MHN 601 Lecture Notes 1 PDF

Biaka University Institute, Buea. MHN 601 LECTURE NOTES 1 Dr. Takang Tabe Email: [email protected] ; Tel: 677032630 Role and Function of a mental health nurse Role of a mental health nurse The role of a...

Biaka University Institute, Buea. MHN 601 LECTURE NOTES 1 Dr. Takang Tabe Email: [email protected] ; Tel: 677032630 Role and Function of a mental health nurse Role of a mental health nurse The role of a mental health nurse is to promote and support a person’s recovery, helping them live independent and fulfilling lives. Therefore, mental health nurses are concerned with the following: 1. Promotion of optimal mental and physical health and well-being and prevention of mental illness 2. Impaired ability to function related to psychiatric, emotional, and physiologic distress 3. Alterations in thinking, perceiving, and communicating because of psychiatric disorders or mental health problems 4. Behaviors and mental states that indicate potential danger to self or others 5. Emotional stress related to illness, pain, disability, and loss 6. Symptom management, side effects, or toxicities associated with self- administered drugs, psychopharmacologic intervention, and other treatment modalities 7. The barriers to treatment efficacy and recovery posed by alcohol and substance abuse and dependence 8. Self-concept and body image changes, developmental issues, life process changes, and end-of-life issues 9. Physical symptoms that occur along with altered psychological status 10.Psychological symptoms that occur along with altered physiologic status 11.Interpersonal, organizational, sociocultural, spiritual, or environmental circumstances or events that have an effect on the mental and emotional well-being of the individual and family or community 12.Elements of recovery, including the ability to maintain housing, employment, and social support, that help individuals reengage in seeking meaningful lives 13.Societal factors such as violence, poverty, and substance abuse 1 Biaka University Institute, Buea. Duties of a mental health nurse Patient Care Mental health nurses provide patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health. MHNs carry out the following duties in patient care; 1. To conduct Interviewing and assessment 2. To develop rapport with patients 3. To performing all aspects of an evaluation, including eliciting a clear and accurate history, performing physical, neurological and mental status examinations and ordering appropriate diagnostic and psychological tests. 4. To formulate diagnosis based on the data they have obtained, including evaluation of past records. 5. To make a thorough differential diagnosis and plan further steps to clarify the diagnoses. 6. To create an appropriate and comprehensive treatment plan for all diagnoses in the current diagnostic manual in the following treatment areas: -Use of pharmacological regimens, including the concurrent use of medications and psychotherapy -Individual supportive, psychodynamic and cognitive-behavioral psychotherapies (both long-term and brief therapy), in addition to exposure to family, couples, group and other evidence-based psychotherapies -Psychiatric consultation to clients in a variety of medical and surgical settings -Providing care and treatment for the chronically mentally ill with appropriate psychopharmacologic, psychotherapeutic and psycho-social rehabilitation interventions -Psychiatric administration including leadership of interdisciplinary teams and a supervised experience in utilization review, quality assurance and performance improvement -Psychiatric treatment while collaborating and coordinating treatment with non-medical therapists -Recognizing and appropriately responding to family violence (child, partner and elderly physical, emotional and sexual abuse and neglect) and its effect on both victims and perpetrators 2 Biaka University Institute, Buea. Medical Knowledge Mental health nurses must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. MHN must demonstrate knowledge in the following specific areas: 1. The major theoretical approaches to understanding the patient-doctor relationship 2. The biological, genetic, psychological, sociocultural, economic, ethnic, gender, religious/spiritual, sexual orientation and family factors that significantly influence physical and psychological development throughout the life cycle 3. The fundamental principles of the epidemiology, etiologies, diagnosis, treatment and prevention of all major psychiatric disorders in the current standard diagnostic statistical manual, including the biological, psychological, sociocultural and iatrogenic factors that affect the prevention, incidence, prevalence and long-term course and treatment of psychiatric disorders and conditions 4. The diagnosis and treatment of neurologic disorders commonly encountered in psychiatric practice 5. The use, reliability and validity of the generally accepted diagnostic techniques, including physical examination of the patient, laboratory testing, imaging, neurophysiologic and neuropsychological testing and psychological testing 6. The use and interpretation of psychological testing 7. The history of psychiatry and its relationship to the evolution of medicine 8. The legal aspects of psychiatric practice 9. An understanding of culture and subcultures 10.Use of case formulation that includes neurobiological, phenomenological, psychological and sociocultural issues involved in the diagnosis and management of cases 11.The ability to critically appraise and understand the relevant research literature and to apply research findings appropriately to clinical practice, including the concepts and process of evidenced-based clinical practice: 3 Biaka University Institute, Buea. Patient-Based learning and Improvement Mental health nurses have as a duty to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence and to continuously improve patient care based on constant self-evaluation and life-long learning. MHN are expected to develop and demonstrate skills and habits to be able to meet the following goals: 1. Identify strengths, deficiencies and limits in one’s knowledge and expertise 2. Set learning and improvement goals 3. Identify and perform appropriate learning activities 4. Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement 5. Incorporate formative evaluation feedback into daily practice 6. Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems 7. Use information technology to optimize learning 8. Participate in the education of patients, families, students, residents and other health professionals 9. Take primary responsibility for lifelong learning to improve knowledge, skills and practice performance Interpersonal Communication Mental health nurses have as a duty to; 1. Communicate effectively with patients, families and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds 2. Communicate effectively with physicians, other health professionals and health related agencies 3. Work effectively as a member or leader of a health care team or other professional group 4. Act in a consultative role to other physicians and health professionals 5. Maintain comprehensive, timely and legible medical records 6. Interview patients and family in an effective manner to facilitate accurate diagnosis and biological, psychological and social formulation 4 Biaka University Institute, Buea. Professionalism Mental health nurses have as a duty to show; 1. Compassion, integrity and respect for others 2. Responsiveness to patient needs that supersedes self-interest 3. Respect for patient privacy and autonomy 4. Accountability to patients, society and the profession 5. Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities and sexual orientation 6. High standards of ethical behavior which include respect for patient privacy and autonomy, maintaining appropriate professional boundaries and understanding the nuances specific to psychiatric practice. System-based practice Mental health nurses have as a duty to; 1. Work effectively in their health care delivery settings and systems relevant to their clinical specialty 2. Coordinate patient care within the health care system relevant to their clinical specialty 3. Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care as appropriate 4. Advocate for quality patient care and optimal patient care systems 5. Work in inter-professional teams to enhance patient safety and improve patient care quality 6. Participate in identifying system errors and implementing potential systems solutions 7. Advocate for quality patient care and assisting patients in dealing with system complexities, including disparity in mental health care 8. Work with health care managers and health care providers to assess, coordinate and improve health care, particularly as it relates to access to mental health care 9. Advocate for the promotion of mental health and the prevention of disease 5 Biaka University Institute, Buea. 10.Collaborate with psychologists, psychiatric nurses, social workers and other professional and paraprofessional mental health personnel in the treatment of patients 11.Maintain clinical records to demonstrate competence to: -Document an adequate history and perform mental status, physical and neurological examinations -Organize a comprehensive differential diagnosis and discussion of relevant psychological and sociocultural issues -Proceed with appropriate laboratory and other diagnostic procedures -Develop and implement an appropriate treatment plan followed by regular and relevant progress notes regarding both therapy and medication management -Prepare an adequate discharge summary and plan 6