Leadership and
Management Role Mapping
of Psychiatric and Mental
Health Nurse
GEROPSYCHIATRIC NURSING
Description of the Role: The geropsychiatric
nurse is someone who specializes in caring for
older adults with a diagnosis of depression,
dementia, and other mental health disorders.
They are employed in various health care
settings such as home care, ambulatory care
settings, and acute care facilities.
Situational Example: For an elderly patients with Delusions and those with
dementia may seem delusional because of the trouble they have in interpreting
the environment. As a primary care provider, the geropsychiatric nurse should
be proficient at assessing patients’ cognitive, affective, functional, physical, and
behavioral status, as well as their family dynamics. Geropsychiatric nursing is
a collaborative partnership with the older adult, family or other caregivers, and
the interdisciplinary team. Providing nursing care to these patients can be
complex because they are often involved with a number of agencies requiring
coordination of services. He/she should be knowledgeable about somatic and
interpersonal treatments, including the safe use of psychotropic medication
with elderly people. They often work closely with physician and nurse
prescribers to monitor complex medication regimens and help the patient or
caregiver with medication management. They may lead a variety of groups,
such as healthy aging, demotivation, bereavement, and socialization groups,
whereas nurses with advanced degrees may also provide psychotherapy and
prescribe medications
PARISH NURSE
Description of the Role: Parish nursing is the intentional integration of the
practice of nursing with the beliefs of a religious community. A parish nurse is
a registered nurse (RN) specialist who encourages physical and spiritual
health and wholeness by developing and leading programs within faith
communities. The American Nurses Association (ANA) defines Faith
Community Nursing (FCN) as “the specialized practice of professional
nursing that focuses on the intentional care of the spirit as part of the process
of promoting holistic health and preventing or minimizing illness in a faith
community.” Rather than dealing primarily with sickness in a faith community,
parish nurses focus on wellness, disease prevention and health promotion.
Situational Example: Churches have emerged as an important site for community health
nursing because they are mostly underserved and church members are common suffering
from hypertension and diabetes. Previous screening had shown that many members were
undiagnosed and many of those who had been diagnosed had not received treatment.
Therefore, the parish nurses may write articles for their church newsletter or post health
education on a bulletin board. They may visit people in their homes to check on them after
they’ve been in the hospital, review discharge instructions and may refer people to a
community resource that’s needed. They may teach small group classes on something as
basic as hand-washing to as complex as heart disease. Parish nurses seek to increase
health awareness and to help people understand the relationship between lifestyle,
personal habits, attitudes, faith and well-being. They promote health and healing within
the context of values, beliefs, traditions and culture of a faith community. The worker's
most important function is to make strong connections with the churches for health
education and screening, so that no congregant has undiagnosed or untreated
hypertension or diabetes.
COMMUNITY NURSING HEALTH NURSE
Description of Role: The community mental health nurse is a
professional who works in collaboration with an interdisciplinary
clinical team to provide specialized support to families and clients
who are experiencing mental health challenges, some of which
can include anxiety, depression, personality, and eating disorders,
addiction to drugs or alcohol, and host of other mental health
challenges.
Situational Example: Nurse Lee works outside hospitals and visit
her clients in their own homes, out-patient departments or GP
surgeries. She also helps clients to talk through problems and give
them practical advice and support. She can also give medicines
and keeps an eye on their effects. She also had extra training as a
Nurse therapist in particular problems and treatments, such as
eating disorders or behavior therapy.
PSYCHIATRIC CONSULTATION-LIAISON
Description of Role: Psychiatric consultation/liaison nurses
focus on the emotional, spiritual, developmental, cognitive, and
behavioral responses of patients and families. It is an advanced
practice nurse who practices psychiatric & mental health nursing
in medical setting/non-psychiatric setting providing consultation &
education to patients, families, & health care team & the
community.
Situational Example: Nurse Althea, who is a PCLN provides
assessment, recommendations & supportive therapy to her patients
who are anxious, depressed or experiencing other psychological
problems or emotional distress. She helps her patients, family, staff,
and the entire healthcare system cope with a medical illness and its
treatment. She also ensures that her patient's emotional needs are
met, patients and families feel more cared for and respected, and
patient satisfaction is increased.
