Roles of Nurses in Mental Health Nursing

Introduction

One of the main issues in defining nurse practitioners’’ (NP) roles in the mental health area have to do with the fact that, whereas the scope of nursing responsibilities continues to be perceived through the lenses of the euro-centric (symptom-eliminating) paradigm of healthcare, this state of affairs no longer appears thoroughly appropriate. The reason for this is that there are now a number of discursive preconditions to believe that it is specifically by adopting a holistic (concerned with ensuring harmony between one’s body and mind) outlook on their duties that nurses will be able to be able to prove themselves thoroughly effective, as healthcare professionals.

The purpose of this paper/research project is to contribute to the improvement of nursing services, provided to patients that show the signs of mental impairment. The initial hypothesis is based upon the assumption that by being able to choose in favor of the circumstantially proper approach to encouraging mental patients to communicate their anxieties, nurses can prepare themselves for the challenges of their would-be professional performance, in regards to every individual patient.

The paper’s foremost objective is to identify the professional responsibilities of a nurse, as someone whose foremost task is concerned with providing emotional/physical comfort to mentally inadequate patients. The paper also aims to test the validity of the idea that this task is best accomplished within the rehabilitative (patient-oriented) service framework, as opposed to the allopathic (conventional) one, which downsizes a nurse’s role to that of the physician’s mere helper.

The main question that our research project strives to answer can be formulated as follows: Can we safely assume that the time has indeed come for the allopathic nursing paradigm in mental healthcare to be re-examined, which in turn will lead towards redefining the roles of a nurse in the mental care-setting? The secondary question is as follows: What are the main driving forces behind the anticipated development, in this regard?

Hypothesis. Suppositions regarding research outcomes:

• Hypothesis 1: The reconsideration of the roles of nurses in the contemporary mental health field will allow for a redesign of the activities that nurses will carry out to manage the emerging issues and provide the required services, as well as for the adoption of the patient-centered approach, which will help improve the quality of the nursing services provided.
• Hypothesis 2: The current set of roles that nurses play in the mental health domain is restricted to a comparatively short number, which prevents nursing specialists from delivering the services of the required quality.
• Hypothesis 3: The significance of the nurses’ roles related to counseling and behavioral therapy needs to be increased in the contemporary area of mental health issues.

Methodology: Working with Data Available

The validity of the initially provided suppositions needs to be proven empirically. The task in question is best achieved by the mean of applying a qualitative inquiry into the subject matter in question. The rationale behind this suggestion has to do with the phenomenological nature of the discussed issue – people’s opinions (in regards to whether the currently deployed psychiatric nursing model is fully appropriate or not) are highly subjective. What it means is that the significance of these opinions is always the matter of interpretation. And, making it possible to interpret the discursive implications of the empirically obtained and analytically synthesized data has always represented the main objective of just about any qualitative research (Biggerstaff & Thompson, 2008).

The methodological approach to conducting this study is chosen to be the interpretative (meta-synthetic) analysis of the themes and motifs, contained in the academic articles/books of relevance. The reason for choosing in favor of this particular approach has to do with the fact that, as time goes on, the role of a nurse in mental health area continues to be reassessed, so that it remains consistent with the currently prevailing nursing-related discourse. In its turn, this implies that it is crucially important for researchers to be able to recognize the actual vector of this discourse’s development – something that is best achieved by the mean of analyzing/synthesizing its effects on how NPs perceive the scope of their professional responsibilities, with respect to mental patients.

The empirical part of this research is concerned with reviewing scholarly articles/books that discuss different aspects of the subject matter in question. These articles/books were obtained from the academic databases of ProQuest and EBSCO. The point was made in selecting the most up-to-date and yet highly relevant academic materials.

Findings: Nurses and the Mental Health Domain

As of today, a psychiatric nurse is expected to act as an aide to psychiatrists; as a technical expert, capable of diagnosing basic mental illnesses and prescribing patients with the anxiety-relieving medications/therapies; and as a counselor, in charge of helping patients to remain in the state of emotional equilibrium (Townsend, 2014). However, the effectiveness of NPs, in this respect, is hampered by the fact that they continue to be encouraged to address the problems of mental patients in the essentially ‘mechanistic’ manner, while believing that a psychotropic pill is a main key to making such patients feel better (Perraud, Delaney & Carlson-Sabelli, 2006).

