Principles and Contemporary of Mental Health - Essay Example

? Principles and Contemporary of Mental Health Principles and Contemporary of Mental Health Introduction Womble (2005, p. 7) writes that mental health literally means the absence of any mental disorder. It simply refers to cognitive well-being of an individual. Townsend (2005, p. 113) writes that emotional well-being, referring to how one thinks, behaves and how one feels, are all components of mental health. Further, Townsend (2008, p. 17) writes that mental health nursing is a nursing specialty that offers care to people of all ages who are suffering from mental illnesses, distress; among them psychosis, schizophrenia, depression and dementia. In this area, nurses receive specialized training in psychological therapies that builds on therapeutic alliance in dealing with challenging behavior which leads to administration of psychiatric medicine. In summary, mental health is a psychological state of well being in which one has an achievement of a satisfying amalgamation of one’s instinctual motivations tolerable to both oneself and one’s social locale; an apposite balance of leisure pursuits, love and work (Wilkin, 2003, p. 139). The Patient: Barker’s model In one of his theories, Barker wrote that a mental patient care should encompass a Meta theoretical approach. This is to say that several theories are necessary while dealing with mental patients. The application of this theory helped in taking care of the patients. First, there was demonstration of the nursing knowledge, the grand theory, where there was stating the empirical terms and hypotheses to demonstrate understanding of the theory of nursing. To demonstrate a clear understanding of the situation, I applied the Barker’s tidal model, which is philosophical in nature. With this model, I had to understand the fact that I knew little about the experiences of my patient. I took my patient as a mystery to be learnt and explored in developing a nurse-patient relationship and identify the needs. This characteristic of curiosity helps to understand more about the patient (Barker & Barker, 2005, p. 108). Secondly, the key to understanding my patient was taking them in with their resourcefulness in acknowledging the reality of my patient’s problems as the resources towards proper therapy. Other resources were within their social and interpersonal network, which I had to explore to help in proper therapy. Another important aspect that I had to consider was to understand the personal wishes of the patient. This laid emphasis on the importance of collaboration with the patient. This helped in identification of the needs of the patient. Respect to the needs also helped to ease therapy towards quick recovery. Mental health is more psychological and therapy has to be more collaborative through identification of what the patient deems important. However, this did not mean ignoring professional knowledge about the patient’s condition, but the wishes of the patient remained at the heart throughout the therapy session. Then there was viewing the patient’s condition as an opportunity, a natural signal indicating the need for services, my services. It was an opportunity for change and a chance for the patient to take a new opportunity in life. In mental health care, there are goals that professional nurses set to achieve. They are to be the end point of the nursing care process. I had to consider the fact that there are small steps which I needed to take in order to move away from the circumstances that brought my patient to the care setting. Finally, Barker’s model in practice helped me to understand the fact that I had to identify the simplest possible action that helped to bring about the help necessary for the patient to get well from their condition. Basing On Evidence Because I had to administer psychotherapy basing on evidence, I had to employ several techniques that had to base on empirical relationship building, communication, dialogue and behavior change with a designation to improve mental health of my patient and/or group relationships. The main idea in this setting was to understand that all evidence was from the patient, and not from me as a nurse. This means a serious mutual relationship had to develop between my patient and me. According to Fortinash and Worret (2004, p. 109), mental health nursing is confined within the nursing models that utilize nursing care plans seeking to care for the person as a whole. Mental health nursing lays emphasis on development of a therapeutic alliance between the nurse and the patient. This means that there should be a positive engagement and collaboration between the nurse and the patient. This will enable the patient to be motivated towards well being, in addition to any other form of treatment they might be receiving. Maintenance of a positive therapeutic relationship with psychiatric patients is the most important aspect of mental nursing in clinical setting. This is because the most imperative elements of mental health care revolve around interactions and interpersonal relationships that are established between the professional nurses and clients, who in this case are the psychiatric/mental patients. This practice requires intensive presence of the care givers and people with strong desires to be supportive to the sick (Fortinash & Worret 2004, p. 109). Diagnosis Diagnosis of mental health patients is mainly based on observation and attentive listening. This is because mental illnesses are mainly psychological and the modes of expression by the patient are the key to understanding their conditions (Sauber, 1997, p. 17). To understand my patient, I had to develop close relationship to make them open up to me, I had to earn a level of trust and confidentiality for me to had a thorough diagnosis of their condition. Medication There have a lot of interventions in the field of medicine after a series of studies in the relationship between mental illnesses and the biochemical processes of the brain. This has successfully developed psychiatric medicine. In administering medication to my patient, I had to consider the fact that the medicine might have side effects to the patient; some of them might be severe. It required close supervision throughout the patient medication period. This was necessary to ensure safety in alleviating the effects of mental illnesses that were negative. The mental health nurse As a mental health nurse, I had to consider being empathetic and understanding, supportive and provisional, individuality, availability, being genuine, equality promotion, respectfulness, clarity in boundary