TELEHEALTH NURSING
Description of the Role: Telehealth nursing is the nursing care
delivered by remote device monitoring, phone, video chat and
other technologies. Telehealth nursing is thought of as the use of
telemedicine and technology to conduct nursing and deliver care
in a remote location. Nurses who practice telehealth utilizes the
latest technology to provide distance healthcare to patients
through monitoring and virtual visits.
Situational Example: During this COVID-19 pandemic, it really affects
older people's lives beyond morbidity and mortality from the virus itself.
Seniors spend less face-to-face time, which includes medical
appointments. With this, it is advised all healthcare facilities and providers
to adopt social distancing in offices and offer services through virtual
means, like phone calls and video chats. Like in the situation of Mrs.
Lagmay, she isn’t able to go out and have consultations because of the
pandemic. That’s why, she sets a virtual appointment with her nurse,
Nurse Miki, to have monthly consultation and monitoring through zoom
meeting or phone call.
CASE MANAGER
Description of the Role: Case management nurse oversees the
long-term care plan for his or her patients. Often working with a
specific type of patient requiring ongoing medical care (e.g.,
geriatrics, HIV/AIDS or cancer patients), the case management
nurse collaborates with other medical professionals to create and
implement a long-term care plan that insures a patient gets the
comprehensive care they need. Case management nursing is a
particularly rewarding field that allows nurses to develop long-term
relationships with their patients, often working with them for the
entire course of their illness and treatment.
Situational Example: In the community, Nurse Cami, a case
manager nurse, works her patient, Biya who is clinically
diagnosed with mental retardation, on a broad range of issues
from accessing her needed medical & psychiatric services to
carrying out her tasks of daily living such as eating, taking a
bath, managing money & buying groceries.
FORENSIC NURSE
Description of Role: Concerned with the management
and treatment of offenders with mental health issues.
Those patients who encounter the criminal justice system
because of their mental health or who become unwell
following a criminal offence.
Situational Example: A client with PTSD committed a murder. The
forensic psychiatric nurse will therefore obtain the perpetrator’s (the
PTSD client) medical and social history from relatives or the client’s
doctor; examine his mental status; and investigate the scene of the
death. Thus, if proven guilty, forensic psychiatric nurse will be involved
in assessing a person’s suitability to be admitted and decide on which
level of security he should be admitted to. May it be prison, general
adult wards or other secure wards in either high or low secure units,
depending on legal matters and mental status of the client.
PSYCHIATRIC HOME CARE NURSE
Description of the Role: Provides holistic psychiatric nursing
care via flexible scheduling home visit basis to attend to special
needs of persons with mental condition. They conduct physicals
assessment regularly and assessment through interview with
the patient and relatives to gather vital information in the plan of
care, administers and notes reactions to psychotropic drugs and
other medications. With enhanced access, psychiatric home
care nurse coordinates patient care across mental health
continuum and a whole range of healthcare providers
Situational Example: Nurse Rabiya, a psychiatric home care
nurse is having her regular home visit to her client who is suffering
from Schizophrenia. Nurse Rabiya checked if the client has been
religiously taking her neuroleptic medication as well as reeducated the significant others about efficiently assisting the client
in taking meds. Since nurse Rabiya divided focuses in every visit,
the focus of today’s visit is to promote social skills where she
assisted the client in recognizing social cues and how to properly
respond to them.
NURSE RESEARCH
Description of the Role: Nurse researchers are
providing a unique scientific perspective of how
nurses can help patients manage multiple symptoms
caused by either their conditions or certain
treatments. They create and implement scientific
studies to improve healthcare services and patient
outcomes.
Situational Example: With the COVID19 pandemic situation,
mental health in higher education has become a growing
concern. The nurse researcher's job will be to perform
interviews/surveys about the impact of COVID19 on their
mental health and to establish approaches and prevention
measures to address the mental health of college students.
PSYCHIATRIC NURSE EDUCATOR
Description of the Role: Nurse educators who work in mental
health services have two specialties: nurse educators and mental
health professionals. The mental health nurse applies expert
expertise of clinical teaching, learning, and practice to improve
consumer treatment in mental health services as a nurse
educator (NE). Also, the psychiatric nurse educator’s works in
educational institutions, staff development department of health
care agencies, patient education department (teach the mentally
ill patients & their families about care to provide at hone). Another
function of nurse educator in planning & changing the curriculum
planning according to the needs of the society & learner.
