulating the specific aspects of the nurse practitioner role that are favourably perceived by consumers of services. This study contributes to the limited body of knowledge in the psychiatric/mental health nursing field and specifically emphasizes the importance of the relationship between nurse practitioner and consumer in facilitating the provision of effective care and treatment.     

精神科护士心理状况调查及对策

应用症状自评量表（ＳＣＬ－９０）对１４０名精神科护士进行调查评定,并以中国成人常模作比较。结果显示：精神科护士心理问题阳性率明显高于常模。精神科护士较多的心理问题与其工作对象、工作风险、工作压力等有关。为减少精神科护士心理问题的发生率,提高精神科护士心理健康水平,稳定护理队伍,提高护理质量,提出了相应对策     

The implementation of a mental health nursing clinical course in a rehabilitation setting

Locating clinical sites for psychiatric/mental health nursing students had become increasingly difficult due to deinstitutionalization of mental health patients. The rehabilitation setting provides a unique opportunity for student nurses to learn about adjustment to disability and other psychosocial issues related to disability. A clinical course was developed and implemented by two rehabilitation clinical nurse specialists at a 55-bed regional rehabilitation center at the request of an associate degree nursing program. The clinical course helped nursing students meet the requirements for their psychiatric/mental health nursing course. The objectives and content for the clinical course are described in this paper. Implementation of the course was successful and the program has been repeated for three years.     

Counselling and mental health nursing: a qualitative study

The author draws upon his experience of training, practising and teaching both counselling and mental health nursing in order to examine the relevance of counselling skills training to mental health nurses. The qualitative study reported in this paper elicits the feelings and thoughts of five mental health nurses about their attitude towards individual counselling work with mental health clients. It is asserted that newly qualified mental health nurses may feel inadequately prepared for this aspect of their work and they may also feel inadequately supported. Additional counselling training may help equip mental health nurses for the skills they need to work within the therapeutic relationship. By not providing adequate counselling skills training, mental health nurse educators may contribute to a cycle of incompetence. Training methods are identified that may enhance nurse training and help promote competence and confidence for the newly qualified nurse.     

The die has been cast? Rediscovering the essence of psychiatric nursing

Examination of the international literature that focuses on the historical 'developments' in psychiatric nursing shows a 'back and forth' shift in emphasis from interpersonal/therapy-based models to a concentration on pathophysiology, pharmacology and biological causation. Within this context, a number of ontological questions appear with conspicuous regularity and these are worthwhile considerations as they are tied to the very nature of psychiatric nursing. Examination of the relevant literature reflects this historical duality and indicates the existence of (at least) two versions of psychiatric nurse, each with a distinct emphasis. Given this documented duality, it is the duty of each nurse to ask themselves: What type of psychiatric nurse am I? What type do I want to be and what type would I want participating in the care of someone I love? Consequently, this article draws on bodies of literature pertaining to the extent of mental health problems, the views of mental health service users, and the different types of psychiatric nurse, in order to assist nurses in considering these questions. In the light of the clear emphasis evident within contemporary mental health policy and psychiatric nursing curricula, the article concludes that it may not be possible to reconcile the activities associated with both types of psychiatric nurse.     

Identifying the mental health needs of preschool children.

The city of Chicago offers publicly funded preschool education to 20,000 3- and 4-year-olds through its State Pre-Kindergarten program. The students attend some 300 schools, and their health needs are monitored by 11 nurses and 8 aides. In the last several years, the nursing coordinator recognized the need to improve the mental health assessment skills of the school nurses. To that end, a relationship was developed with a child psychiatric nurse who had expertise in assessing young children's behaviors, particularly in the context of the classroom milieu. The collaboration of the school nurse and mental health nurse-consultant was structured as one-on-one sessions, each focusing on a particular child. A case is presented to illustrate the assessment method and accompanying suggestions for early intervention strategies. The case also points out how school nurses can structure assessments of at-risk children that lead to classroom-based interventions.     

Home health care's unique role in serving the elderly mentally ill

Psychiatric home health services are a viable option for providing essential treatment to elderly clients having major mental disorders or acute psychiatric problems secondary to a medical illness. This valuable adjunct to in-home treatment can be provided by psychiatric mental health nurse specialists who work collaboratively with other mental health disciplines. If a home health agency does not have a psychiatric treatment component, it can expand its services by hiring a qualified psychiatric nurse and educating its interdisciplinary staff in the appropriate care of mentally ill clients. Referrals can be obtained from facilities for acute psychiatric disorders, psychiatrists, general hospitals, outpatient clinics, and patients themselves or their families. This important service can benefit acutely ill psychiatric patients by enabling them to be discharged from inpatient settings sooner and treated comfortably in the less restrictive environment of their home while receiving appropriate and adequate follow-up and referral. As such, it is cost-efficient to the client and society and represents the community-based care of the future for the mentally ill.     

Recruiting licensed staff in mental health.

This 4- to 6-month mental health internship program for new graduates vocational nurses (GVNs) involves a 4-month mental health course, a new graduate course, management of assaultive behavior course, and a 1:1 preceptorship in mental health. This successful program has recruited and trained 18 VNs to improve licensed staff/patient ratios in mental health. These new graduates are licensed at the end of 4 months and are working successfully as licensed staff on the psychiatric units. All of these licensed vocational nurses (LVNs) are now completing prerequisites or entering registered nurse (RN) programs to earn an advanced degree. They bring their medical skills, positive attitudes, and therapeutic strategies to contribute to the milieu on the nursing units. They have reduced the facility's licensed staff shortage in mental health.