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Mental Health and Psychiatric Nursing

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INTRODUCTION TO THE COURSE You are welcome to this interesting specialty nursing courseoffered inthe general nursing curriculum. The course focuses on the study of mental health and psychiatric nursing as part of general nursing and it is designed to provide you the opportunity of applying the nursing sciences in the care of patients suffering from psychiatric illnesses. This course will broaden your knowledge and skills needed for meeting the ever changing needs of psychiatric clients/patients, their families and society. The whole course will take 84 hours on theory and 210 hours practical experience which embraces community psychiatry. It is a full course similar to medicine and medical nursing. Psychiatry is a branch of medicine which deals with the study and treatment of mental diseases. It deals with the mind, emotions and behaviour of man precisely; the least understood portion of the human being. Psychiatric illness is characterized by a breakdown in the normal pattern of thought, emotion and behaviour. Psychiatric symptoms, problems and illness of all kinds are very common throughout life. Psychiatric nursing is a specialized branch of nursing in which the nurse utilizes personal knowledge of psychiatric theory and the available environment to effect therapeutic changes in the patients’ thoughts, feelings and behaviour. The nurse’s ability to effect these changes varies according to the nurse’s experience and education. The therapeutic role of the psychiatric nurse cannot be described only in terms of attitudes, feelings, relationship and understanding. What the nurse brings as a person to the treatment situation is directly related to her therapeutic effectiveness. Psychiatric nursing is concerned with the identification, promotion, prevention and care of patients suffering from mental disorders (Keltner, Schwecke and Bostrom, 2007). Thus, psychiatric nursing is the process whereby the nurse assists persons, individuals or groups in developing a more positive self-concept, a more harmonious pattern of interpersonal relationships and a more productive role in the society. MAIN COURSE OBJECTIVE Students will be equipped with knowledge and skills in mental health to enable them understand human behaviour and manage clients with mental disorders. COURSE OBJECTIVES At the end of the course, you should be able to: 1. Describe normal human behaviour 2. Describe abnormal human behaviour 3. Describe common psychiatric conditions 4. Apply psychiatric nursing principles in managing patients suffering from mental illness 5. Explain how the family can be used as a primary resource in rehabilitating patients suffering from mental illnesses 6. Identify resources within the community for rehabilitation of patients suffering from mental illness 7. Describe how available resources can be utilized in rehabilitation of the mentally ill 8. Apply communication skills in identifying clients at risk within the family and community COURSE CONTENT This course has eight units/titles. UNIT 1: Introduction to Mental Health-Psychiatric Nursing In this unit, you will be introduced to mental health and psychiatric nursing concepts and approaches to create an understanding of this specialty. Psychiatric nursing as you may understand, is a branch of nursing concerned with identification, prevention and care of people suffering from mental illness (Townsend, 2010).Hence, from this brief description of psychiatric nursing, it is understood that you will be able to provide minimal specialised care to patients suffering from mental health and psychiatric illnesses in communities around you as well as at the health facility you will be working from after you qualify from your training in general nursing. UNIT 2: Psychiatric Nursing Skills You might acknowledge that psychiatric nursing skills comprise the foundation of a nurse-patient therapeutic relationship, which is key to intervention modality of psychiatric nursing and for a psychiatric nurse to be a good communicator; he/she should reinforce self-awareness before dealing with the concerns of a psychiatric patient (Corpel, 1996).Thus, you will learn numerous psychiatric nursing skills as organised in this unit 2. UNIT 3: Classification and Management of Psychiatric Disorders As for this unit, youwill learn about classification of psychiatric disorders mainly from two mostly recognised classification criteria by World Health Organisation (WHO) despite that there are many other diagnostic criteria by the Chinese, Russians and Japanese. The International Classification of Diseases (ICD) of British origin has undergone numerous changes from ICD1 to the current ICD10; probably there should be even a newer version now which could be in the way out for publication. The other approach to classification of disease entities in mental health is through the American Diagnostic Statistical Manual (DSM) which also went through several reviews up to the current DSM V (2014) from DSM I, II, III and IV. The DSM uses Axes; Axis I, II, III, IV and V in providing a diagnosis while the ICD 10 uses a code F for instance F00-F99, where F20 implies schizophrenia, F30, F10, mean other disease entities, among others. UNIT 4: Conditions not attributed to mental disorders that are a focus of attention and treatment You may be aware that in psychiatry and psychiatric nursing, other conditions might be treated but they do not imply that they are psychiatric illnesses; nevertheless, because of behavioural disorders that arise due to a medical condition, psychiatric attention is and may be rendered/ provided. Epilepsy for example is a medical condition that receives awesome management in psychiatry. UNIT 5: Management of a Client with Psychiatric Emergency As you proceed in learning in this unit on psychiatric disorders, you will come across psychiatric disorders that jeopardise the lives of the patient him/herself, staff and people in the community and such conditions are treated as psychiatric emergencies hence special supervision has to be enhanced. You will examine and learn more about psychiatric emergencies in unit 5. UNIT 6: Forensic Psychiatry You should be aware that psychiatric patients may not have immunity to litigation once they commit an offence in society but there are legal aspects that apply in psychiatry