Situational Example: A 23-year-old, female patient who is
clinically diagnosed with anorexia nervosa has just been released
from the hospital. The psychiatric-mental health nurse instructs
the family to insist that the patient participate in regular family
meals and clean up after dinner, even though she does not eat, in
order to encourage recovery at home.
NURSE ADMINISTARTOR
Description of the Role: A nurse administrator manages the nursing staff at a
healthcare facility.
He or she has a broad and versatile range of
responsibilities. Traditionally, the main component of their job is to supervise
the nursing staff at their healthcare facility, including clinics, medical facilities,
and other institutions. The nurse administrator operates in two major areas.
First, they oversee the operations and functioning of staff, deal with personnel
issues, and address any concerns the team has. Second, they are also a part
of the administrative team of their organization, where they focus on areas of
finance, human resources, and protocol compliance. Their administrative duties
include attending meetings, conducting performance reviews, and developing
personnel procedures.
Situational Example: A situation wherein an institution is having the ethical
problems of caring for chronically nonadherent patients. The severity of the
patient's conduct was having a significant negative impact on the team's
ability to deliver treatment according to defined expectations. In certain
cases, chronic nonadherence was exacerbated by aggressive attitudes
against nursing staff and other patients on the unit. To address this issue,
the ethics committee, at the urging of the nurse administrator, convened a
subcommittee with the goal of assembling tools and creating guidelines for
dealing with chronically nonadherent patients in ways that both respected
their autonomy and encouraged better adherence by patients who genuinely
wanted to benefit from medical care. The nurse administrator's participation
on the ethics committee and as part of the consult service was central to
helping our institution develop guidelines for addressing one of the very
challenging ethical issues facing nurses in day-to-day practice.
PSYCHIATRIC NURSE AS COLLABORATIVE
MEMBERS OF THE INTERDISCIPLINARY TEAM
Description of the Role: The Psychiatric Nurse collaborates with
the patient’s interdisciplinary team in order to achieve common goals
as an outcome of care. The nurse helps to facilitate the mental health
of the patient, family or community within the context of the treatment
team.
Situational Example: Registered nurses identify patient cases that could
potentially benefit from an interdisciplinary client care conference, they plan
and arrange for these conferences and they participate in them. Planning
interdisciplinary client care conferences is often challenging. An agenda is
developed, information is collected for presentations, healthcare team
members are invited, a time, a date and a room is decided upon and the
client and significant others are encouraged to attend. Participating in
groups, including an interdisciplinary client care conference, requires
preparation; therefore, nurses should be prepared for these meetings. They
should have data and information readily accessible to discuss and they
should also have some recommendations for future care that may enhance
the client's outcomes of care.
NURSE PSYCHOPHARMACOLOGY
Description of the Role: Psychopharmacological agents treat
specific symptoms of neurobiological illnesses with significant
effectiveness, although side effects and adverse reactions of
drug therapy require expertise and sound clinical judgment on
the part of the nurse. Moreover, psychopharmacological
treatment should be integrated with the principles of psychiatric
nursing practice presented throughout this book. The psychiatric
nurse has a wealth of knowledge and competencies that make
the nursing care provided to people with psychiatric disorders
unique in many ways. Following are some examples of the
nurse’s role in psychopharmacological treatment of persons with
neurobiological illness.
Situational Example: Mae is the student nurse caring for a 27-year-old patient who
has been newly diagnosed as a schizophrenic. The patient has been prescribed
ziprasidone (Geodon). The patient asks Mae how long the medication will need to be
taken.
a. What is the student nurse's responsibility to the patient regarding patient
education?
- Nurse Mae should educate the patient about the disease-Education about the
disorder can help motivate the person with the disease to stick to the treatment plan.
Education can help friends and family understand the disorder and be more
compassionate with the person who has it.
- Nurse Mae should educate on importance of taking the drugs for lifetime-people
most benefit from taking medication for schizophrenia most of their lives.
Thank you for listening