Trends and issues in Psychiatric Mental Health Nursing- Pradeep
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This document provides an overview of trends and issues in psychiatric mental health nursing. It discusses the history and evolution of the field from institutionalization to deinstitutionalization. Current trends include expanded roles for psychiatric nurses in primary care, collaboration, education, and community-based care. Legal issues addressed include informed consent, restraints, seclusion, and liability concerns. Ethical principles of autonomy, beneficence, and justice are considered in the context of common dilemmas around treatment refusal, privacy, and dual relationships.
Trends and issues in Psychiatric Mental Health Nursing- Pradeep
- 1. MENTAL HEALTH ( PSYCHIATRIC) NURSING A Presentation on TRENDS and ISSUES
- 2. Points for Discussion A) Trends Introduction History Psychiatric Nursing In Globalization era Present scene Changes and Challenges Current trends Trends in the Role of a Psychiatric Nurse
- 3. B) Issues Legal Aspects • Terminologies • Types of laws • Legal Issues Ethical Aspects • Principles • Dilemmas • Issues
- 4. Trends in Psychiatric Mental Health Nursing History Institutionalization
- 5. In the Globalization Era De Institutionalization Psychotropic Drugs
- 6. How do we integrate with Mental Health Community? • Experience and Education • Role and Functions • Relationships with other professions - Leininger(1973)
- 7. Present Scene of Mental Health • 450 million people affected worldwide • Mental problems common to all countries • 1 in every 4 persons going for health services has atleast one emotional problems • Mental problems of Clients with Chronic disorders • Unavailability of cost effective treatment • Lack of recognition, awareness and action
- 8. Issues around Mental health Nursing • Hard to justify scientifically due to the lack of Research results • Less ready to face the free market • Role differentiation based on education and experience is unclear. • Become Psychiatric Nurse is not an option for students!
- 9. Changes and Challenges Demographic changes Social changes Economic Changes Technological changes Mental health care changes
- 10. a) Demographic Changes Type of family Increasing No. of Elderly
- 11. b) Social changes • Intergroup and intra group loyalty maintenance • Peer Pressure
- 12. c) Economic changes • Industrialization • Urbanization • Raised Standard of Living
- 13. d) Technological changes • Mass media • Electronic Systems • Information Technology
- 14. e) Mental Health care changes • Increased awareness in public about Mental health • Need to maintain mental stability • Increased mental health problems
- 15. Current trends in Mental health carte • Educational Programmes for Psychiatric Nurse • Development of Code of Ethics • Legal aspects in Psychiatric Nursing • Promotion of Research in Mental Health Nursing • Cost effective Nursing Care • Focus of Care • World Health Day • Mental Health Global Action Programme • Health and Human Rights • Revision of Hospital Medical Code • Getting ready for DSM-5
- 16. New Trends in the Role of a Psychiatric Nurse
- 17. New Trends in the Role of a Psychiatric Nurse Primary Mental Health Nursing Collaborative Psychiatric Nursing Practice Clinical Nurse Specialist Nurse Psychotherapist Psychiatric Nurse Educator Psycho social Rehabilitation Nursing
- 18. New trends Child Psychiatric Nursing Gerontological and Geriatric Nursing Deaddiction nursing Neuro psychiatric Nursing Community Mental Heath nursing
- 19. Issues in Psychiatric Mental Health Nursing
- 20. Legal Aspects
- 21. Basic Terminologies • Civil Law: Civil law defines the rights and duties of the individuals in relation to each other. Civil law protects the private and property rights of the individuals and businesses. I. Tort • Intentional • Unintentional II. Contract
- 22. • Criminal Law: Criminal law defines certain acts as offences against the state and in doing so makes them punishable. The criminal law is enforced by or on behalf of the State. Criminal law provides protection from conduct deemed injurious to the public welfare
- 23. • Statutory Law: A statutory law is a law that has been enacted by legislative body, such as country or city council, the state legislature or the parliament. An example statutory law such as the Indian Nursing Council Act. • Common Law: Common laws are derived from decisions made in previous cases. These laws apply to a body of principles that evolve from court decisions resolving various controversies
- 24. • Right to Confidentiality is a basic one, and especially so in psychiatry. Although social attitudes are improving, individuals have been discriminated against in the past for no other reason than for having a history of emotional illness. • Informed Consent is a client’s permission granted to a physician to perform therapeutic procedure, before which information about the procedure has been presented to the client with adequate time given for consideration about the pros and cons.