demonstration, and self awareness for the patients. First, empathy and understanding from mental health nurses helps to strengthen an affirmative balance for mental health patients. Showing an understanding provides the patient with a sense of importance. This is manifested when the nurse allows the patient to express feelings and thoughts without judging, blaming or belittling. Further, nurses will also empower patients to feel important and ignore stigmatization, which is common in any society against the mentally ill because of their disorder. This brings them closer to a feeling of being normal. Nurses should know and understand that when the mental health patients are subjects of harsh personal attacks, the nurse has kept hold of the aptitude and urge to comprehend the patient. Nurses should have the essential ability to empathize with unfortunate situations. Of equal importance is involvedness. This is so because mentally ill patients expect nurses to understand and act even in situations when they are unable to express their situations and conditions verbally. Treatment improvement chances increase positively to a great deal when the nurse gains understanding of the patient. It is also important for nurses to get to know and understand their patients (Wilkin, 2003, p. 143). This is when individualized care becomes imperative. To achieve this level, the nurse should see and perceive patients as individual people living beyond their mental illnesses. This is quite important as it makes patients to feel respected and valued. For mental health nurses to value, accept and respect their patients as individuals, they must not allow their own values, ideas or their pre-understanding of mental health patients to control them in handling the patients. Nurses will meet patients’ individual needs only by bending the standard interventions and assessment rules. This will however come with proper interpretation of rules and risk evaluation. Legal and Ethical Issues In dealing with my patient, I had to consider the fact that being a professional, there were legal issues that I had to have in mind. Reid and Silver (2003, p. 431) write that there are legal issues that nurses have to bear in mind while handling and helping their mental health patients. Some of them are in making decisions about their patients. They sometimes create ethical dilemmas among nurses. Decisions can be made by family members on behalf of patients in order to protect them from harming themselves, or others. However, patients also have rights to decide up on their own fate; hence they can contest such positions. Confidentiality is a basic requirement for nurses when dealing with their patients. Divergent of information to a nurse by a patient presents dilemma to the nurse in reporting the information. This is because the truth in such information is relative bearing in mind that the patient is mentally ill (Townsend, 2000, p. 179). By caring for mentally ill patients, a mental nurse faces difficult decisions along the line of duty. Mental health nurses should also be ready to provide support to their patients. This is so because the relationship between therapeutic patients and their nurses should base on positive support. This can include many different active responses. Some of them can be as minor as shopping together, reading magazines together, and taking meals together can help improve the care and support. Use of touch can be useful as physical support. Patients will appreciate feelings of connection when mental health nurses put hands on their backs, or even when they hug them. Patients will also feel comfortable when nurses hold their hands, and it creates a wonderful working relationship (Richards, Campania & Muse-Burke, 2010, p. 249). For instance, it will be relief to patients with depression to get hugs from nurses. Essentially, physical touch will create comfort and will console patients who will be ready to embrace such sensations in readiness to share mutual feelings with their nurses. Another aspect of mental health nursing is the fact that the nurses should always be there and available for the patients. They should be approachable to make patients feel more comfortable. They should be readily open to multi personal connection levels. With such personal connections, nurses help uplift patients’ spirits, which, in turn, secures confidentiality. Availability makes patients to open up and reveal personal stories which help mental health nurses to comprehend the sense behind each story. In the end, the nurses will make unbiased view of the stories from patients. Being there and availability facilitates empirical connections that quell any sort of negative feelings within patients (Richards, Campania & Muse-Burke, 2010, p. 247). Another principle of mental health nursing is being genuine which must be from within without reluctance. This requires the psychiatric nurse to be bona fide or original in the way they interact with their patients. This calls for the nurses to be in accordance with their values and believes. Reliability and consistency in both character and punctuality sums up to genuinity. The level of consistency that nurses exhibit between their choral and non oral actions determines the level of their genuineness. Townsend (2000, p. 124) argues that fulfillment of their intended tasks will also check their genuineness. Being open and honest is also important to the nurses and they reflect it by being honest and open. This sums up to be self disclosure; here, the nurse shares life experiences. It is quite essential to development of therapeutic relationships as it helps patients to feel that the relationship is not one sided, hence makes them to open up to the nurses. Others are straight talk, blunt feedback and tearfulness. Together, they boost honesty and openness between mental health nurses and their patients (Richards, Campania & Muse-Burke, 2009, p. 7). A therapeutic relationship friendship is unique in that as opposed to sociable friendship, it is naturally asymmetrical. The basic concept here is being true and upholding to one’s word. This boosts trusts between nurses and their patients. Equality promotion is also an important principle in mental health nursing. This is because in order to form successful curative relationship, t6here must be an establishment of a beneficial co dependency between the patients and their nurses. A disparaging observation of the patient’s position in the clinical situation dilapidates to a therapeutic association between them and nurses (Langley & Klooper, 2005, p. 13). This is because mental health patients require nurses