When thinking about the model of a psychiatric-mental health nurse, one might recall the infamous fictional character, Nurse Mildred Ratched. This terrorizing tyrant was characterized in the 1962 novel One Flew Over the Cuckoo’s Nest,and was later popularized in the 1975 film that featured a young Jack Nicholson. Fortunately, this nursing specialty has a noble role model: Hildegard Peplau, widely acknowledged as the “mother” of modern psychiatric nursing. Dr. Peplau (1909-1999) was a national and international leader, inducted in the ANA Hall of Fame for her significant contributions to the nursing profession. Deeply disturbed by the provision of solely custodial care to residents of state mental hospitals, she advocated the use of therapeutic care for the mentally ill, described in her landmark book, Interpersonal Relations in Nursing (1952). Her contributions shaped nursing education, as her theories and practices were gradually included in preparing future nurses.
The Professional Opportunity
Psychiatric nurses are called to practice in a broader, holistic manner – aware that no one develops in isolation. Human beings are social creatures, and emotional development is greatly impacted by the family structure and the socio-economic stressors impacting that family. Cultural and spiritual implications are a vital part of holistic nursing care, as well as knowledge of the biological and psychological theories of the mental health/mental illness continuum.
Choosing Psychiatric Nursing
Think you might be interested in this aspect of nursing? Throughout psychiatric nursing, the “therapeutic use of self” is the active ingredient. Most nurses are comfortable with the task-oriented aspects of nursing, such as changing dressings, checking vitals signs, and assisting with activities of daily living. But a psychiatric nurse must desire to move beyond the tasks to listen – really listen – to another’s inner pain and turmoil. One must be upfront, honest, and truly genuine in their approach.
There are additional aspects that a psychiatric nurse must master. For example:
- Performing an assessment of the patient, including physical, emotional and social factors
- Collaborating with other disciplines, such as pastoral care or social service, to foster a comprehensive view of the patient
- Understanding the various ways of coping with stressors, both healthy and unhealthy (such as substance abuse)
- Identifying creative and relevant resources for patients and their support systems
The Bottom Line: Career Opportunities
Once prepared as a psychiatric nurse, there are countless opportunities for employment, both with adults and with families.
- Hospitals: Care for the acutely ill (short-term stabilization); the chronically ill (long-term residential facilities); and for detoxification from various abused substances.
- Jails: Care for the criminally insane.
- Outpatient Community Mental Health Centers: Care for victims of rape and abuse; those suffering from situational crisis, such as loss of a partner or job; and follow-up for the chronically ill who are stable in group homes or residential environments.
- Veterans/Military: Care for those with post-traumatic stress from a combat situation.
- Hospice: Care for the grief associated with the terminally ill and their families.
Check It Out
As a nurse considering this unique opportunity, check out the website for the American Psychiatric Nurses Association (APNA). With over 7,500 members, the APNA is dedicated to “the specialty practice of psychiatric mental health nursing, health and wellness promotion through identification of mental health issues, prevention of mental health problems and the care and treatment of persons with psychiatric disorders.” Six times a year, this organization publishes a peer-reviewed journal. Read an article or two; see if it captures your interest. As a nurse, there are many practice opportunities, so it is important to use all available resources to see if this area of nursing is for you.