Chapter 6 Mental Health Nursing in Community Settings
10
Copyright © 2002 by W. B. Saunders Company. All rights reserved. Chapter 6 Mental Health Nursing in Community Settings Menu F
-
Upload
hoyt-terry -
Category
Documents
-
view
25 -
download
5
description
Chapter 6 Mental Health Nursing in Community Settings. F. Menu. Helpful Attributes for CMHNs. Awareness of self; personal and cultural values Calm external manner; nonjudgmental; flexible Skills: problem solving, psychosocial and health assessment, communication - PowerPoint PPT Presentation
Transcript of Chapter 6 Mental Health Nursing in Community Settings
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Chapter 6
Mental Health Nursing in Community Settings
Chapter 6
Mental Health Nursing in Community Settings
Menu F
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Awareness of self; personal and cultural values
Calm external manner; nonjudgmental; flexible
Skills: problem solving, psychosocial and health assessment, communication
Ability to cross service systems, recognize need for consultation, see strength and ability in even the severely ill
Knowledge of community resources, psychopharmacology, political vision
Willingness to work with those identified by client as support people
Understanding of the social, cultural, and political issues that affect mental health and illness
Awareness of self; personal and cultural values
Calm external manner; nonjudgmental; flexible
Skills: problem solving, psychosocial and health assessment, communication
Ability to cross service systems, recognize need for consultation, see strength and ability in even the severely ill
Knowledge of community resources, psychopharmacology, political vision
Willingness to work with those identified by client as support people
Understanding of the social, cultural, and political issues that affect mental health and illness
Helpful Attributes for CMHNsHelpful Attributes for CMHNs
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Additional Elements of Importance for CMHNs Recent service utilization
Vocational success/difficulty
Income and source of income
Housing adequacy and stability
Family and support system
Level of activity
Meets needs independently/with assistance
Cultural beliefs, re: care
Additional Elements of Importance for CMHNs Recent service utilization
Vocational success/difficulty
Income and source of income
Housing adequacy and stability
Family and support system
Level of activity
Meets needs independently/with assistance
Cultural beliefs, re: care
Bio-Psychosocial Nursing AssessmentBio-Psychosocial Nursing Assessment
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Inpatient Settings
• Locked unit
• Staff-set boundaries
• Regular food, housekeeping, security services
• Medication encouraged
• Milieu
• Health care team support
CMH Settings
• Locked apartment
• Client-set boundaries
• Erratic food, housekeeping, security services
• Client may be noncompliant
• Social isolation
• Limited support
Comparison: Inpatient & CMH settingsComparison: Inpatient & CMH settings
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
CMH Goals
• Client will maintain stability in the community
• Client will participate as active member of treatment team
• Client will demonstrate improved ability to function
Inpatient Goals
• Client symptoms will be stabilized
• Client will return to community
Comparison: Inpatient & CMH GoalsComparison: Inpatient & CMH Goals
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Inpatient Boundaries
•Enforced by seclusion and restraint
CMH Boundaries
• Access negotiated with client or gained trough family, police, or landlord
Inpatient Relationship
• Develop short-term therapeutic relationship
CMH Relationship
• Maintain long-term therapeutic relationship
Comparison: Inpatient & CMH InterventionsComparison: Inpatient & CMH Interventions
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Inpatient Medication
• Supervised, even court-ordered
CMH Medication
• Negotiate consent for and adherence to taking medication
Inpatient Socialization Activities
• Provided and required
CMH Socialization Activities
•Assist client to identify and use community resources
Comparison: Inpatient & CMH Interventions, cont.Comparison: Inpatient & CMH Interventions, cont.
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Inpatient Self Care, Nutrition, Health
Care
• Assist self care, nutrition
• Health assessment and intervention prn
CMH Self Care, Nutrition, Health Care
• Negotiate meaning of adequate self care, nutrition, and health care with client and social support system
• Assist client in assessing for needed community services
Comparison: Inpatient & CMH Interventions, cont.Comparison: Inpatient & CMH Interventions, cont.
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Inpatient Sociocultural Context
• Develop plan of care that attends to sociocultural context of individual
CMH Sociocultural Context
• Work with client and support system to plan
and implement care consistent with sociocultural belief system and context
Comparison: Inpatient & CMH Interventions, cont.Comparison: Inpatient & CMH Interventions, cont.
Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Issue of Social Control
What’s best for individual vs. what’s best for community
Issue of Privilege
Confidentiality vs. obligation to report
Issue of Social Control
What’s best for individual vs. what’s best for community
Issue of Privilege
Confidentiality vs. obligation to report
Common Ethical Dilemmas in Community Mental Health NursingCommon Ethical Dilemmas in Community Mental Health Nursing
MenuB
