Role of Professional Nurse in Relation with the Mental Health of Alcohol Abusers - Term Paper Example

 ROLE OF PROFESSIONAL NURSE IN RELATION WITH THE MENTAL HEALTH OF ALCOHOL ABUSERS INTRODUCTION: There is a growing importance given to the issue of public health in recent times all around the world. The main aim is evidently to improve the community's health and provide healthy living standards (Olfson and Braham, 1992). Different health professionals contribute in their own way to public health insurance. The role of professional nurses to contribute to the public health programmes is unavoidable. One of the growing public health issues is alcohol abuse, and is fast becoming a global public health problem. Nurses, forming the largest group of health care facilitators, can serve as potential resource to offer screening and brief intervention services for these patients. Analysis of the distinct needs and problems of mentally unfit people, as a result of alcohol abuse will be initially discussed. The role of professional nurses in order to deal with the problem will also be discussed in detail. ALCOHOL AND DEPRESSION Consumption or abuse of alcohol may be a reason or a result of mental depression and ill health. Alcoholic abuse severally affects the personal as well as professional lives of the patients. These problems may take the form of family conflict, job loss and financial problems (Association for Medical Education and Research in Substance Abuse, 2002). These issues eventually lead to serious mental problems like increased levels of anxiety and depression. But the abuser initially experiences placebo effect on consumption of alcohol, a state of feeling illusionary pleasures. Later the exploitation of alcohol starts to exert a depressing effect on the central nervous system, resulting in behavioral and mood changes (Vadlamudi, Adams, Hogan, Wu, Wahid, 2008). This results in increasing alcohol consumption to an extent that the mental health recovery becomes even more difficult. The role of nursing in influencing the mental health of great many people is highly important. The unique skills practiced by nurses in dealing with variety of patients puts a lot of pressure on their duties. Mental health nursing can be considered as one of the most multifarious and challenging fields of nursing. A mental health nurse may have to work in a group which possibly consist of general practitioners, psychiatrists, psychologists, social workers, occupational therapists and assistants or individually in dealing with public health issues. These mental health patients who feel themselves extremely excluded and rejected need not only medical but also emotional help. Hence it becomes very important to endeavor as much as possible to bring them back to their normal mental health and social condition. These mental health disorders range from neuroses, psychoses, psychological and personality disorders all come under the broad heading of mental health (Antoun and Lana 2007). The key role and challenge involved in mental health nursing is to form therapeutic relationships with psychologically ill people and their families (Carey, M. P., Carey, K. B. & Meisler, 1991). THE SPECIAL DEMANDS FROM MENTAL HEALTH NURSES: The special demands placed on the mental health nurses are related with the ability to deal with alcohol abusers in a positive manner and not consider them as stigmatic. Alcohol abuse is one of the Substance abuse disorders that account for the largest number of deaths, illnesses and disabilities than any other avertable health condition (Munro and Edward, 2008). Hence a powerful personality accompanied with effective communication skills, will serve as the main tools for the professional nurses. There is a strong need to empathize with the mental health patients, who are usually held very low in society. The attitude of the professional nurses should be full of kindness and care towards them. Helping the individuals and their families to combat and deal skillfully with the problem, is a key part of the job (Allen, Hamilton, Nunn, Crock , Frecker & Burk, 2009). It is possible to combine training as a mental health nurse with social work, for effective treatment of this public health problem. A timely diagnosis is extremely important, which is itself dependent upon the primary assessment in the form of screening (Edward and Munro, 2009). The screening is a helpful assessment process to classify individuals with risky or destructive drug use, in addition with connected risk behaviors (insecure sexual activity, potential violent behavior, suicide risk). The level of help required by the patient can be determined by means of such standardized tools (Freeborn, Polen, Hollis and Senft, 2000). This area of public health has a number of other issues intertwined with it. The unhealthy social practices such as suicide may be caused by persistent abuse of alcohol. Hence the role of health practitioners in this area is really sensitive. There are various areas of care needed by these patients, besides physical care. They need be comforted psychologically as well. Such needs can be met by verbal communication and discussions. In this way their fears can be minimized and soon they will regain their confidence in people (Lovibond & Lovibond 2004). The needs of care and comfort can be determined by the specific needs of individual patient. What can best suit one patient may not be appropriate for everyone, depending upon the social and cultural differences. ROLE OF PROFESSIONAL MENTAL HEALTH NURSE: Being representative of a large workforce, the mental health nurses have a more significant role to play besides screening and basic intervention of mental health problems (Vadlamudi, Adams, Hogan, Wu, Wahid, 2008). Hence