A brief description of psychiatric nursing and its nature and scopes in nursing

1. S R A D H A N J A L I B I S W A L
T U T O R
K A L I N G A I N S T I T U T E O F N U R S I N G
S C I E N C E S
K I I T D E E M E D T O B E U N I V E R S I T Y
B H U B A N E S W A R

2. INTRODUCTION
• Psychiatric–mental health nursing is a specialized area
of nursing practice committed to promoting mental health
through the assessment, diagnosis, and treatment of
behavioral problems, psychiatric disorders and comorbid
conditions.
Psychiatric–mental health nursing intervention is an art and
a science, employing a purposeful use of self and a wide
range of nursing, psychosocial, and neurobiological research
evidence to produce effective outcomes.

3. DEFINITION OF MENTAL HEALTH NURSING
Psychiatric mental Health Nursing is an integral part of the continuum
of nursing practice. The American Nurses’ Association (ANA) describes
psychiatric mental health nursing as a specialized area of nursing practice
committed to promoting mental health through the assessment, diagnosis,
and treatment of human responses to mental health problems and psychiatric
disorders (ANA, 2007).
As a core mental health profession, psychiatric mental health nursing
employs a purposeful use of self as its art and a wide range of nursing,
psychosocial, and neurobiological theories and research evidence as its science
(ANA, 2007).

4. GOALS
The primary goal for psychiatric nurses is client
mental health. Four major objectives for achieving those
goals are:
 Promotion of mental health
 Prevention of mental disorders
 Treatment for clients with mental disorders
 Restoration of health.

5. SCOPES IN PSYCHIATRIC MENTAL HEEALTH
NURSING
Psychiatric Mental Health registered nurses practice in a variety of
clinical settings across the continuum of care and engage in broad array of
clinical activities including health promotion and health maintenance,
intake screening, evaluation and triage, case management, provision of
therapeutic and safe environment, promotion of self care activities,
administration of psychobiological treatment regimens and monitoring
response and effects, crisis intervention and stabilization, and psychiatric
rehabilitation.

6. CONT…
The scope of practice in psychiatric mental health nursing
is continually expanding as the context of practice, the need
for patient access to holistic care, and the various scientific
and nursing bases evolve. It is within the scope of practice of
the psychiatric mental health nurse to provide primary
mental health care to patients seeking mental health services
in a wide range of delivery setting.

7. PRIMARY MENTAL HEALTH NURSING:
Psychiatric nurses are moving into the domain of
primary care and working with other nurses and
physicians to diagnose and treat psychiatric illness in
patients with somatic complains. Cardiovascular,
gynaecological, respiratory, and gastrointestinal, and
family practice settings are appropriate for assessing
patients for anxiety, depression, and substance abuse
disorders.

8. REGISTERED PSYCHIATRIC MENTAL HEALTH
NURSING:
A registered Psychiatric Mental Health Nurse provides psychiatric
mental health care to individuals, families, and groups to enable them to
enable them to function at an optimal level of psychological wellness
through more effective adaptive behaviours and increased resilience to
stress.
She must be able to provide safe, basic physical care, have a wide
understanding of psychological and developmental problems and their
treatment and have a highly developed level of communication skills. She
works children, adolescents, adults, and elderly with dysfunctional
behaviour patterns, and developmental handicaps.

9. CONT….
Nurse Generalist: a licensed nurse providing
primary mental health care. Holistic approach, prevention
programmes, community and day care centers,
psychiatric rehabilitation facilities, homeless shelters etc.
Nurse Specialist: Psychiatric Clinical Nurse
Specialist (CNS): have a master degree in mental health
nursing. Autonomous functioning, prescription
privileges, manages overall care of emotional and
psychiatric problems. Eg. Crisis Interventio0n specialists,
Milieu Specialists, Psychotherapists etc.

10. CONT..
• Community Mental Health Nurse
(CMHN): Diagnosis, appropriate referrals, care
and rehabilitation of mentally ill people in the
community.
• Psychiatric Home Care Nurse: direct
patient care, behavioral management, crisis
intervention, psycho education, detoxification,
medication etc.
• Forensic Psychiatric Nurse: works with

11. CONT…
Psychiatric Consultation - Liaison Nurse
PCLN: Psychiatric nurse who work in non- psychiatric
setting and provide necessary support, guidance and
counselling for those affected with anxiety,
depression and other psychological problems.
Case Manager: Nurse manager acts as
advocates by coordinating care and linking patient
with physician and other members of health care
team. Works in community and helping in daily living
of a mentally ill person such as transportation,

12. CONT…
Gero -Psychiatric Nurse
Parish Nurse: An RN with spiritual mature. Supports
health education, social services, and carry out non-
invasive nursing care. Common in US.
Tele health / Tele nurse: Nurses engaged in tele-
nursing practice use technologies such as internet,
computers, telephones, digital assessment tools &
tele-monitoring equipment to deliver nursing care. In
India around 10 hospitals are having telemedicine
departments. Eg. Apollo hospitals, Narayana
Hrudayalaya.

13. CONT….
Nurse Researcher:
Nurse researchers design, conduct & disseminate
findings of research at professional meets & in peer
reviewed journals. They are doctorally or post-
doctorally prepared persons who initiate or
participate in all phases of the research process.
Psychiatric Nurse Educator:
Nurse Administrator/Manager
Nurse Pharmacologist: The psychiatric clinical nurse
specialist with prescriptive authority.
Holistic Nurse: Integrates complementary and
alternative modalities such as relaxation,

14. NATURE OF PSYCHIATRIC NURSING
It is a profession possessing its unique
history, ideology, knowledge and skills.
It is both an art (nurse – patient relationship)
and a science (skills for the purpose of gaining
insight, effective change, healing mental and
emotional wounds and promoting growth).
Understands the principles of nursing and
remain current in knowledge and practice.

15. Every individual has intrinsic worth and dignity
and is worthy of respect.
Each person functions as holistic and react to
environment as a whole.
All behaviour of an individual is meaningful. It
can be understood from an internal frame of the
patient.
Behaviour has perceptions, thoughts, feelings
and actions. Individuals vary in their coping
capacities. All are prone for health and
illness.

16. Nursing is aimed to promote wellness,
maximize functioning and enhance self
actualization.
IPR can produce change in growth of an
individual.
Psychiatric nursing is based on
psychosocial and biophysical sciences

17. CASE MANAGEMENT
Using case management, a psychiatric mental health nurse is responsible
for assessing needs, identifying services, and monitoring and evaluating
client states. A case manager co- ordinates care through collaboration with
all involved health professionals ensuring accessibility and availability of
care.
Case management for the psychiatric mental health nurses involves
population specific nursing knowledge coupled with research, knowledge of
the social and legal systems related to mental health and expertise to engage
a wide range of services for the patient to engage a wide range of services
for the patient, regardless of setting.