Essay Sample on Mental Health & Acute Care Nursing

Introduction

Mental health nurses, also called psychiatric nurses, are tasked with helping the patients manage their mental illnesses and live fulfilling lives (Nurse Journal, 2020b). They also provide psychological assessment, medication, therapy, and crisis intervention to patients with mental health problems (Nurse Journal, 2020b). Conversely, acute care nurses assist patients with critical and urgent medical needs, such as motor vehicle accidents and chronic diseases such as diabetes (Nurse Journal, 2020a).

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One of the differences between a mental health nurse and an acute care nurse pertains to their work. The former is tasked with the treatment of patients with psychological or mental problems (Nurse Journal, 2020b). Conversely, an acute care nurse helps patients in the treatment of acute conditions— especially preparation of patients for surgical procedures and provision of postoperative care (Nurse Journal, 2020a). In the treatment of a new patient, a mental health nurse starts with an interview and an assessment aimed at gaining an in-depth understanding of client’s history, presentation of the illness, other diseases, and behavior (Nurse Journal, 2020b). On the contrary, acute care nurses utilize technology to address patient needs and take necessary steps to thwart medical problems that may arise (Nurse Journal, 2020a).

Another difference between a mental health nurse and an acute care nurse is their target patients. The former helps individuals with psychological disorders, dementia, substance abuse, and mood disorders (Nurse Journal, 2020b). Conversely, the latter works with patients who require immediate and critical management, e.g., those in an emergency room and intensive care (Nurse Journal, 2020a). Therefore, acute care nurses work in hospitals and medical organizations offering critical and emergency care.

Incorporating Mental Health Nurse Role

Majority of the conditions and diseases presented by the patients in the clinical setting have a psychological component. For instance, mental health nurses are needed in psychiatric emergencies. In a psychiatric emergency, a patient displays disturbance of mood, thought, and behavior which if unattended leads to harm to self or others. In such instances, mental health nurses are needed because of their specialization in treating psychological illnesses.

Peplau's Interpersonal Theory of Nursing

Peplau’s theory defines nursing as an interpersonal therapeutic relationship that occurs when registered nurses interact with individuals who need health services. In this theory, the relationship between a nurse and a patient is three-phased— orientation, working, and termination. In the orientation phase, the patients realize that they require help and try to adjust to their new experiences (Hagerty et al., 2017). Concurrently, nurses meet the patients and try their best to gain vital information from them as individuals with peculiar needs. The orientation phase is crucial to mental health nursing because through respect and interest given to the patient. The nurse helps the patient to understand what s/he is currently undergoing and the need for help.

The orientation phase is also crucial to mental health because the patient has an opportunity to ask questions, convey needs, and share presumptions and expectations related to past experiences. Consequently, a mental health nurse identifies the problem experienced by the patient and use available services and resources to address the client’s needs. In the second phase (working), the patient identifies with those who are capable of helping him or her. The working phase is comprised of identification and exploitation sub-phases.

The identification sub-phase is vital because this is the stage the nurse utilizes his or her professional skill, education, and knowledge to solve a specific problem. It is also worth noting that ‘identification’ is critical because a better understanding of a patient’s problem guides a nurse in the provision of unconditional care and empathy. The exploitation sub-phase helps the patient to obtain full benefit from the excellent relationship developed with the nurse. At this sub-stage, the nurse’s role in helping the patient overcome his or her psychological problem is the setting of new behavioral goals to be accomplished through personal effort. Therefore, a patient’s treatment shifts from the nurse to the patient.

In the working phase, the patient has more control of his treatment and care as s/he becomes less dependent on the nurse. During this stage, the nurse activates the discharge process and acts chiefly as an educator and a leader. Therefore, in the treatment of a mental health problem or other diseases, a nurse teaches the patients about the issues affecting them through evidence-based educational techniques. The treatment of a patient can be accomplished faster and better if a nurse utilizes patient-centered teaching methods or using approaches considered by the client as helping get better quickly.

