A practitioner in the field of psychiatric nursing is a combination of clinical specialist and mental health diagnostician. It was determined at the end of the 19th century that patients in mental hospitals required nursing care. In modern medicine, psychiatric nursing is a growing field that requires advanced training, according to Nurses for a Healthier Tomorrow. A psychiatric nurse practitioner utilizes distinctive skill sets to provide therapeutic mental health care to children, teens and adults.
The first stage of any treatment protocol is assessment. The nurse practitioner must access the basic health and mental status of patients using evidence based clinical practice guidelines. The assessment process involves medical and mental health history. The nurse may opt to perform a complete physical exam to rule out organic conditions that may contribute to mental health issues.
Part of the initial evaluation includes a comprehensive mental health assessment that identifies any history of violence and self-harm behavior. The practitioner looks for evidence of suicidal tendencies, sexual and substance abuse, as well as diagramming the patient’s developmental and social particulars.
Diagnosis is a key function of the psychiatric nurse practitioner. The diagnostic phases include differential, examination of critical thinking processes and the interpretation of data. A nurse practitioner may use any of the following steps to help evaluate and diagnose mental illness, explains the National Panel for Psychiatric-Mental Health NP Competencies.
•Laboratory and mental health testing
•Determine typical and atypical presentation of mental illnesses
•Identify exacerbation and recurrence of a chronic psychiatric disorder
•Assess symptoms of new mental health problems
•Evaluate stressors and situational contributing factors within the family structure
Once the nurse establishes a workable diagnosis, the next step is the development of treatment protocol based on established criteria. A psychiatric nurse practitioner must be able to conduct both individual and group therapy sessions. For some patients, the nurse will provide psychotherapy for the entire family.
Treatment protocol for mental health issues requires a nurse to minimize situations that may complicate or negate the treatment. For example, as part of the therapy, a patient may need to avoid certain stressors. The psychiatric nurse practitioner must be able to determine what scenarios contribute or exacerbate the patient’s condition.
A nurse practitioner prescribes medication for patients, and must be fully versed on the current drug therapies. This specialty requires detailed knowledge of psychotropic drugs and their therapeutic applications. The practitioner diagrams drug treatments based on the patient’s status and health assessment.
The therapeutic relationship in the mental health industry is fragile. The nurse practitioner must be able to gain a patient’s trust, and maintain that relationship over a long period of time. The practitioner uses communication as a tool to reduce stress and enhance cognitive skills while maintaining professional boundaries.
A psychiatric nurse practitioner teaches mental patients how to manage and overcome certain disorders that may plague them all their life. The nurse provides psycho-education to families, and other significant individuals to promote understanding and management of the illness. It is the job of the nurse to know what topics are approachable with family members without breaching the patient confidentiality.
A psychiatric nurse promotes and teaches self-care to patients to advance their health status. It is the goal of a practitioner to educate patients about healthy behavior regarding their condition.
The skills required to be an effective psychiatric nurse practitioner go beyond what they teach in school. It is a distinctive healthcare role that requires intuition, communication and sensitivity. A practitioner must be able to deal with frantic patients in crisis, as well as concerned loved ones. A nurse receiving advanced education in psychiatry will be part of a larger team working to improve the mental health of their patients.