which provide a platform for their cases to be heard in a court of law in a proficient approach compared to an ordinary court case. Therefore, you will have an explicit orientation particularly in this unit 6 on how such forensic patients receive care while in a detention centre andabout special forensic care units in Zambia. UNIT 7: Community Psychiatry Community psychiatry is a subsidiary of the psychiatric specialty that is concerned with psychiatric issues that arise in the community. You will therefore be tasked to learn about how families cope with the pressures of looking after a relative diagnosed with a psychiatric illness. Besides, you will learn about patient’s social networks as far as psychiatric treatment andsupport are concerned. UNIT 8: Advocacy in Psychiatry You may be aware that psychiatric patients are vulnerable people in society because of the nature of their disorders, hence, others should stand and speak on their behalf so that where need arises, they might have recognition in the communities they live. Non-governmental organisations (NGOs) in this view may provide such support for instance MHUNZA speaks for those suffering from mental illnesses in Zambia. This may not imply that individuals are excluded in providing support to psychiatric patients, for example MHAZ (Mental Health Association of Zambia comprises of many individuals who have taken up independent individual roles in promoting mental health in Zambia. CLINICAL EXPERIENCE Your practical experience in mental health-psychiatric nursing will last for four weeks and you are expected to do it in the following areas: 1. Psychiatric wards 2. Community health centres 3. Drop in centres 4. Orphanages 5. Skills training centres 6. Geriatrics 7. Support groups DEMONSTRATIONS During your clinical experience the following demonstrations will be done:  Admission  Interview (Simulation)  Psychosocial counselling skills  Group therapy ASSESSMENTS Your work in this course will be assessed in the following two ways: 1. Tests and assignments will make up 40% of your continuousassessment results. • Two written tests which will constitute 20% of your continuous assessment. One group assignment which will constitute 10% of your continuous assessment. One individual assignment in the form of a case study during your clinical placement which will constitute 10% of your continuous assessment. 2. A written examination will take place at the end of the course. This exam is worth 60% of the final mark. LEARNING TIPS: How long will it take? It will probably take you a minimum 90 hours to work through this course. The time should be spent on studying the Course and the readings, doing the activities and self help questions and completing the assessment tasks. Note that units are not same length. Unit 3 is the longest and needs more hours to complete. You therefore need to plan and pace how you will cover your work. PRESCRIBED READING There is a list of further reading at the end of this course. This includes books and articles referred to in the Course in case you need to explore certain topics further. You are encouraged to read as widely as possible to get different viewpoints and approaches. UNIT 1: INTRODUCTION TO MENTAL HEALTH AND PSYCHIATRIC NURSING 1.1 Unit introduction In this unit you will look at the definitions of common terminologies used in mental health and psychiatric nursing. You will also have a privilege to learn how mental health has evolved in Zambia from the colonial days up to date. The unit will also introduce you to legal aspects of psychiatric – mental health nursing, some of the mental health laws and mental health policies in Zambia Mental illness has been with man since time immemorial (Stuart and Laraia, 2005). Over the years mental health and psychiatry have gone through a lot of changes. This has shifted from looking after psychiatric patient from prisons to hospital. In order to fully appreciate mental health nursing, It will be important to define key concepts used in psychiatry and mental health, look at the history of psychiatric nursing in Zambia, learn about psychiatric nursingprinciples and the guidelines that govern the care of the mentally ill, 1.2 Unit Objectives By the end of the unit, you should be able to: 1. Define common terminologies in mental health and psychiatric nursing: 2. Discuss the history of mental health and psychiatric nursing in Zambia. 3. Outline the principles of psychiatric nursing. 4. Explain the legal aspects of psychiatric-mental health nursing 5. Explain mental health laws that apply in Zambia 6. Discuss the mental health policies in Zambia 1.3 Definition of commonterminologies used in mental health and psychiatric nursing : 1. Psychiatry: A specialized or branch of medicine that deal in the diagnosis and management of mental disorders. 2. Mental health: ‘Wright Taylor 1970’ defines mental health as being happy, efficient, lack of anxiety, maturity, able to adjust, practicing autonomy and self-esteem is high. 3. Health: A state of well being, but not merely the absence of disease or infirmity 4. Psychiatric nursing is a branch of nursing concerned with identification, prevention and care of people suffering from mental illness 5. Mental health nursing is a specialized nursing involved in identification, diagnosis and management of psychiatric disorders. This definition is synonymous with psychiatric nursing (Townsend, 2011). Other terminologiesused in Psychiatry • Communication: Interaction between people and their environment based on stimuli and responses. • Language: This is a method by which thoughts and activities are made available to conscious awareness. It can be vocal, written or sign represented. • Agraphia : An inability to write occurring in general dysphasia also called apraxia. DISORDERS OF PERCEPTION Illusion: miss-interpretation of stimuli. Hallucinations: presence of perception without stimuli. DISORDERS OF THINKING: • Flight of ideas: Too much ideas flowing together. • Retardation of thought : slowed thought process • Circumstantial thinking : A talk that does not go directly to the topic but takes time for that individual to state the point or simplybeating about the bush. • Fragmented thinking: disjointed ideas. • Delusion : false and fixed belief not based on founded fact(s) or evidence- based research and is not related to an individual’s educational background, religion, race or culture. • Obsession: These arere

