How The Practice Of Mental Health Nursing Differ From That Of The Other Members Of The Multidisciplinary Team
Mental health nursing is a very complex and demanding areas of nursing. This area deals with people who have mental problems. Mental health nursing practice differs from that of the other members of the multidisciplinary team in a variety of ways. Mental health nursing involves nursing that cares for all people of all ages who have mental illness such as schizophrenia, psychosis, dementia and bipolar disorder. The nurses in this field receive more training in psychological therapy unlike the other members of the multidisciplinary team. This helps them build a therapeutic alliance that deals with challenging behavior and the administration of psychiatric medication. The members of the multidisciplinary team may be psychologists, social workers, occupational therapists, psychiatrists and support workers (Chang and Daly, 2007).
The key challenge to these nurses is to form therapeutic relationships with mentally sick people and their families. The main tool for a mental health nurse is strengthening their own personality and communication skills. They need to empathize with the people they deal with and show care and warmth towards them. This branch of nursing is faced with danger of violence often. Therefore, it requires a special skill to recognize build up tension and suppress it.
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Skillful mental health nursing requires more than a sound knowledge of human physiology, psychology, pharmacology and psychiatry. The mental health nurses need to understand both the theory and practice of the profession. Unlike the other members of the multidisciplinary team, the mental health nurses practice in inpatient and outpatient mental health clinics. They work with individuals, groups and families. They carry out assessment to patients who attend inpatient wards to understand their nursing needs. Each nurse is assigned a patient. The nurse is supposed to maintain a regular contact with the patient assessing progress and changes in their medical and daily needs. The nurse collaborates with the patientâ€™s family, friends and the psychiatrist responsible for the patient. The nurse also has the responsibility to coordinate and arrange for further care that may be needed when the patient has been discharged (Ball, 2000).
The nurses talk to the patients whenever the patients feel to talk to them. The mental health nurses carry out counseling and psychotherapy with the mentally ill patients. This may be formal or informal. They have the responsibility of teaching the patients on how to cope with anxiety and relaxation techniques. A charge nurse is responsible for the entire mental health nursing staff and also the nursing care of patients.
A mental health nurse can request an urgent opinion from a psychiatrist when they are concerned with the condition of the patient. This is more so when the nurse feels that the patient may be at risk to himself or herself when he or she leaves the ward. They have the power to detain the patient up to six hours to enable the psychiatrist carry out an assessment on the patient.
The issue of professional boundaries arises because the nature of mental health practice necessitates the development of therapeutic relationships. The beginner nurses may get confused when navigating the complex issues that come along with professional boundaries.
Many areas within the relationship that mental health nurses share with consumers may constitute in to problematic behavior that may include physical contact, gift giving, and self disclosure, personal and social involvement in the work.
A multi disciplinary team is considered as routine in the provision of mental health care within the community. The multi disciplinary team is necessary in mental health care in order to provide a holistic treatment or approach to care. The different professional groups provide complementary approaches that honor the complexity that the consumer has. Each discipline has a body of knowledge and a framework for practice that emphasizes different aspects of how to work with patients and other consumers. A single discipline cannot prepare workers with the range of knowledge and skills required to offer help to the patients with diversification encompassed in mental health practice.
A general practitioner is the first contact person for patients with depression. A general practitioner offers treatment to depressed patients. They offer advice and support to the depressed patient. The general practitioner may refer the patient to a counselor, psychologist or consultant psychiatrist.
Psychiatrists on the other hand works with the community mental team and have responsibility for a number of patients in a hospital ward. They use psychological treatments to help a patient who is depressed. Clinical psychologists see patients who are referred by general practitioners or the mental health team they carry out assessment of the mental health needs of the patient. They do psychological therapies with individuals and groups (Videbeck, 2010).
Community psychiatric nurses provide support to people through difficult periods in their illness. They see patients who are living in the community and not inpatients. They also see patients who have healed to check on their progress. They work with the patient`s family and care givers to cope with the patient and the illness. They receive patients from general practitioners, psychiatrists and inpatient wards (Elder, Evans and Nizette. 2009).
Psychotherapists offer therapy to the patients who are referred to them. They liaise with the person who referred the patient to them and give updates of the patientâ€™s progress. Counselors offer counseling to the mentally ill patients and others who are in need of their service. They identify the problem that the patient has and help bring out measures of coping with those problems. They work in different places such as hospitals, and general practitioner surgery rooms.
In mental health practice, the nurses carry out almost all of the tasks and duties mentioned above that are carried out by the multidisciplinary team members.
Our knowledge, views, beliefs, attitudes, and approach inform our intervention and care for the consumer in various ways. Our knowledge is a very important device to the consumer in this case, the patient. For a patient to take intervention and care properly and with seriousness they should be educated about the intervention and care that they are to be given. This education should not come from other people but preferably from us, the people who are directly involved and dealing with them. Our knowledge comes in handy because we should provide them with the appropriate and relevant information they require. If we give them the correct information, they are likely to get healed because they will most likely follow what we tell them. However, if we provide them with the wrong information their condition is likely to get worse because we will have misled them.
Consumers who acquire knowledge from their doctors regarding intervention and care in most cases change their lifestyle and show awareness of risk rather than those who are uninformed. Our knowledge provides essential information on the benefits of intervention to the consumer. It guides the consumer in making well informed decisions about their health. Therefore we should ensure that our knowledge is relevant, appropriate and reaches the consumer in the best way they can understand.