The final phase of Peplau's interpersonal theory is the termination phase. The nurse and the patient dissolve their nurse-patient relationship. Therefore, termination is characterized by discharge plans aimed at helping a patient organize himself or herself towards self-reliance. In this phase, the treatment of a patient is accomplished by ensuring that s/he has relevant knowledge and skills needed for self-management. The knowledge and skills are imparted to the patient by the nurse, leading to the client’s display of desirable behavior.

Historical Events in Mental Health Nursing

Mental health nursing utilizes human behavior theories as a scientific approach for diagnosis and treatment of actual and potential psychological illnesses. The history of mental health nursing dates back to 1773 when the first hospital was set up in the United States—Williamsburg, Virginia (Hashem, n.d.). Two decades later (1793), Philip Pinel revolutionized psychiatry when he freed mentally ill patients who were incarcerated in Bicetre, a hospital outside Paris (Hashem, n.d.). Almost 20 years later, the first psychiatric book was written in 1812 by Benjamin Rush regarded as the father of psychiatry. In the same year, an ex-patient (Clifford Beers) of a psychiatric hospital documented the challenging experiences in the hospital.

The late 18th century was a milestone in the treatment of mental illnesses as moral aspects were incorporated into the treatment. The need to be kind, compassionated, and be human when treating mentally ill individuals was emphasized. A century later, the term schizophrenia was coined by a Swiss psychiatrist, Eugene Bleuler, in 1912 (Hashem, n.d.). This was followed by the introduction of insulin coma therapy for schizophrenia in 1927. A decade later (1938), psychosis treatment advanced to the use of electroconvulsive therapy (ECT). In 1939, Sigmund Freud developed psychoanalytical theory leading to a better understanding and treatment of psychological illnesses. Pharmacological treatment of mental diseases was also introduced in 1949 (lithium) and 1952 (chlorpromazine). However, the 20th century was characterized by divergent views regarding the causes of mental disorders. Some researchers attributed mental illnesses to biological aspects, while others attributed them to psychological causes (Hashem, n.d.).

Key Concepts in Mental Health Nursing

According to Shattell et al. (2008), the therapeutic milieu was developed in the era of lengthy hospitalizations, few medications, and face-to-face nurse-patient interactions. The therapeutic milieu is aimed at providing inpatients with stability and coherence in the social organization through a goal-oriented treatment plan (Mahoney et al., 2009). Therapeutic milieu utilizes behavioral, physical, spiritual, and psychological interventions aimed at supporting and stimulating healing (Mahoney et al., 2009). An optimal healing environment is characterized by high-quality care, patiently loyalty, high patient satisfaction, and the presence of highly qualified professionals (Mahoney et al., 2009). The CAM therapies have been found to be effective in the treatment of mental illness, such as post-traumatic stress disorder in the military (McLay et al., 2013).

Crisis intervention refers to the methods used to provide immediate short-term help to someone who has undergone an event that results in behavioral, physical, mental, and emotional distress or problems. On the other hand, pharmacological intervention refers to the treatment of illnesses or diseases by the use of drugs such as the use of antidepressant medication to treat depression. In biological intervention, the condition is treated using portions of a patient’s natural immune system. An example of biological therapy for depression is the administration of selective serotonin reuptake inhibitors (SSRI) which work by increasing serotonin level in the brain.

Complementary and alternative medicines (CAM) refer to different approaches which are not part of the standard conventional medicine (Falci, 2016). The CAM is used to complement conventional medicine or in preference to standard medical treatments (Falci, 2016). Example of CAM interventions includes mind-body therapies, movement therapy, acupuncture, massage, and osteopathic or chiropractic manipulative treatment (Falci, 2016).

Conclusion

Despite the differences described above, a mental health nurse and an acute care nurse share some similarities in their education and training. For instance, both of them are required to have a degree in nursing (BSN) before being enrolled in certification courses and licensure exams. Becoming a mental health nurse requires one to have a BSN, completion of the National Council Licensure Exam (NCLEX-RN), and Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) certification (Nurse Journal, 2020a). Similarly, an acute care nurse must have a BSN and an Advanced Practice Registered Nurse (APRN) certification (Nurse Journal, 2020b).