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Voorbeeld van de inhoud

DIPLOMA IN REGISTERED NURSING
eLEARNING TRAINING PROGRAMME




Course Title: Mental Health and Psychiatric Nursing
Course Code: MHP 026




Writer(s) : Lungu Rabson
: Nkhosi Jane Kumalinga




Reviewer(s): Mhango, Vincent, Chiwele, George, AminuAbulmajeed
TABLE OF CONTENTS
TABLE OF
CONTENTS........................................................................................................................
........2 LIST OF
TABLES..............................................................................................................................
............5 LIST OF
FIGURES............................................................................................................................
............6 LIST OF ABBREVIATIONS AND

,ACRONYMS............................................................................................7
INTRODUCTION TO THE
COURSE.............................................................................................................8 MAIN
COURSE
OBJECTIVE........................................................................................................................
8 COURSE
OBJECTIVES.....................................................................................................................
...........8 COURSE
CONTENT...........................................................................................................................
..........9 CLINICAL
EXPERIENCE.....................................................................................................................
.......10
DEMONSTRATIONS..........................................................................................................
.........................10
ASSESSMENTS ................................................................................................................
.........................11 LEARNING
TIPS:...................................................................................................................................
.....11 PRESCRIBED
READING............................................................................................................................
11
UNIT 1: INTRODUCTION TO MENTAL HEALTH AND PSYCHIATRIC
NURSING...................................12
1.1 Unit
introduction .....................................................................................................................
...........12
1.2 Unit
Objectives.......................................................................................................................
...........12
1.3 Definition of common terminologies used in mental health and psychiatric
nursing :........................12
1.4 History of mental health and psychiatry in
Zambia............................................................................14
1.5 Principles of psychiatric
nursing........................................................................................................15
1.6 The legal aspects of psychiatric-mental health
nursing.....................................................................15
1.7 Mental Health Laws in
Zambia..........................................................................................................16
1.8 Mental health policies in
Zambia .......................................................................................................16
1.9
Summary.........................................................................................................................
..................17
1.10 Self Assessment
Test......................................................................................................................17



2

, 1.11
References......................................................................................................................
................18
UNIT 2: PSYCHIATRIC NURSING
SKILLS................................................................................................19
2.1
Introduction.....................................................................................................................
...................19
2.2
Objectives ......................................................................................................................
...................19
2.3 Communication
skills.........................................................................................................................20
2.4 Self awareness
skills.........................................................................................................................22
2.5 Assertiveness training
skills...............................................................................................................23
2.6 Counselling
skills...............................................................................................................................
25
2.7 Social
skills................................................................................................................................
........28
2.8 Observation
skills..............................................................................................................................2
9
2.9 Stress management
skills..................................................................................................................32
2.10 Behaviour modification
skills ...........................................................................................................33
2.11 Therapeutic nursing intervention
skills ............................................................................................35
2.12 Physical assessment of a psychiatric
patient ..................................................................................38
2.13Admission of psychiatric
patients ....................................................................................................40
2.14Summary..................................................................................................................
.......................47
2.15 Self Assessment
Test......................................................................................................................47
2.16
References .....................................................................................................................
................49
UNIT 3: CLASSIFICATION AND MANAGEMENT OF PSYCHIATRIC
DISORDERS ................................50

3

, 3.1
Introduction.....................................................................................................................
...................50
3.2
Objectives ......................................................................................................................
...................50
3.3 Definition of
terms .............................................................................................................................
50
3.4 Neurosis/ Anxiety
Disorders..............................................................................................................51
3.5Child birth and Mental
Health............................................................................................................62
3.6Psychosis...................................................................................................................
.......................66
3.7Summary....................................................................................................................
.......................95
3.8 Self Assessment
Test........................................................................................................................96
3.9References.................................................................................................................
.......................99
UNIT 4: CONDITIONS NOT ATTRIBUTED TO MENTAL DISORDERS BUT ARE A
FOCUS OF
ATTENTION AND
TREATMENT ..............................................................................................................101
4.1
Introduction.....................................................................................................................
.................101
4.2
Objectives ......................................................................................................................
.................101
4.3 Children with special education
needs ............................................................................................102
4.4 Attention Deficit
HyperactivityDisorder ...........................................................................................110
4.5
Summary.........................................................................................................................
................111
4.6 Self Assessment
Test......................................................................................................................111
4.7References.................................................................................................................
.....................112
UNIT 5: NURSING MANAGEMENT OF A CLIENT WITH PSYCHIATRIC
EMERGENCY.......................113



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