Our views, beliefs and attitudes are also very vital in informing interventions and care for the consumer. Patients form their own views, beliefs and attitudes about intervention and care provisions basically from our beliefs, views and attitudes towards the same. The patient may either be positive or negative towards intervention and care based on the experience they get form us regarding the issue. Many depressed patients have negative beliefs and attitudes towards antidepressants. This has led to poor adherence to drugs, low perceived well being, poor role functioning, life quality and unfavorable depression outcome. This could however be rectified if doctors and other multidisciplinary team members develop a positive attitude and belief to the depressed patients through their views about antidepressants.
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Our views acts as important mediums of knowledge break down of intervention and care to the consumer in the same way as our knowledge. Consumers take our views regarding intervention as the most appropriate. From our views the patients learn and form their own. This is because they trust the medical practitioners and thus believe whatever views they get from the medical practitioners. If we have a view, belief and attitude that a patient will heal very fast by observing certain intervention measures and care and they know about this, the patient will form a positive attitude towards the care and intervention and this will help so much for instance in the therapeutic intervention and care.
Our beliefs for informing our intervention and care for the consumer can be looked at in two perspectives. Some of us take the dualism belief while others have belief in holism. Dualism originated from the Cartesian philosophy that there is a mind and body duality. The body is the passive agent or vehicle with an immortal soul that is separate and distinct from the body. The concept of dualism has made the body the channel for medication and the mind the domain for religion and philosophy. Those among us that believe in dualism look for only that which can be observed. Their focus is on the deficits within the functioning of the brain. To them the mind does not influence the physical body. They value the meaning of the symptom for the person and understand the impact of the symptom to the patient`s life. This belief if applied when offering intervention and care may be limited in the sense that patients who have lived with mental distress for a long period of time have not found symptoms and problems helpful.
Holistic practice in mental health nursing focuses on healing the whole person knowing the importance of the relationship between biological, psychological, social, and spiritual characteristics of the consumer. Those nurses who believe in the holistic approach state that it is meaningless to separate a personâ€™s body into parts as if they were discrete entities. They believe that the whole is better than putting together the parts (Barker, 2004).
They state that a person`s social life cannot be separated from treatment but must be considered putting in mind all aspects of the person. Holistic procedure attends to the patient`s relationship with their own self, others, the society, and their participation within the greater cultural context of the community. They follow certain principles that underlie this practice. These principles include trust, hope respect for individuality and individual freedom allowing people to exercise their rights even when they are sick.
The rights considered are civil, social, and personal rights including the right of choice and dignity of risk. The holistic belief has a well informed and richer nursing experience that validates the complexity of life and cultural and societal experience. Thus our belief in the holistic perspective seems to be very vital to the consumer than the dualism perspective. The belief in the holistic perspective helps us to offer intervention and care to the consumer considering their diverse and different aspects that may help us understand them well enough. Putting together these different aspects like age and gender and combining them to form a whole helps us give the consumer a more relevant care (Finch, 2004).
People who have had the experience of mental distress usually state that when a professional has helped them, it is very important to them and their self worth to respond to treatment. The approach of facilitating, intervention and care for a patient is essential to other fields. Some approaches informing intervention and care may operate at the level of individuals, groups, systems organizations or society. For instance the contract based interventions to improve adherence to treatment and health promotion may be directed to patients, family care givers and other practitioners providing these services.
Psychological treatment of depression assists the patient in a number of ways. It helps take away the pain of depression and hopelessness that comes with depression. It changes the pessimistic ideologies and unrealistic expectations that encourage and sustain depression. This approach helps the patient know the problems that are critical and those that are minor. It helps the patient develop positive life objectives and self assessment.
Our approach must be at the level of patient care. The consumer must be able to understand the intervention and care approach that is being used on him or her. We should not prescribe an approach to a patient without letting them know what approach is being used on them, the benefits of the approach and how it works. A consumer should be told about the impacts of the intervention and care approach being used on them (Happell and Cowin 2008).
The information about the harm and the benefits should be readily availed to the patient. The patient should be included in the decision making concerning the intervention and care approach that will be applied on them. In cases where the patient cannot understand the approach, his or her family members or any other person responsible for them should be made aware on their behalf. As physicians we are supposed to be custodians of our patients. We should be trustworthy to our patients so that they develop a good rapport with us and be free to talk to us. This will help them to bring out issues that may be disturbing them (Burns, Purandare and Craig, 2002).
Mental health promotion is a population based approach to mental health. This approach attends to the mental health status and the needs of the whole population. It emphasizes the need for continuum care from universal prevention to long term individual care with early intervention and treatment. Mentoring can also be used. This aims at promoting growth and development by means of partnerships with other health professionals. It involves problem solving, feedback, support and relationship building. This helps consumers to develop courage to face the problem that the have at hand (Park, Murray and Delaney, 2006).
Mentoring also helps in providing more information to consumers on the problem they are facing and the step that they can take to ensure that it becomes better for them. We could also use the normalization approach to informing on our intervention and care. This is a humanistic model of care for patients with an intellectual disability. They are given rights and opportunities in the same way and magnitude as any other person. This helps us to understand the consumer very well. It helps us know how the patient can act when given an opportunity to exercise his or her free will. This in turn will help us come up with proper intervention and care measures that will benefit the patient in the best way possible and in his situation (Sartorius and Schulze, 2005).
Health consumers and health providers have an interdependent relationship. For the patient to heal, he or she needs the health provider who will offer advice, treat, prescribe medicine or refer him or her to the relevant medical practitioner. The health providers need the health consumer for them to work with. They need people to treat and offer medication and advice to. Without the health consumers, the health providers have no work to do.
Therefore, mental health nursing practice puts nurses in that field on a very sensitive role. They are the ones who do much of the work that the patient requires. Our views, beliefs, attitudes and approaches informing our intervention measures for health consumers should fit the health consumersâ€™ needs and requirements even in cases where the consumer does not know or understand the needs that re required for the condition they are in.
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