Psychiatric Nursing Overview

Overview of Psychiatric Nursing

• Psychiatric Nursing entails a professional nurse practitioner aiding individuals, families, and communities.
• It aims to promote mental health, prevent or cope with mental illness and suffering, and discover meaning.
• Mental health constitutes adapting successfully to stressors from the internal or external environment.
• It showcases thoughts, feelings, and behaviors that align with age and cultural norms.
• Psychiatric nursing is a specialized practice that uses human behavior theories and purposeful self-use.
• Purposes of Psychiatric nursing are helping patients accept themselves, promoting good relationships, and encouraging them to function independently.

Evolution of Psychiatric-Mental Health Care

• Mental health care evolution has shifted from driving out evil spirits to community-based primary care.
• Historically, the treatment of the mentally ill was influenced by cultural and religious beliefs.
• Early history associated insanity with sin and demonic possession, leading to inhumane treatments.
• In the Middle Ages (14th century), the insane were often imprisoned or forced to beg if not cared for by their families.
• They relied on religious groups for charity and were admitted to almshouses or hospitals when space allowed.
• From the 15th through 17th centuries, skepticism persisted, and asylums became repositories with deplorable conditions.
• Patients were poorly clothed, fed, chained, caged, and deprived of basic needs, treated as less than human.
• In the 18th century, Dr. Benjamin Rush aimed to bring attention to the plight of those with mental disorders.
• He believed in pleasant surroundings, diversional and moral treatment.
• Rush is considered the father of American psychiatry.
• The 19th century saw the evolution of the psychiatric nurse and the establishment of humane treatment.
• McLean Asylum in Massachusetts was the first US institution to provide human treatment in 1817.
• Humane treatment promoted understanding and contentment for mental and physical health.
• The 20th century marked psychiatry's era as a scientific study.
• Theorists and researchers set the groundwork for understanding and demystifying mental illness.
• Adolph Meyer emphasized studying a person's entire environment to determine its effect on their personality.
• Meyer accepted that mental disease resulted from an individual's maladjustment.
• Clifford Beers provided a descriptive account of his experiences in mental institutions.
• Harry Stack Sullivan (1892-1949) believed anxiety interfered with coping and communication.
• He surmised anxiety could be reduced through meaningful interpersonal relationships.

The Mental Health Nurse

• According to Peplau (1957), nurses take on several subroles within psychiatric nursing.
• The nurse fulfills a mother-surrogate role, assisting with basic needs to establish relationships.
• The nurse acts as a technician performing technical procedures competently and efficiently.
• The nurse identifies learning needs and provides necessary information to patients or families.
• The nurse is a socializing agent, participating in activities to relieve patient stress.
• The nurse serves as a counselor or psychotherapist, using interpersonal techniques to assist patients.
• The nurse functions as a manager, manipulating the environment to improve patient recovery.

Interdisciplinary Team and Mental Health Illness Continuum

• An interdisciplinary team involves members from different disciplines working to achieve goals.
• These team examples include physicians, psychologists, social workers, and occupational/ physical therapists.
• Mental health is defined as adapting successfully to stressors with age-appropriate behaviors.
• Positive indicators of mental health include a positive attitude towards oneself.
• Mental health also consists of objective views, knowledge, and acceptance of personal strengths and limitations.
• Indicators that suggest a reflection of mental health include growth, development, and self-actualization.
• The correlation is dependent on achieving tasks at each development level.
• Successfully meeting achievements in each level gives motivation for advancements to one's potential.
• Mental health also includes integration and integrative capacity that focuses on equilibrium among life processes.
• This includes adaptive responses and a life philosophy, managing anxiety in stressful situations.
• Autonomy in mental health is the ability to perform independently and take responsibility for choices.
• Mental heath includes the unbiased perception of the environment, empathy, and social sensitivity.
• Environmental mastery means a satisfactory role in society/environment and accepting love from others.
• It involves strategizing, making decisions, adjusting, adapting, and finding satisfaction.

Maintaining Mental Health

• Interpersonal communication involves exchanging information and feelings.
• Direct face-to-face communication is significant for effective interaction.
• Using defense mechanisms/coping mechanisms involves handling pain differently, whether healthily or unhealthily.
• Normal and abnormal people use these to be free from anxiety.
• Cognitive distortions are used to control situations.
• To maintain mental health, having significant others or a support system
• This looks like a person who is important to one's well-being
• This can especially be your spouse or one in a similar relationship or group of people sharing common experiences.

Mental Illness and its Causes

• Mental illness is characterized by psychological or behavioral manifestations with functioning impairment.
• This may be due to social, psychologic, genetic, physical/chemical, or biologic disturbances.
• Predisposing causes are conditions making individuals susceptible to later effects like heredity.
• Heredity transmits physical and mental qualities through inheritance.
• Age has three vulnerable life periods - adolescence (peer pressure), menopause/childbearing (hormone fluctuations), and senile period (physiological changes).
• Sex is a factor since statistics show higher incidence in women during specific reproductive phases.
• The environment impacts the customs of one's culture that may cause financial depression, family separation, or health situations.
• One's job may lead to both direct and indirect contact with harmful chemicals that affect the mental capacity of the individual.
• Previous attacks increases the chance of additional attacks.
• Precipitating causes are exciting events such as the death of a loved one, personal failure, divorce, or financial losses.
• Psychic causes involve neurotransmitter disturbances.
• Neurotransmitters transmit information throughout the body.
• Key neurotransmitter examples; dopamine controls movements and emotions. Serotonin is inhibitory and plays a role in mood and anxiety. Histamine controls alertness. GABA is inhibitory and modulates other neurotransmitters. Epinephrine and Norepinephrine are involved in fight or flight responses.
• General criteria to diagnose a mental disorder include:
  • Dissatisfaction, ineffective relationships, and a lack of coping skills.
• There is also an avoidance of problems rather than attempting to deal with them.