January 14, 2019

Psychiatric Nurse Practitioner Spreads Awareness Of The Mental Health Crisis

Psychiatric Nurse Practitioner Spreads Awareness Of The Mental Health Crisis

By Portia Wofford

In the face of a national mental health crisis, nurses have a more important role than ever before. Nearly one in five U.S. adults lives with a mental illness (44.7 million in 2016). Nurses are often the first point of contact for those struggling with a mental illness. 

Psychiatric-mental health nursing is a specialty, within nursing, that largely focuses on caring and advocating for individuals, families, groups, and communities with mental health issues. 

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Interview With a Family & Psychiatric Nurse Practitioner

The American Psychiatric Nurses Association states that psychiatric nurses are experts in crisis intervention, mental health, medications, and therapies to assist patients in mastering mental illnesses. They develop a nursing diagnosis and plan of care, implement the nursing process, and evaluate it for effectiveness

With a broken mental healthcare system many adults with mental illnesses go untreated (60% according to a report from USA Today). One thing PMH nurses can do to help a patient is to recognize their need for intervention. 

Venus Miller-MSN, APRN, FNP-BC, PMHNP-BC, DNP(s) states, “the passion, knowledge, and ability to communicate on the patient’s level related to their diagnosis is imperative for nurses. Nurses should seek education, literature review, webinars, and seminars that focus on mental wellness to be the best caregivers and advocates for their patients.” 

Despite the Mental Health Reform (21st Century Cures Act) which brings awareness, finances, and educational resources that assist in the treatment of mental illnesses, mental health services are being drastically reduced. 

Challenges Of Psychiatric Nursing

USA Today reports that in recent years, $5 billion in mental health services has been cut by states. This makes the job of psych nurses even more challenging. 

When asked what other challenges PMH nurses face Miller stated, “The challenges that nurses face are multifactorial in providing care. The mental disease process can prevent medication administration and counseling from having their full effect. No medication increases the chance of worsening symptoms causing hospitalization. Certain illnesses cause paranoia, leading to a fear of the caretaker or provider. This can cause a refusal of treatment, causing an automatic crisis that harms the patient and others.” 

Nurses must build a trusting rapport with family and significant others, as well. They play a vital role and must fully understand the illness and instructions given so that they can assist with care. 

Ask questions! Nurses should listen carefully for signs of worry, fear, or hopelessness which could point to more serious issues. Difficulty sleeping or eating can also be signs of a larger mental health concern. Open communication is one of the best ways for a nurse to identify a patient with mental health needs. Using resources like the PHQ-9 is also a way for nurses to educate themselves. 

Becoming a PMH nurse

Although many organizations allow LPNs to work in the psych/mental health arena, most require RNs with a psychiatric nurse certification

How do you become certified? 

  • Hold a current, active RN license in a state or territory of the United States or hold the professional, legally recognized equivalent in another country.
  • Have practiced the equivalent of 2 years full-time as a registered nurse.
  • Have a minimum of 2,000 hours of clinical practice in psychiatric–mental health nursing within the last 3 years.
  • Have completed 30 hours of continuing education in psychiatric–mental health nursing within the last 3 years.

Once you complete eligibility requirements to take the certification examination and successfully pass the exam, you are awarded the credential: Registered Nurse-Board Certified (RN-BC). This credential is valid for 5 years.

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Risk, benefits, and qualities

Miller acknowledges that working as a PMH nurse has influenced her everyday life. She states, “It’s mostly positive and involves being an advocate for many. The negative relates to the tragedy that is experienced from mental illness which is poorly controlled; leading to harm of the patient or others. This is why mental wellness and medication management is a priority when it’s related to safety.” 

As a psych nurse practitioner, she notes that the specialty has affected her total mindset. This includes how she cares, holistically, for the patient (e.g., the physical, mental, social, spiritual and psychological focus needed that promotes wellness).  Miller values being able to help bring a person back to a place of wholeness. 

As with any job, there are occupational hazards associated with working in psychiatric-mental health. Safety is the main concern for both the nurse and the patient. Many patients can exhibit paranoia, suicidal thoughts, aggressiveness, impulsiveness, volatile behavior, and an array of other symptoms. Treatment is safety focused, first. Miller notes the best way to maintain safety is to calm the patient and keep him or she focused on something positive. Involve the patient. Reassure. Listen. Keeping the patient involved with active, constant reassurance is an important tool for the job.  

What it takes to be a Mental Health Nurse

  • Mental health nurses should be passionate, patient, flexible, and have great communication and listening skills. 
  • They should also have empathy and a high level of emotional intelligence; yet, remain assertive. Often times, these nurses are their patients only advocates.
  • Familiarity and continuity of care is a priority for those suffering from mental illness. 

Nurses already possess the skills required to care for individuals with a mental health illness. Commitment to being a career-long learner and providing compassionate, individualized care (along with the nursing process) is imperative in helping to combat the mental health crisis. Let’s save lives!

Portia Wofford is a nurse, millennial strategist, healthcare writer, and micro-influencer. Chosen as a brand ambassador or collaborative partner for various organizations, Wofford strives to empower nurses by offering nurses resources for career development--while providing organizations with tools to close generational gaps within their nursing staff. Follow her on Instagram and Twitter for her latest.

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