following roles are important to be adopted by the professional mental health nurse: 1. Accountability In general accountability is an ability to answer for your own action. A professional nurse is required to give justifications for any chosen action or decision performed for the interests of patients. In order to deal with the mental health of alcohol abusers, this accountability becomes essentially critical (Bendtsen, and Åkerlind 1999). Hence the decisions made should be relevant and appropriate for the health of patients. The use of professional knowledge and skills while making a decision is essential to staggering recovery of patient. In the context of nursing, the accountability is twofold. Their acts are accountable both for their moral implications as well as professional repercussions. Hence there is a need of acquiring enough knowledge and training to be able to justify the acts of professional nurses. They are accountable for their duties and truth and honesty is expected of them (Freeborn, Polen, Hollis and Senft, 2000). 2. Record Keeping A complete written account of patients’ assessments and condition should be maintained by the nurses. The record keeping is very important as it helps in preparing an appropriate decision about the future needs of patients. In addition, nurses are also professionally accountable for ensuring that any duties, delegated to members of the inter-professional health care team should be documented with full details (Rush, Bass, Stewart, McCracken, Labreque, and Bondy, 1994). The importance of record keeping cannot be understated in case of community screening for the provision of high quality care. Hence the workforce of nurses can play a leading role in establishing accurate and complete record of such patients. This record should be updated on regular basis as well. However, there is no single model for record keeping (Carey, M. P., Carey, K. B. & Meisler, 1991).The best format is one produced to pursue the needs of the environment and the patient through consulting with them. The regular practice of record keeping helps ensuring an exact account of treatments which can help in detecting problems or potential changes with time. The information maintained through documentation can also help in improving communication between the patient and mental health nurse. 3. Duty Of Care Nurses are abide both legally as well as professionally to for the provision of best care. By counselling and showing empathy while dealing with such patients can help them in returning to normal health and lifestyle to a great extent. These patients should be psychologically encouraged for lessening the alcohol usage. It is extremely important to spot and identify the risks areas and try to diffuse the matters of tension leading to alcoholic abuse. By considering the treatment of such patients’ not just part of duty but a social obligation can help in improving the level of care (Bendtsen, and Åkerlind 1999). In addition, it is also important to disclose any decisions of alterations or modifications in patients’ treatment to fellow professionals and sometimes to patients’ family members. 4. Autonomy: Thinking through all facts the decision should be based on sufficient consideration of all the facts. For a professional mental health nurse, the ability to form independent opinion and draw sound conclusions becomes very important. There are a number of meanings linked with autonomy when it comes to the nursing profession. These range from freedom to make independent decisions, self-regulation, Taking independent decisions as well interacting at an individual level with other professionals is very important. These nurses are totally dependent upon themselves to get their work done. The professional nurse should be able to carry out an independent and coherent thinking process, but this doesn’t mean that a nurse can exercise her/his knowledge in whichever way she wants. The observational study of such patients should not appear intrusive. The mental health professionals, specially the nurses need to respect the privacy and respect the personal space of patients. The autonomy should be accompanied by professional accountability (Priebe , Oliver & Kaiser 1999). The actions taken by professional nurses are judged for their rationality on the basis of circumstances. While making a decision, it is important to explore a variety of alternatives, as the decisions formulated can result in severe impacts on the health of these vulnerable souls. 5. Confidentiality Requires that those with access with health information to a 3rd party without consent “Persons with mental disorders have the right of confidentiality of information about themselves and their illness and treatment; such information should not be revealed to third parties without their consent.” (World Health Organization, 2005). The health professionals, specially the nurses should not unnecessarily disclose the patient’s history and records to any other person. Such information should be given the due importance and patients’ privacy should always be respected. The substance abuse and mental health issues can never be separated from each other (Olfson and Braham, 1992). A professional nurse must exhibit and practice the knowledge regarding screening and basic intervention in the best possible manner in order to deal with this public health care issue. 6. Avoiding Professional negligence There should be a maximum effort to minimize the risks faced by the mental health patients to a satisfactory level. The professional nurses have a very important but sensitive role to play, while dealing with mentally ill patients. The incompetent, offensive and unskilful behaviour and malpractice by a mental health nurse can result in very serious consequences. The professional nurses need to avoid negligence as a compulsion (Edward and Munro, 2009). Carelessness in dealing with mental problems of alcohol abusers can result in serious repercussions and can even lead to fatalities (Priebe , Oliver & Kaiser 1999). 