The PMHNP needs to analyze the ethical and legal implications of psychotherapy and the other aspects of the PMHNP role in order to provide safe and effective care.
The Standards of Mental Health Nursing & Standards of Professional Practice outline the basic competencies for all psychiatric mental health nurses with additional competencies for advanced practice nurses. For this assignment you will review the Standards of Psychiatric Mental Health Nursing Practice, Standards of Professional Practice, Standard 7: Ethics, and address the following:
- Identify two psychiatric mental health registered nurse competencies you found meaningful/important and give an example of a practice intervention for each of the points you identified.
- Identify two additional competencies for the psychiatric-mental health registered nurse you found meaningful/important and give an example of a practice intervention for each of the points you identified.
Full Answer Section
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Competency 2: The PMH-RN applies knowledge of the principles of trauma-informed care. Trauma-informed care recognizes the widespread prevalence of trauma and its impact on mental and physical health. It emphasizes creating a safe and supportive environment, avoiding re-traumatization, and promoting patient empowerment.
- Practice Intervention: A PMH-RN is working with a patient who has a history of childhood abuse. The nurse avoids asking direct questions about the abuse during the initial assessment, instead focusing on building rapport and establishing trust. The nurse explains the importance of trauma-informed care and assures the patient that they are in control of what they choose to share. The nurse creates a safe and non-judgmental space for the patient to discuss their experiences at their own pace. The nurse also collaborates with the treatment team to ensure that the patient's treatment plan is trauma-informed.
2. Two Additional Meaningful/Important Competencies for the PMH-RN & Practice Interventions:
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Competency 1: The PMH-RN engages in therapeutic relationships with patients, families, and groups. The therapeutic relationship is the cornerstone of psychiatric mental health nursing. It involves building trust, empathy, and respect, and using therapeutic communication techniques to facilitate healing and growth.
- Practice Intervention: A PMH-RN is leading a group therapy session for individuals with anxiety disorders. The nurse uses active listening skills to create a safe and supportive environment for group members to share their experiences. The nurse facilitates the discussion, ensuring that all members have an opportunity to speak and that no one is judged or criticized. The nurse also teaches coping skills and strategies for managing anxiety.
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Competency 2: The PMH-RN collaborates with the interprofessional team to provide holistic and integrated care. Mental health care often requires the collaboration of various professionals, including psychiatrists, psychologists, social workers, and other healthcare providers. Effective communication and teamwork are essential to ensure that patients receive comprehensive and coordinated care.
- Practice Intervention: A PMH-RN is working with a patient who is being discharged from an inpatient unit. The nurse collaborates with the psychiatrist to ensure that the patient has a follow-up appointment scheduled with an outpatient therapist. The nurse also contacts the patient's primary care physician to coordinate medication management. The nurse communicates with the social worker to ensure that the patient has access to community resources, such as housing and food assistance. The nurse advocates for the patient’s needs with the interprofessional team.
These are just examples, and the specific competencies and interventions may vary depending on the setting and the population being served. It is essential for PMH-RNs to be knowledgeable about the Standards of Psychiatric Mental Health Nursing Practice and the Standards of Professional Practice and to integrate these standards into their daily practice. This ensures that patients receive safe, effective, and ethical care. Ethical decision-making is an ongoing process that requires careful consideration of all relevant factors and consultation with colleagues and supervisors when necessary.
Sample Answer
Let's explore the ethical and legal implications of psychotherapy and the PMHNP role, focusing on the Standards of Psychiatric Mental Health Nursing Practice and Standards of Professional Practice, specifically Standard 7: Ethics.
1. Two Meaningful/Important Psychiatric Mental Health Registered Nurse Competencies & Practice Interventions:
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Competency 1: The psychiatric mental health registered nurse (PMH-RN) demonstrates knowledge of ethical and legal implications related to mental health care. This is fundamental. Nurses must be aware of laws and ethical principles governing involuntary commitment, confidentiality, duty to warn, informed consent, and other relevant issues.
- Practice Intervention: A PMH-RN working in an inpatient setting becomes aware that a patient is expressing suicidal ideation with a specific plan. The nurse recognizes the legal and ethical duty to protect the patient from harm. The nurse immediately notifies the treatment team, including the psychiatrist, and documents the patient's statements and the notification. The nurse advocates for the patient to be placed on close observation and ensures that appropriate safety measures are taken. The nurse also collaborates with the team to assess the patient's risk and develop a safety plan.