Centre for Psychiatric Nursing Psychiatric Mental Health Nursing.

Centre for Psychiatric Nursing

Psychiatric Mental Health Psychiatric Mental Health NursingNursing


Overview of Overview of Psychiatric/Mental Health Psychiatric/Mental Health

NursingNursing

Outline Similarities & differences between

psychiatric nursing and other fields of nursing

Skills & knowledge of the psychiatric nurse


Overview of Overview of Psychiatric/mental Health Psychiatric/mental Health

NursingNursing

The importance of psychiatric nursing skills in all clinical settings

Career opportunities Postgraduate study & endorsement Professional affiliation


The Psychiatric/mental Health The Psychiatric/mental Health NurseNurse

“Mental Health Nursing is a specialised field of nursing which focuses on meeting the mental health needs of the consumer, in partnership with family, significant others and the community in any setting. It is a specialised interpersonal process embodying a concept of caring….” (p. 3)

ANZCMHN (1995)


The Essence of The Essence of Psychiatric/mental Health Psychiatric/mental Health

NursingNursing Lies not in tasks performed or with the presenting

illness but in the relationship that develops with clients and families and their responses to the illness, including the impact that the illness has on their lives.

The essence is in establishing a ‘therapeutic partnership’, a connectedness, between the nurse and client which is based on empathy and trust.

Elsom (2001)


Similarities & DifferencesSimilarities & Differences

SIMILARITIES Work in close contact with people from a wide

variety of backgrounds Provide CARE for people with a wide variety of

illnesses Involved in health promotion and illness

prevention Nursing philosophy of benevolence



SIMILARITIES Education: must meet required level of

knowledge and skills to attain registration/endorsement

Governed by the Nurses Codes –

Professional Conduct & Ethics Structure of work hours, salary, benefits


Similarities & DifferencesSimilarities & DifferencesDIFFERENCES

Core focus of Psychiatric Mental Health Nursing Therapeutic relationship Use of self as a therapeutic tool People-centred approach, engaging clients in

discourse, promoting change Less task orientated Less technical environment Professional autonomy

Moir & Abraham (1996)



DIFFERENCES Clinical competence based on interpersonal

techniques Stuart & Laraia (2001)

Less repetition in process & procedures due to client individuality Moir & Abraham (1996)


Philosophy of the ProfessionPhilosophy of the Profession

Each individual: Has intrinsic worth and dignity and each

person is worthy of respect.Has the potential to change.Has common, basic human needs…Varies in their coping capacities


Philosophy of the professionPhilosophy of the profession

Each individual(s):Behaviour is meaningful…Has a right to equal opportunity for

adequate health care.Has the right to participate in decision

making regarding their care.Has the right to self-determination…


Philosophy of the professionPhilosophy of the profession

The fundamental premise is:The goal of nursing care is to promote wellness, maximise integrated functioning….nursing care is based on mutually determined needs and expected treatment outcomes..An interpersonal relationship can produce change and growth within the individual….Stuart & Laraia (2001, p. 7)


The Knowledge, Skills & The Knowledge, Skills & Attitudes of the Attitudes of the

Psychiatric/mental Health NursePsychiatric/mental Health NurseThe knowledge base of the psychiatric/mental health nurse is

grounded in the integration of the biological, psychological, spiritual, social and environmental realms of the human experience.Stuart & Laraia (2001)



Psychiatric/mental Health NursePsychiatric/mental Health Nurse

Broad context of care Requires purposeful use of self as a therapeutic

tool “Knowing you, Knowing me” (Awareness of self)

Barker, Jackson & Stevenson (1999)

Requires great sensitivity to the social environment & advocacy needs of clients/families

Requires careful consideration of legal & ethical issues



Psychiatric/mental Health NursePsychiatric/mental Health NurseTHERAPEUTIC NURSE-CLIENT RELATIONSHIP

• Physical dimension• Safety dimension• Social dimension• Spiritual dimension• Provision of treatment modalities• Encouraging self-determination• Provision of information