to aid their recovery, and at the same time nurses require patients to develop experience and skills. Mental health nurses are simply team members and facilitators of the relationship between them and their patients, instead of just being the leaders. I had to empower my client with a sense of participation and power, hence encouraging them to be independent (Mullen, 2010, p. 13). This means that exclusive control of certain circumstances should not be solely for nurses. One to one communications between nurses and patients encourage development of equal interactions. Some would include engaging in activities that do not seem to make the nurses more dominant; activities like mutual conversations, having lunch together, among others strengthens equality levels between professionals and their patients. The end result will be a creation of choice illusion within patients, even if they might be in confinement (Frisch & Frisch, 2006, p. 303). According to Norman (2004, p. 78), demonstration of respect is also important for mental health nurses. This is because there is the need to make patients feel respected, appreciated and important. The most vital way of showing respect to them is through unconditional acceptance of their faults and problems, besides helping them to see themselves as worthwhile and worthy members of the society. It is also a professional principle that nurses should show clarity of boundaries, which will act as protection to both the nurses and their patients in maintenance of a therapeutic relationship that is functional. This will help to protect patients from thwarting behavior, hence instilling feelings of containment and safety within patients (Smith, Segal & Segal, 2011, p. 213). It also protects the mental health nurses from burn-out, preserves stability and promotes a quality relationship between the nurse and patient. Of utmost importance is the ability to demonstrate self awareness. This is because nurses should be aware of personal vulnerability that will boost professional development. For this, psychiatric nurses require awareness on essential humanistic values and self knowledge that will help improve the depth of self understanding (Stuart& Laraia, 2005, p. 511). Nurses respond to their psychiatric patients differently because of their personality differences. Self awareness makes a nurse more knowledgeable on approaching interactions with ones patients. Formation of patient relationships requires interpersonal skills which are acquired through learning more about oneself. Promotion of interpersonal skills can be through clinical supervision, which provides opportunities for nurses to reflect on their relationships with patients and helps them to improve their clinical skills and repairing difficult relationships (Croce, 2010, p. 106). Such reflections that mental health nurses articulate by clinical supervision fosters self awareness. Nursing interventions in mental health care is divided into two categories: biological interventions and physical interventions (Varcarolis, Carson, & Shoemaker, 2006, p. 108). Administration of psychiatric/mental medication is the most common intervention by mental health nurses. This is either oral or intramuscular injection. Mental health nurses stipulate medicine prescription. Thereafter, they monitor for side effects and then they respond using their own assessment. They also offer medication information for the patient can take and make choices that are informed and basing on evidence. Another intervention that nurses apply in dealing with mental health is use of electroconvulsive therapy. This helps in preparation and recovery of patients for recovery from mental health treatment; it mainly involves anesthesia. This is normally a desperate measure if all other interventions have failed to help the patient’s recovery. Mental health nurses also intervene in areas requiring physical needs by their patients. This may be ensuring that their patients have proper nutrition, good personal hygiene, enough sleep, among others. Others would be attendance to any affiliated physical illnesses (Barry & Farmer, 2002, p. 337). There are also psychosocial interventions that nurses try to use to help their mental patients. These are interventions like psychotherapy: family therapy, cognitive behavioral therapy, milieu therapy, among others. Dziopa and Ahern (2009, p. 7) write that they can help in easing a wide range of problems like depression, psychosis, anxiety, among others. Nurses can teach their patients some psychological techniques that help in recovery and management of any mental health issues, even in future. Such interventions are used in conjunction with mental health medications. According to Jackson and Stevenson (2000, p. 379), these interventions should base on evidence based practice in nursing; hence they should follow specific guidelines basing on the effectiveness of the research in nursing. Conclusion The overall roles of a mental health nurse in caring for their patients are numerous. Though the key function is formation of a therapeutic relationship with the patients, other important functions may include being psychologists, psychiatrists, general practitioners, art therapists, healthcare assistants and occupational therapists. References Barker, P. J., & Barker, P. (2005). The tidal model a guide for mental health professionals. Hove [England: Brunner-Routledge. Barry, P. D., & Farmer, S. (2002). Mental health & mental illness (7th ed.). Philadelphia: Lippincott, Williams & Wilkins. Croce, N. (2010, February 12). About Psychiatric-Mental Health Nurses (PMHNs) - American Psychiatric Nurses Association. Home - American Psychiatric Nurses Association. Retrieved February 21, 2012, from http://www.apna.org/i4a/pages/index.cfm?pageid=3292 Dziopa, F, and K Ahern. (2009): "What makes a quality therapeutic relationship in psychiatric/mental health nursing: a review of the research literature." Journal of Advanced Nursing Practice 10.1 1-19 Fortinash, K. M., & Worret, P. A. (2004). Psychiatric mental health nursing (3rd ed.). St. Louis, Mo.: Mosby. Frisch, N. C., & Frisch, L. E. (2006). Psychiatric mental health nursing (3rd ed.). Clifton Park, NY: Delmar/Thomson Learning. Jackson, S, and C Stevenson. (2000): "What do people need psychiatric and mental health nurses for?." Journal of Advanced Nursing 31.2 378-388. Langley C, and Klooper H. 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Psychiatric and Mental Health Nursing: The craft of caring. London: Arnold. pp. 26–33. Womble, D. M. (2005). Introductory mental health nursing. Philadelphia: Lippincott Williams & Wilkins. Read More