Mental health 1

• Chapters


  • Chapter 1: Foundations of Psychiatric-Mental Health Nursing
  • Chapter 2: Neurobiological Theories and Psychopharmacology
  • Chapter 3: Psychosocial Theories and Therapy
  • Chapter 4: Treatment Settings and Therapy Programs
  • Chapter 5: Therapeutic Relationships
  • Chapter 6: Therapeutic Communication
  • Chapter 7: Client's Response to Illness
  • Chapter 8: Assessment
  • Chapter 9: Legal & Ethical Issues
  • Chapter 10: Grief & Loss
• Always think about which answer is the most therapeutic/safest
• PATIENT SAFETY is priority
• Responses should acknowledge patient's feelings
• Reorienting patients
• Reinforcement/reminder of safety
• Read through ALL options, many of them are statements
• Match your answer back to your question
• Know examples - many questions require application of the content, rather than simple recall and recognition
• Mental Health


  A state of emotional, psychological, and social wellness evidenced by satisfying relationships, effective behavior and coping, positive self concept, and emotional stability
• Mental Illness


  Has no single universal definition. It is dynamic and ever changing

  
• Influencing Factors


  • Individual (personal)
  • Interpersonal (relationship)
  • Social/cultural (environmental)
• The individual parts are not necessarily equitable with mental health/illness. The same way that car parts do are not equitable with a car when unassembled
• Disorders that affect


  • Mood
  • Behavior
  • Thinking
• General criteria for diagnosis

  • Dissatisfaction with characteristics, abilities, accomplishments
  • Ineffective or unsatisfying relationships
  • Dissatisfaction with one's place in the world
  • Ineffective coping with life events
  • Lack of personal growth
• Mental health is unique to each individual and exists on a continued spectrum
• Characteristics/Behaviors of Someone Who is Mentally Healthy

  • Ability to self soothe
  • Coping mechanisms that are healthy
  • Awareness of actions
  • Self understanding
  • Empathy
  • Can identify resources (Asks for help)
  • Capacity for meaningful relationships
  • Capacity for self care (ADLs)
• Person first language is always used as opposed to condition first language
• The relationship of mental health parts - thoughts, feelings, behavior - combine enough to have mental health. Missing some parts results in mental illness

  
• Nurses help with the part where the person's thoughts/feelings/behavior is at odds with their culture
• All mental health conditions cause persistent distress, dysfunction, and the person's thoughts/feelings/behavior is at odds with their culture

  
• Mental Illness Stigma Framework (MISF)


  Focuses on stereotypes, prejudice, and discrimination

  
• Stigma


  • Stereotypes (cognitive)
  • Prejudice (affective)
  • Discrimination (behavioral)
• Self Stigma


  When someone with a mental illness starts to believe the negative ideas that society associates with that negative illness

  
• Types of Prejudice


  • Fear/Avoidance
  • Unpredictability - trustworthiness
  • Authoritarianism
  • Malevolence
• Basic-Level Functions of Psychiatric Nurses

  • Counseling
  • Milieu therapy
  • Self-care activities
  • Psychobiological interventions
  • Health teaching
  • Case management
  • Health promotion, maintenance
• Advanced-Level Functions of Psychiatric Nurses

  • Psychotherapy
  • Prescriptive authority for drugs
  • Consultation, liaison
  • Evaluation
• Saying the wrong thing - no one magic phrase will solve your client's problems, just like no single statement will make them worse. Listen carefully, show interest and care about the client is the most important
• Talking to people may make the student seem like they are not doing anything but really it does and it takes time and patience to develop the client nurse relationship
• Students should not see behavior like being rejected or not talking to them as an insult or failure rather just be available and be ready for a patient to come when they are ready
• Personal things should not be the first thing to say to the patient, this can happen after you have built a relationship and rapport with the client
• Clients usually hurt themselves more than they harm others. Staff must monitor clients for clues of violence or impending outburst
• If you see someone you know on the unit, it can be a shock or if you have similar stories or backgrounds with clients. Many people handle situations differently
• Everyone has unique values, ideas and beliefs so there might be conflict between that especially with clients. You need to accept the differences and view each client as worthwhile
• CHIME-D


  • Connectedness
  • Hope
  • Identity
  • Meaning in life
  • Empowerment
  • Difficulties
• Empowerment


  A process of self-identifying needs and values, taking action, and gaining mastery
• One strategy to support and cultivate empowerment is through patient-centered care and therapeutic communication
• Good nurses ask good questions
• How nurses identify good needs
• What will help you now most