Sample Essay: Systems Framework For The Psychiatric Nurse Practitioner in a Psychiatric Acute Care Setting

Psychiatry is the medical discipline to study, prevent, and treat mental disorders in humans beings. Mental illnesses such as schizophrenia, bipolar disorder, depression, amongst others reduce the life quality of the sufferer. As a result, these victims are unable to work and mingle with society at large. They are unable to hold on to their jobs for long and are thus financially dependent on their caregivers, namely their parents, siblings or relatives. They require constant medical care and for some sufferers, they need to take expensive medication for life. Hence, in a psychiatric acute care setting, the psychiatric nurse practitioner needs to be properly trained so as to render optimum palliative care possible to these patients ( http://www.google.com.my/search?hl=en&defl=en&q=define:Psychiatry&sa=X&oi=glossary_definition&ct=title).

Schizophrenia

For example, schizophrenia happens to 1% of the entire population and every 1 person in a group of 100 will suffer this mental illness. It is believed to be caused by a combination of genetic and environmental triggers such as prolonged stress. There is a 50% chance of getting it if your identical twin does and a 10-15% chance if your parent or sibling does. Various environmental triggers appear to increase the risk of getting it, such as in uterus infections and growing up in a dysfunctional family where there is a lot of yelling and emotional expressiveness (http://psychiatrist-blog.blogspot.com/2008/04/latest-genetic-news-in-schizophrenia.html). As there is no cure to schizophrenia, the patient needs to be cared for her or his entire life while taking medication for a more chemical balance in the brain. There is too much dopamine leaks to the brain causing this debilitating illness. The worst case scenario that can happen to a schizophrenic patient is suicide and care needs to be taken to ensure a stress free environment for him (http://www.subjectpool.com/dl/y4_general/meehl1962.pdf).

System framework

The system framework of the psychiatric nurse practitioner in a psychiatric acute care setting involves the continuity of patient care, most probably his or her entire life in the hospital or a special home. The safe environment in a home away from unfriendly people and much yelling to ensure a good recovery and prognosis with medication for the patient. A big financial amount needs to be set aside for treating mental illnesses as these patients are jobless and completely dependant on their caregivers (http://scholar.google.com/scholar?hl=en&q=author:%22Hravnak%22+intitle:%22Is+There+a+Health+Promotion+and+Protection+Foundation+to+…%22+&um=1&ie=UTF-8&oi=scholarr).

Psychiatry exists to treat mental disorders which are divided into three general categories; mental illness, severe learning disability, and personality disorder. As a result of changing perspectives in psychiatric practice and increasing fiscal limits caused by economic issues, psychiatric nurses have found their traditional models of practice challenged by shortened lengths of stay and the requirement for more efficient assessment and treatment. Short-term nursing therapy, which includes crisis intervention and brief psychotherapy, was developed to provide psychiatric nurses with a cohesive, comprehensive nursing philosophy for practical application in changing inpatient settings (http://ps.psychiatryonline.org/cgi/content/abstract/37/5/493).

The psychiatric mental health nurse practitioner is educationally prepared to provide the full range of psychiatric services, including the delivery of primary mental health care services, as delineated in the competencies. Some educational programs may prepare the psychiatric mental health nurse practitioners to provide services to a specific patient population (e.g., adult, child) and additional, age-specific competencies may be necessary (http://www.aacn.nche.edu/Accreditation/psychiatricmentalhealthnursepractitionercopetencies/FINAL03.pdf).

The psychiatric mental health nurse practitioner is a provider of direct mental health care services. Within this role, the psychiatric mental health nurse practitioner synthesizes theoretical, scientific and clinical knowledge for the assessment and management of both health and illness states. These competencies incorporate the health promotion, health protection, disease prevention and treatment focus of psychiatric mental health nurse practitioner practice.

Bipolar Disorder Patient

A local US celebrity, Britney Spears has been diagnosed with having bipolar disorder recently (http://www.usmagazine.com/britney_spears_31). Prior to being diagnosed with having a mental illness, people could not understand why she shaved her head bald out of the blue, used an umbrella to hit the paparazzi’s car and locked herself in with her younger son in the bathroom. Apparently stress due to her divorce from Kevin Federline precipitated this mood disorder in her. Her psychiatrist had ordered her to be forcefully taken from her home to the hospital stating that she is a threat to herself and to those around her. A good solution to this would be to hire a psychiatric nurse practitioner to monitor and care for Britney in the comforts of her home while going for consultation now and then in the hospital.

Other Scopes of System Framework

Another scope of the system framework for the psychiatric nurse practitioner in a psychiatric acute care setting involves management of patient illness, such as analyzing and interpreting symptoms, physical findings and diagnosing information to develop appropriate differential diagnoses. The psychiatric nurse practitioner needs to manage acute and chronic conditions while attending to the patient’s response to the illness. These also include prioritizing health problems, intervening appropriately and initiating effective emergency care (http://www.aacn.nche.edu/Accreditation/psychiatricmentalhealthnursepractitionercopetencies/FINAL03.pdf).

The nurse practitioner demonstrates competence in the domain of the nurse practitioner-patient relationship when s/he creates a climate of mutual trust and establishes partnerships with patients. Besides validating and verifying findings with patients, s/he also communicates a sense of “being present” with the patient and provides comfort and emotional support. The nurse practitioner advocates for the patient to ensure health needs are met and consults with other health care providers such as private and public agencies. On top of that, s/he incorporates current technology appropriately in care delivery and uses information systems to support decision-making and to improve care (http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume/No1aJune/PrimaryCareNursePractitioners.aspx).

Summary

The psychiatric nurse practitioner must monitor the quality of own practice and participate in continuous quality improvement based on professional practice standards and relevant statutes and regulation. S/he also needs to evaluate patient follow-up and outcomes including consultation and referral. And finally s/he also monitors research in order to improve quality care for the patient with mental illness. This sums up the system of framework for the psychiatric nurse practitioner in a psychiatric acute care setting.

References

http://psychiatrist-blog.blogspot.com/2008/04/latest-genetic-news-in-schizophrenia.html

http://ps.psychiatryonline.org/cgi/content/abstract/37/5/493

http://www.subjectpool.com/dl/y4_general/meehl1962.pdf

http://www.aacn.nche.edu/Accreditation/psychiatricmentalhealthnursepractitionercopetencies/FINAL03.pdf

http://www.usmagazine.com/britney_spears_31

http://www.google.com/search?hl=en&defl=en&q=define:Psychiatry&sa=X&oi=glossary_definition&ct=title

http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume/No1aJune/PrimaryCareNursePractitioners.aspx

http://scholar.google.com/scholar?hl=en&q=author:%22Hravnak%22+intitle:%22Is+There+a+Health+Promotion+and+Protection+Foundation+to+…%22+&um=1&ie=UTF-8&oi=scholarr

http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume/No1aJune/NursePractitionerRole.aspx

http://linkinghub.elsevier.com/retrieve/pii/S0883941703000050