It is a role that developed in the late 19th Century and is now, unfortunately, associated with rather unpleasant fictional characters. Like Nurse Ratchet from One Flew Over the Cuckoo’s Nest.
However, psychiatric nursing is an important role and, just like most nursing, a very tough one!
It is also a job that has many different names. Depending on the country you are working in. In the UK, it is a mental health nurse. In parts of the USA, your title may be a behavioral health nurse. The role is, for the most part, largely the same. You will be a nurse who looks after people with mental health issues. In some cases, you may be looking after those who have dementia. Or there may be genetic elements to the illness, such as Wilson’s disease or porphyria.
Like most areas of nursing, you can even specialize in the area of mental health you want to work in. Some professional nurses become experts in treating those who have eating disorders.
Like anorexia, bulimia, and binge-eating disorder. Others become experts in nursing in child psychology. Or you may want to help those who have psychotic illnesses. Like schizophrenia and psychosis. So, there are lots to choose from in this field.
So what does a standard day in the life of a psychiatric nurse entail? What is involved in this job? Here is an introductory guide to the job of a psychiatric nurse.
1. Design and Implement Treatment Plans
Suppose you are a mental health nurse working on an award. For patients who are diagnosed with schizophrenia and psychosis. This is an environment in which you and your team can implement treatment plans.
Where you can oversee if they are workable or not and, of course, whether or not the patient wants to engage with them. Treatments plans are guidelines to help the patient to recover and can include things like medications and access to certain kinds of therapy. They also try to take into account the patient as a whole. So, they can incorporate the patients’ hobbies to help them get better.
It can often be the case that a patient is too ill to agree to a treatment plan. So, it is the responsibility of you, the psychiatrist and the care workers to implement it. It will usually involve an array of multidisciplinary meetings. Where the patients’ illnesses will be assessed.
How they are responding to medication will be explored. Along with social factors. Such as whether they have a good support network at home. Or whether they can access external groups when they leave the hospital.
This sounds complicated because it is, and in some instances, there will be failures. The patients’ presentation may change. Or they may deteriorate, and the plan will need to be redesigned. As a mental health nurse, you will have to change the plans and make sure that your team is up to speed on the new changes.
2. Monitor Patients
Following on from the example of a ward nurse. It is your responsibility to monitor the patients under your care.
This means checking in with the support staff and highlighting any changes to more senior members of the team.
Remember, mental health is a complex area. The road to recovery may not be straightforward for your patients. So, you will need to assess them each day.
This also extends to medication. As a psychiatric nurse, you will be responsible for giving your patients meds. As well as ensuring that they take them and once again, monitoring and recording how they respond to the meds. Are they sleeping more? How is their mood? All of these points need recording. Alongside the standard observations.
You and your team will also need to discuss if a patient suits their medication. As is the case with a lot of psychiatric meds, they just don’t suit the patient. They can make symptoms worse. Or cause them to sleep for hours on end. Thus, hindering their functioning.
3. Training New Nurses
When it comes to working in any setting, you will need to oversee trainees and this is where you take on a leadership/mentor role for student nurses.
There are many training courses that may send trainees to your ward. Some may be training in nursing overall and some may be looking to train as mental health nurses. Some may be undertaking more specialized programs. Such as Wilkes University nursing programs. As a nurse, you will need to help them to learn. So be prepared for lots of questions and lots of demonstrations!
You will also need to sign off on and perform assessments on your students. So, this will require you to learn the material from which they are being trained. As before, there are many programs that are teaching nursing and you will need to know a bit about all of them in order to supervise effectively.
4. Connect With Your Patients
This area is one that can cause a lot of student nurses to trip up. Especially on their psyche rotation.
Connecting with your patients is what makes this role fulfilling but also very challenging.
Take the example from before of a nurse working in a psychiatric ward. For patients with schizophrenia. These patients may be suffering from extreme delusions. Or they may be hallucinating. In some cases, they may be neglecting their self-care. All of this can make connecting with them difficult but you need to do it.
Sit with them and talk to them one to one. Don’t assess them solely on what they have written in their case file. It is important to remember that they are ill and in need of care. So, try to coax them out of their shell.
One of the top things that can help a patient to recover is a supportive environment. So, aim to provide one where they know they can turn to you, and you know what their favorite TV show is. It sounds simple, but it really helps!