Nevertheless, as time goes on, it becomes increasingly clearer to professionals in the domain of mental healthcare that the actual needs of mental patients often revolve around these people’s deep-seated need for attaining the state of body-mind wholesomeness – something that has traditionally been considered the main objective of the so-called ‘person-centered’ therapies (Caldwell et al., 2010).

The needs of mental patients can be understood better within the methodological framework of the earlier mentioned ‘holistic’ (or ‘integrative’) concept of nursing care. According to Zahourek (2008): “In holistic health, the concept of healing does not necessarily mean cure (the lack of illness) but implies coping, growth, and often a spiritual transformation and transcendence” (p. 35). The validity of this suggestion is supported by the recent breakthroughs in the fields of neurobiology, psychology, physics and cybernetics.

Quite a few authors agree that the above-mentioned calls for the deployment of the so-called ‘person-centered’ approach to treating mental patients by NPs. This approach is concerned with the idea that nurses are more than capable of empowering mental patients in a variety of different ways, even though the very process of being provided with psychiatric care has been traditionally considered strongly disempowering – at least in the social sense of this word. The approach’s main focus is not on managing the symptoms, but rather on helping patients to achieve self-actualization – something that is believed to be strongly beneficial to the mentally ill person’s overall well-being (Barker, 2001).

Thus, the current trend of more and more healthcare professionals choosing in favor of the person-centered (holistic) approach to treating patients appears thoroughly justified. Apparently, as time goes on, NPs grow increasingly aware that, “Since nursing’s mission is to diagnose and treat human responses, it is critical that nurses understand the experiences of people” (Jenner, 1997, p. 10). The existence of a positive correlation between a nurse’s willingness to apply an extra effort into accommodating patients and his or her experiential seniority, substantiates the suggestion’s validity perfectly well.

The application of the person-centered approach to treating patients in the psychiatric care-settings should prove especially justified. The reason for this is that the concerned practice appears fully consistent with the discourse of post-modernity in healthcare, which in turn has been triggered by some recent scientific discoveries. Apparently, many mentally ill patients are indeed more than capable of integrating into society as its productive members – the fact that more and more NPs grow increasingly aware of it is directly related to the approach’s rising popularity.

The idea that mental patients should benefit from being exposed to the ‘holistic’ nursing therapies, and that nurses should enjoy more executive autonomy while providing care to such patients, is fully consistent with the common practice of choosing the most experienced (and not the most educated) nurses for promotion (Townsend, 2014). As a result, we can assume that this particular idea is indeed thoroughly objective, which in turn suggests the conceptual soundness of all three of the initially provided suppositions. Hence, the main role of a nurse in the contemporary nursing care-setting – to act as the agent of bringing the disjointed parts of a mental patient’s personality together, rather than to be merely in charge of administering him or her with the prescribed drugs and checking the person’s overall physical condition. It is understood, of course, that this validates once again the ‘holistic’ outlook on the scope of nursing responsibilities in the concerned setting.

Data Analysis: Interpreting Information

Given the apparent objectiveness of nurses’ strive towards empowerment; it will be thoroughly logical to expect a number of changes to the role of a psychiatric nurse to take place in the future. The main of them will be concerned with requiring nurses to think systemically when it comes to treating a particular mental patient, and to work in the semi-autonomous mode. Another impending change, outlined by the empirical phase of this research, will have to do with integrating the factor of cultural competence into the very paradigm of mental nursing.

As it was implied earlier, the very realities of today’s living call for the expansion of nurses’ scope – especially when the domain of psychiatric nursing care is at stake. The most logical development, in this respect, would be requiring nurses to care as much about the well-being of a person’s mind, as they do about the well-being of his or her body. In its turn, this will establish the objective preconditions for psychiatric nurses to strive to acquire as many professionally relevant skills, as possible – throughout the course of their careers (Chinn & Kramer, 2013). The most obvious implication of this is that the deployment of the person-centered approach to treating mental patients is indeed justified.

