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Mental Health Nursing

Mental Health Nursing



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Published by dlneisha61

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Published by: dlneisha61 on Mar 19, 2009
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Mental Health Nursing
Chapter 1: Through the Door Your First Day in Psychiatric Nursing
Mentally Healthy
A person is mentally healthy when a person possesses knowledge of oneself; meetsone’s basic needs; assumes responsibility for one’s behavior and for self-growth; haslearned to integrate thoughts, feelings, and actions; and can resolve conflicts successfully.
A mentally healthy person maintains relationships, communicates directly with others,and respects others.
A mentally healthy person adapts to change in one’s environment.
Mentally Ill
The mentally ill show deficits in functioning; it is usually these deficits that bring themto the facilities where you will encounter them.
Mental illness occurs when an individual is not able to view oneself clearly or has adistorted view of self, is unable to maintain satisfying personal relationships, and isunable to adapt to one’s environment.
The American Psychiatric Association defines mental disorder as “clinically significant behavior or psychological syndrome or pattern that occurs in an individual and isassociated with present distress (i.e., negative response to stimuli that are perceived asthreatening) or disability (i.e., impairment increased risk of suffering, death, pain,disability, or an important loss of freedom).
See p. 5 for possible signs of mental illness
Chapter 2: Psychiatric Nursing Evolution of a SpecialtyCare of the Mentally Ill
Early Civilization
The insane were treated through magical rituals, prayer, and exorcism.
The Greek and Roman cultures developed ideas of body “humors” – blood, black bile,yellow bile, and phlegm-which could influence emotional stability.
Hippocrates believed that excesses of black bile caused melancholy and that bloodletting could remove this excess.
Middle Ages and Renaissance
The term “lunatic” emerged to refer to one controlled by the lunar body.
Treatment of the mentally ill was influenced by beliefs that the mentally ill were evil,witches, or heretics.
The mentally ill were excluded from community life or institutionalized.
Care was custodial and were poorly fed and clothed and were restrained.
Eighteenth and Early Nineteenth Centuries
The mentally ill were committed to asylums.
They were place in prison if they committed a crime.
Their care was performed by persons without training or interest in helping others andwas often lacking in compassion.
A few physicians in the U.S. and England began to view the insane as persons sufferingdisease and needing some kind of treatment.
English physician William Battie’s word elevated mental services to somethingrespectable physicians could do. He also believed that the care of the mentally illshould be done by carefully selected and trained.
Insanity was viewed as a disease.
Physicians began to classify mental disorders.
They described moral and physical causes of mental illness.
In 1846, the term psychiatry was introduced by physicians and they published their work in The Journal of Mental Science.
Asylums were built for the treatment and cure of the insane.
Nineteenth Century
Conditions in the asylums became unbearable.
There was a called for reform.
Dorothea Lynde Dix
became a leader for reform. She advocated for humanetreatment as well as safe and comfortable environments for the patient. Throughher efforts, care was improved in the U.S., Canada, and Scotland.
Nursing Education
Eighteenth and Nineteenth Centuries
In 1882, the McLean Asylum in Somerville, Massachusetts, opened the first trainingschool in the world for mental health nurses.
Edward Cowles, the physician superintendent of McLean, believed that the presence of a “nurse” indicated not only that the patient was ill but also that there was a hopeof recovery.
Other schools were opened:
Bellevue Training School in New York 
Connecticut Training School in New HavenThese schools operated under the Nightingale model.The year 1893 marked the first meeting of organized nursing in the U. S.
Important Nurse Leaders included:
 - Isabel Hampton and- Lavinia Dock.
Mental health nurses continued to be trained at asylums and their training evolved to keepup with new approaches in psychiatric care.
Twentieth Century
The American Psychiatric Association established a committee on Training Schools for  Nurses.
Johns Hopkins Hospital School included psychiatric nursing in the training of generalnurses. This was the first time a hospital program offered training in psychiatriccare to all students.
By 1920, the first psychiatric nursing textbook was publish, Nursing Mental Disease byHarriet Bailey.
In the 1930s, somatic therapies emerged.
In 1946, the U.S. Congress passed the National Mental Health Act, which establishedthe National Institutes of Mental Health.
See Table 2-2 for additional important events and trends in psychiatric nursing history.
Psychiatric Mental Health Nurse
Psychiatric Mental Health Advanced Practice Registered Nurse (APRN) see [/ 19
Psychiatric Mental Health Nursing’s Phenomena of Concern (p. 20)
Community-Based Roles in Psychiatric Nursing (p. 20)
Chapter 3: Theory as a Basis for Practice
Nursing is a practice discipline in which the practice is derived from theory that has been developed through or tested by research.
Nursing theory may guide and inform specific steps of the nursing process in psychiatric care or may supply a general approach to providing care.
Hildegard Peplau
Described nursing as a therapeutic interpersonal relationship that provides a growthopportunity for both the nurse and the patient.
Described a four distinct phases of a interpersonal relationship: Orientation,identification, exploitation, and resolution.
In 1997, Peplau combined identification exploitation into the working phase, andrenamed resolution, termination.

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