Psychiatric nurses are found in psychiatric hospitals, psychiatrists' offices, prisons, mental health clinics and home health agencies. These nurses guide their patients through difficult times such as suicidal crises, hallucinations, panic attacks, drug addiction and unresolved grief. A good psychiatric nurse invokes confidence by demonstrating solid mental health skills.
Psychological Assessment Skills
Initially, a psych nurse assesses a patient. She might ask simple questions to determine if a patient knows who he is and where he is. During this time, she is actually assessing whether he's comprehending her questions, as well as his manner of speech. She must determine if he seems paranoid, if he's seeing and hearing properly, if he's delusional, or if he's capable of harming himself or someone else. A psych nurse needs to determine if a patient is responding honestly or if he's attempting to manipulate her -- and whether he might attempt to leave the facility without a proper discharge. She must continue to monitor him to determine if he is actually improving, or just saying that he's getting better because he no longer wants treatment.
The psychiatric nurse must have a thorough understanding of psychiatric medications including regularly prescribed ones, as well as those administered in a psychiatric emergency. She should understand dosing and how to determine if a patient is actually swallowing his pills. A psych nurse needs to know how to give injections. She should fully understand possible side effects of all medications -- and know what to do when a patient is experiencing side effects.
The psychiatric nurse must know how to de-escalate a potentially violent situation. To do this effectively, she must speak calmly, allow the patient to engage in decision-making, give the patient a sense of space, and bring the crisis to a nonviolent resolution. Therapeutic communication and a good client-nurse relationship are at the core of conflict-solving. The nurse must also know how to restrain a patient, as well as understand seclusion techniques for situations that she cannot resolve otherwise.
Mental health nurses educate patients about their conditions and the medications they need to take. As so many psych meds have serious side effects, teaching patients and their families how to respond to side effects and when to seek immediate medical assistance is often the difference between life and death. Psych nurses also teach clients how to control anger, improve self-esteem and assert themselves in positive ways.
Physical Assessment Skills
Psychiatric nurses must earn their chops in medical nursing as well. Their patients may exhibit physical symptoms due to their diseases, syndromes, or living situations. Patients might have health issues associated with age, tumors, picking at themselves, poor nutrition, or drug abuse. Psych nurses must stay at the top of their games to recognize problems and advise their patients accordingly to keep them as healthy as possible.
- Psychiatric Mental Health Nursing: Concepts of Care in Evidence Based Practice, Fifth Edition; Mary C. Townsend; 2006
- Psychiatric Nursing: Contemporary Practice, Fourth Edition; Mary Ann Boyd; 2008
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