Discussion: Suggestions for Making Nurses’ Scope Larger

Among the main suggestions for making nurses’ scope larger, can be named the following:

Psychiatric NPs must work on increasing the rate of their workplace adequacy by the mean of acquiring ever more professional skills and competencies, as they go through life. This state of affairs is predetermined by the conceptual essence of nursing, as a profession that presupposes its affiliates’ emotional comfortableness with the requirement to indulge in experiential learning on a constant basis. After all, as practice indicates, it is specifically one’s endowment with ‘quick-mindedness’, which more than anything else defines the quality of this person’s performance, as a nurse. In its turn, the psychological trait in question often proves to be the key to establishing the emotional connection between nurses and mental patients – something of a great therapeutic value for the latter. Consequently, the establishment of such a connection creates the objective preconditions for the would-be applied treatment to be as effective, as possible.

The additional role of a psychiatric nurse is to implement the provisions of ‘cultural competence’ in the nursing care-settings, which in turn is concerned with making it possible for the ethnically diverse mental patients to receive a culturally sensitive treatment. In this respect, nurses are expected to be able to communicate effectively with patients, even in cases when the language-barrier appears especially strong. The above-mentioned objective can only be achieved, if nurses do apply a conscious effort in familiarizing themselves with other cultures, on one hand, and in growing increasingly capable of recognizing their own cultural biasness, on the other.

The obtained analytical insights call for the adoption of the Transformational model of leadership in psychiatric nursing, as such that is based upon the essentially holistic assumption that the truly effective leading-process presupposes the absence of any clearly defined difference between leaders and followers. In its turn, this should contribute even further towards creating a patient-friendly atmosphere in the care-settings (Perraud & Carlson-Sabelli, 2006).

Conclusion: Nurses’ Roles in the Modern Mental Health Area

It will be thoroughly appropriate to conclude this paper by reinstating once again that the ongoing transformation of a nurse’s role from that of the physician’s uncritical assistant to that of the ‘wellness expert’ of its own, has been dialectically predetermined (Boling, 2003). This, of course, requires a critical reassessment of many of the currently legitimate, but deeply euro-centric assumptions about what the relationship between nurses and mental patients is ought to be all about – just as the initial thesis presupposed. Even though our study is rather limited (due to the page-count requirement), it nevertheless does put us in the position to suggest that it is indeed only the matter of comparatively short time, before the role of a psychiatric nurse becomes so much more all-encompassing, as compared to what it appears to be the case with it nowadays. Such an eventual development will prove fully consistent with how the laws of scientific progress define the discursive dynamics in the field of psychiatric healthcare.

Comparison table

References

Barker, P. (2001). The tidal model: Developing a person-centered approach to psychiatric and mental health nursing. Perspectives in Psychiatric Care, 37(3), 79-87.

Biggerstaff, D., & Thompson, A. (2008). Interpretative phenomenological analysis (IPA): A qualitative methodology of choice in healthcare research. Qualitative Research in Psychology, 5(3), 214-224.

Boling, A. (2003). The professionalization of psychiatric nursing: From doctors’ handmaidens to empowered professionals. Journal of Psychosocial Nursing & Mental Health Services, 41(10), 26-40.

Caldwell, B., Sclafani, M., Swarbrick, M., & Piren, K. (2010). Psychiatric nursing practice & the recovery model of care. Journal of Psychosocial Nursing & Mental Health Services, 48(7), 42-48.

Chinn, P., & Kramer, M. (2013). Integrated theory & knowledge development in nursing. St. Louis: Elsevier Health Sciences.

Jenner, C. (1997). The art of nursing: A concept analysis. Nursing Forum, 32(4), 5-11.

Perraud, S., Delaney, K., & Carlson-Sabelli, L. (2006). Advanced practice psychiatric mental health nursing, finding our core: The therapeutic relationship in 21st century. Perspectives in Psychiatric Care, 42(4), 215-226.

Townsend, M. (2014). Psychiatric mental health nursing: Concepts of care in evidence-based practice. Philadelphia: F. A. Davis.

Zahourek, R. (2008). Integrative holism in psychiatric-mental health nursing. Journal of Psychosocial Nursing & Mental Health Services, 46(10), 31-37.