5. Risk Assessments
A risk assessment will be part of a care plan but due to the wording, it seems wise for the sake of this article to separate them.
When a patient is on your ward or working with you in the community, risk assessments will need to be performed. This will help to keep you safe, your team is safe, the community safe and your patient safe.
That is not to say that mental health patients are violent. Quite the contrary. The majority of those in inpatient care are more likely to harm themselves. So, as their nurse, you must conduct a risk assessment. This may involve a bit of detective work. If you feel your patient is lying to you about their drug use, for example. Or if they have been self-harming, this needs to be flagged up and reported to someone higher on the team.
If you work on awards, you will also oversee keeping patients safe from each other. Sometimes, they may be an antagonistic patient. Who is upsetting many of the other patients? It is your job, and your team’s job, to assess the risk of this escalating into a fight. If this does happen, you need to fill out the appropriate paperwork and meet with other professionals on the team to explore what happened.
6. Liaising For Your Patients
It is an unfortunate truth that many people in psychiatric care do not have a large support network. There is still a stigma around mental health in the US. This means that many of your patients will not have someone to fight their corner. So, to speak.
This can come into play more in a forensic psychiatric setting. Where your patients may be facing court appearances or assessments from legal teams. It is your role as their nurse to liaise with others on their behalf. This will involve sitting with them when they are being interviewed. Or when they are attending court. You may need to write notes on their behalf too.
Pulling back from this example, there is the standard liaison too. Suppose the ward psychiatrist wants to put your patient into a group. To help to build on their social skills, but your patient has told you previously that they do not want to attend this.
You will need to liaise on their behalf with the psychiatrist to meet a compromise. Remember, the aim of such things is to help the patient to recover, but not at a pace they cannot maintain. As this will ensure a higher failure rate.
7. Talking With Family Members
There are a few people who you will meet that have strong family networks. Some may have partners. Some may be married, and some may have children.
As a mental health nurse, you will need to communicate with relatives. Much as any nurse would in any setting. You will have to answer questions in a straightforward way. While also delivering potentially upsetting information.
For instance, your patient may have injured themselves on purpose. Which will need to be passed on to their family if it is deemed relevant. Alternatively, they may have gotten into a fight. Which could lead to them needing stitches etc.
This is where your role as a compassionate caregiver will shine. You will need to provide comfort to the relatives. Especially if they have children. Should the relatives come to the ward, you may need to sit in on their visits. To ensure that your patient doesn’t become agitated. You can also talk to the family about the diagnosis that your patient has received and be sure that they have access to material to learn more about it. This will help to support the patient once they leave the hospital. While also reducing the chances of them coming back. Or becoming a revolving door patient.
8. Help Patients Develop
Back to the patients!
As a psychiatric nurse, it is your job to help them to develop. Especially with coping skills and dealing with their emotions. This can be challenging and should only be attempted with the help of other professionals initially. Such as a psychologist or therapist.
You may need to help them with ward activities. Such as cooking. Or cleaning. Or even helping them to keep their room tidy. This may sound odd, but these are skills that can be neglected. Especially by people who have severe mental health issues. By showing them how to do it, you can really help them to learn skills.
You can even extend this to referring them to outside help. This can be a local sports team if they like sport. Or an art club. Provided that they are well enough to attend and do not pose a risk. This can help your patients to develop their social life.
As well as building their confidence. Which may have been lost since they have been in hospital. If you are a community nurse, you can operate under a similar mindset, but you can refer your patients on to therapy groups. Ensure that they are signed up for doctors and dental surgeries, and of course, make sure that they have somewhere to live. Alongside access to money.
All of these things can help them to recover and develop, and can really make the job worthwhile.
This article is, of course, just a short guide to the role of a psychiatric nurse. It will vary based on where you are located. The environment you work in, and the role you have. A senior mental health nurse will have more responsibilities, for instance.
The role of a psychiatric nurse is a very tough one. It allows you to truly make a difference in the lives of those who are the most vulnerable. As well as meeting some great people! There will be challenging times, but many mental health nurses report a high level of job satisfaction. Making it a great area to train in if you truly love helping people, and if you truly want to make a difference in vulnerable people’s lives.