- 25. • Restraints generally refers to a set of leather straps that are used to restrain the extremities of an individual whose behaviour is out of control and who poses an inherent risk to the physical safety and psychological well-being of the individual and staff. • Seclusion is another type of physical restraint in which the client is confined alone in a room from which he or she is unable to leave.
- 26. • False Imprisonment is the deliberate and unauthorized confinement of a person within fixed limits by the use of verbal or physical means. • Gravely Disabled is generally defined as a condition in which an individual, as a result of mental illness, is in danger of serious physical harm resulting from inability to provide for basic needs, such as food, clothing, shelter, medical care and personal safety.
- 27. • Negligence: The omission (of a person) to do something which a reasonable person, guided by those ordinary considerations which ordinarily regulated human affairs, would do or the doing of something which a prudent and reasonable person would not do.
- 28. • Malpractice:“The failure of one rendering professional services to exercise that degree of skill and learning commonly applied under all the circumstances in the community by the average prudent reputable member of the profession with the result of injury, loss or damage to the recipient of those services or to those entitled to rely upon them.”
- 29. • Libel: Written Defamation • Slander: Oral defamation • Invasion of Privacy: is a charge that may result when a client is searched without probable cause. • Assault is an act that results in a person’s genuine fear and apprehension that he or she will be touched without consent. • Battery is the unconnected touching of another person.
- 30. Types of Laws Types of Laws Statutory Law a)Tort b)Contract Common Law
- 31. Legal Issues • Right to Confidentiality is a basic one, and especially so in psychiatry. Although social attitudes are improving, individuals have been discriminated against in the past for no other reason than for having a history of emotional illness.
- 32. Informed Consent • Informed Consent is a client’s permission granted to a physician to perform therapeutic procedure, before which information about the procedure has been presented to the client with adequate time given for consideration about the pros and cons.
- 33. 3 major elements of informed consent Knowledge Competency Free Will
- 34. Restraints and Seclusion • Restraints generally refers to a set of leather straps that are used to restrain the extremities of an individual whose behaviour is out of control and who poses an inherent risk to the physical safety and psychological well-being of the individual and staff. “Talking down”- a less Restrictive measure • Seclusion is another type of physical restraint in which the client is confined alone in a room from which he or she is unable to leave. Orders re issued for R&S?
- 35. False Imprisonment • False Imprisonment is the deliberate and unauthorized confinement of a person within fixed limits by the use of verbal or physical means.
- 36. Commitment Issues Voluntary Admissions Involuntary Commitment Emergency Commitment The Mentally ill person in need of Treatment Involuntary Outpatient Commitment(IOC) The Gravely Disabled Client
- 37. Malpractice and Negligence Malpractice is the failure of one rendering professional services to exercise that degree of skill and learning commonly applied under all the circumstances in the community by the average prudent reputable member of the profession with the result of injury, loss or damage to the recipient of those cervices or to those entitled to rely upon them Negligence is the omission (of a person) to do something which a reasonable person, guided by those ordinary considerations which ordinarily regulated human affairs, would do or the doing of something which a prudent and reasonable person would not do.
- 38. Failure to prevent Dangerous Client behaviour • “ Tarasoff Duty to warn” An interesting Love story???!!!
- 39. Sexual Involvement with Clients Breaching Confidentiality Failure to Honour individual Rights Control of Violent or Self destructive behaviours
- 40. Law suits that occur in Psychiatric Nursing • Breach of Confidentiality • Defamation of Character Libel Slander • Invasion of Privacy Assault Battery
- 41. How to avoid Liability? Practice within the scope of the nurse practice act. Observe the hospital’s and department’s policy manuals. Measure up to established practice standards. Always put the client’s rights and welfare first. Develop and maintain a good interpersonal relationship with each client and his or her family.
- 42. Ethical Aspects
- 44. Ethical Dilemmas in Mental Health An ethical dilemma is a situation in which ethical principles conflict or when there is no one clear course of action in a given situation.
- 46. • Assessment Subjective and Objective data • Problem Identification Conflict • Plan Explore benefits and Consequences Principles and Theories Select an alternative • Implementation • Evaluation
- 47. Let’s Decide!
- 48. Should a client who is loud and intrusive to other clients on a hospital unit be secluded from the others?
- 49. When a therapeutic relationship has ended, can a health care professional nurse ever have a social or intimate relationship with someone he or she met as a client?
- 50. Are clients who are psychotic necessarily incompetent or do they still have the right to refuse hospitalization and medication?