Cowman, Farrelly & Gilheany (2001)


The Knowledge, Skills & Attitudes The Knowledge, Skills & Attitudes of the Psychiatric/mental Health of the Psychiatric/mental Health

NurseNurse Milieu management Assessing, planning, implementing & evaluating

care Pharmacological interventions Documentation/Administration Legal requirements Educating/supervision Coordination/Multidisciplinary team member


The Importance of The Importance of Psychiatric/mental Health Nursing Psychiatric/mental Health Nursing

Knowledge, Skills & AttitudesKnowledge, Skills & Attitudes

In Australia, one in five persons will at some stage in their lives, experience a major mental illness.

Commonwealth Department of Health and Aged Care Services (1997)




Exposure to clients with mental health problems or illness in any area of practice

Skills will assist the nurse to provide comfort to clients who may be experiencing a myriad of emotions. I.e. grief, anxiety, anger, cognitive deficits and subsequent behaviour, and diagnosed mental illness




Mental state assessment skills

Early intervention - reduced stays, improved recovery rates. Improved client outcomes

Nurse more comfortable, confident in working with clients with mental illness


Career OpportunitiesCareer Opportunities

Diversity within the professionAttractive transferable skillsConsultationManagementEducationIndependent Practitioner



DIVERSITY Public & Private Mental Health Services In-Patient Facilities Out-patient or Day-patient Programs Crisis Assessment & Treatment Teams Community Teams Consultation-Liaison Mental Health Nurse


Career OpportunitiesCareer OpportunitiesDIVERSITY

Adult Acute Community Adult Rehabilitation Child & Adolescent Aged Mental Health Forensic Specialty Programs: I.e. Eating Disorders, Substance

Abuse Treatment, Cognitive Behavioural Programs, Parent-Infant.



Career structure Professional development Clinical supervision Scholarships Graduate nurse Programs Postgraduate Study Paid study leave


Postgraduate Study & Postgraduate Study & EndorsementEndorsement

Postgraduate studies in Psychiatric/Mental Health Nursing

Graduate Diploma Graduate Certificate Endorsement by the NBV (Where relevant) Highly attractive to prospective employers


Professional AffiliationProfessional Affiliation

Australian Collage of Mental Health Nurses ACMHN.

Standards of Practice

Centre for Psychiatric Nursing (CPN)


ReflectionReflection

“Nurses are ‘traveling companions’ with patients, not ‘travel agents’… the heart (of nursing) is the skills and values needed by nurses to establish and maintain human contact with patients.”Peck & Norman (1999)


ReferencesReferences Australian and New Zealand Collage of Mental Health Nurses Inc.

(ANZCMHN) (1995). Standards of Practice for Mental Health Nursing in Australia Adelaide: ANZCMHN Inc.

Barker, P., Jackson, S. & Stevenson, C. (1999). What are psychiatric nurses needed for? Developing a theory of essential nursing practice Journal of Psychiatric and Mental Health Nursing 6,

273-282.

Commonwealth Department of Health and Aged Care Services. (1997). National Mental Health Report 1996: Fourth Annual Report, Changes in Australia’s Mental Health Services under the National Mental Health Strategy 1995-6. Canberra: Australian Government Printing Services


ReferencesReferences Cowman, S., Farrelly, M. & Gilheany, P. (2001). An examination of

the role and function of psychiatric nurses in clinical practice in Ireland Journal of Advanced Nursing 34(6), 745-753.

Elsom, S. (2001). The active participants in Mental Health Services. In Meadows, G. & Singh, B. (Ed.), Mental Health in

Australia, Collaborative Community Practice (pp. 136-162). Melbourne: Oxford University Press.

Grigg, M. (2001) The role of the psychiatric nurse. Australasian Psychiatry 9(2), 143-145.

Peck, E. & Norman, I. (1999). Working together in adult community mental health services: exploring inter-professional role

relations. Journal of Mental Health 8, 231-242

Centre for Psychiatric Nursing Psychiatric Mental Health Nursing.

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