ANP in mental health care

Patricia Lok

12 oktober 2017

in collaboration with obstetrichealth care

Accompanied by Nicole Snaphaan and Carlijn Beerepoot

Contains:

• Carrier and current job

• Rural context

• Regional context

• Our method

• Kind of health issues

• Role of nurse practitioner

Carrier and current job

The main road till now

Positions/ roles

• Nurse

• Mother

• Teacher

• Nurse practitioner

• Grandma

Educations (In dutch)• HBOV

• Docentenopleiding verpleegkunde

• PABO

• MANP

• CGT

Rural context

From question to answer

LKPZ – Answer to a need

Goals:

• Sharing knowledge

• Sharing expiriences

• Producing guidelines

• Same advices to clients

• Inform clients

www.lkpz.nl

Regional context

Various problems so various pathways

Nicole Snaphaan – Midwife and PA

Screening all pregnant women

• Questionaire: Mind2 care

• Used by…

• Kind of questions…

• Ment to: prevent a lackof care, selection, explane, guiding

Several pathways/ specialy POP

• Choise for a pathway(s) depends on kind of problem(s)

• If necessary in consultation / makingchoices

Our method

Collaboration and shared care

Two frontdoors

Verloskunde Psychiatrie

And a big in-between-door

For communication

• Consultation

• Collaboration

• Suggestions

• And so on

Kind of health issues

All psychiatric illnesses

in a special stage of live

and special circumstances

• Mood diseases: depression/ bipolar

• Anxiety diseases like panickdisease/ PTSD/ OCD)

• Psychotic diseases

• ADHD / autism

• Personality diseases

• Addiction

Already existed orsuddenly ocurring

Offer from obstetrics in POP care

• More time per cliënt

• More knowhow aboutpsychiatry

• Excellent skills in communication

• Possibility to offer case-management

• More continuity

• Knowing networkpartners

Offer from psychiatry

• Preconceptional advise

• Treatment and guidingduring pregnancy

• Treatment and guidingpostpartum

Treatment and guiding

Treatment:

Education

Support

Cognitive BehaviourTherapy

Mindfulness

Medication

Guiding:

Organize rest and help as well fromfamily as well professsional agencies

Promote rithm and structure

Balance activities and rest

Drawing partner/family into range

Preparing childbirth and postpartum / preventing overload

Eventually step in also other kinds of help to complete good care

Common themes

• Feelings of guild and failure• Thoughts as being a “bad

mother”• (Non-) acceptance of disease• Sleep disturbances• Own childhood• Preparing being a parent• Preparing pregnancy and

delivery• Preparing postpartum period• Breastfeeding• Perfection and adjustment• Worries about adhesion

Nurse practitioner psychiatryOverview

Centipede with knowledge, resolution and foresighted look

Building bridges

Between nursing and medicine

&

Between psychiatry and gynecology / obstetrics

&

Between in hospital and outdoor

Building bridges (1)

Between nursing and medicine

• From consultation to independence

• Wide view

• Upgrade and update your knowledge

• Common sense

• Dare to decide

• Growing trust

• Settle down old patterns in hierarchy

• Complement each other

Growing in a new role

Building bridges (2)

Between psychiatry and obstetrics

• Knowing the issues: literature and internship

• What do this woman need?

• How can we organize?

• Advocate needs to management

• How can we organize?

• Planning and implementation

• Sharing experiences/ consultation

• Evaluate and improve

Building bridges (3)

Between in hospital and outdoor

Collaboration:• Discuss• Referring (back)• Shared dissision making• Deviding tasks• Formulate observation goals• Organize good care• Home visit

Researches• Overzichtsartikel Tijdschrift voor Psychiatrie 57

(2015) 6, 415 - 423

• Angststoornissen tijdens de zwangerschap en post-partumperiode

• M. van der Veldt, P. Lok, M. Pop-Purceleanu, I. Tendolkar, P. van Eijndhoven

• Article in the Journal of Clinical Psychiatry 2017 Jul18. pii: 16r11083

• Infant-related harming intrusions in the postpartum period: a critical review

• Elke C Brok,* MD2, Patricia Lok, MSc1, Desiree B Oosterbaan, MD, PhD1, Aart H Schene, MD, PhD1,3, Indira Tendolkar, MD, PhD1,3, Philip F van Eijndhoven, MD, PhD1,3

Thanks for your attention

• Any questions?

• Also for my colleagues

Nicole Snaphaan

Carlijn Beerepoot