7. Advocacy “As a registered nurse, midwife or health visitor, you are personally accountable for your practice and, in the exercise of your professional accountability, must act always in such a manner as to promote and safeguard the interests of patients and clients.” (World Health Organization, 2005). While the role of health professional in dealing with the health care of patients is the most fundamental, the importance of partnership relationship with patients is also important. In the dealing with mental health of alcohol abusers, the professional nurses have a difficult role to play. They should not assume that they can bring any positive change by imposing the expert decisions on such patients. Instead the patients should be given the opportunity to choose the kind of assistance he/she wants (Edward and Munro, 2009). The alcoholic abusers are very seldom aware of changing health conditions and don’t usually realize their progresses. Only a successful teamwork between patient and mental health nurse can bring positive results. A professional nurse should try to establish a relationship of trust and make the patient realize that the main aim is to support him/her and not to control them. This can easily be easily achieved by putting some effort in improving their own ability to listen to the patients. In this way the patients will feel free to share their problems and feelings without hesitation or fear. Also it is important to share the progress reports with patients (Frisher, Collins, Millson, Crome and Croft, 2004). For effective communication, the suggestions as well as the complaints from patients should be taken seriously. This will result in building a two-way relationship, which will boost the relation of trust and understanding between the professional nurse and the patient (Priebe , Oliver & Kaiser 1999). The responses whether positive or negative from the patients can help the professional nurses in improving themselves. 8. RISK MANAGEMENT “As a registered nurse, midwife or health visitor, you are personally accountable for your practice and, in the exercise of your professional accountability, must ensure that no action or omission on your part, or within your sphere of responsibility, is detrimental to the interests, condition or safety of patients and clients.” (World Health Organization, 2005) Medically supervised withdrawal is dependent upon the risk management approach. The risk management process should involve relevant assessment tools and should review the planning processes for ensuring maximum care. Risk management should improve care through creating an organized and well thought-out process for making professional judgments about risk. Risk management is highly dependent upon the keeping of accurate records, which can be referred for minimizing and reducing the risks faced by the patients (Bendtsen, and Åkerlind 1999). The patient’s interests should be held at the highest position and in applying a particular risk assessment. The efforts should be aimed at the overall best interests of the patients in every possible. The need to respond smartly and thoughtfully on the part of mental health nurses is important to analyze the risks faced by patients. The aim should be to handle the situation with minimum unprofessional conduct. Nurses can make use of psychological and communication techniques to calm down patient’s offensive and difficult behavior. The practice of physically restraining the patients should be avoided as much as possible. If a professional nurse finds a patient behavior strange in any way, he/she should try to evaluate the underlying reason of patient’s attitude. Physical constraints should e employed only if the situation of the patients gets totally out of control ( Rush, Bass, Stewart, McCracken, Labreque, and Bondy,1994). CONCLUSION: Traditionally the public health care issues of child health and maternity are given the majority of importance. The role of professional nurses needs to be more advanced and assorted in order to deal with the diverse and complicated health issues, existing in the present society (Vadlamudi, Adams, Hogan, Wu, Wahid, 2008). Therefore, there is a strong need for change in the professional role of nurses, if their potential for early intervention in mental health of alcohol abusers is to be fully realized. The mental health of alcohol abusers is one of the serious problems, which need huge importance and consideration of health professionals. A nurse who is fully aware of the duties and roles expected from his/her, and is sensitive to the needs of mentally ill alcohol abusers, can surely bring a positive change in their lives (Frisher, Collins, Millson, Crome and Croft, 2004). REFERENCES: United Nations Office on Drugs and Crime (UNODC) and World Health Organisation (WHO) (2008) Principles of Drug Dependence Treatment: Discussion Paper, accessed at http://www.who.int/substance_abuse/publications/principles_drug_dependence_treatment.pdf on 28 August 2008. Munro, Ian and Edward, Karen-Leigh (2008) Mental illness and substance use: An Australian perspective School of Nursing, Deakin University, Melbourne Campus, Melbourne, Victoria, Australia International Journal of Mental Health Nursing Molloy J, Caraher M. (2007) Public health and the role of the nurse: the need for greater clarity.Royal College of Nursing Development Centre, South Bank University, London, UK Antoun, Marie-Lise and Lana S. 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