Each individual has their own personal philosophy of mental health nursing. Throughout this paper there will be facts, and my personal thoughts. This is including the following topics; mental health, mental illness, continuum of mental health/mental illness, defense mechanisms, therapeutic tools, and self-awareness in the nurse. The words mental health placed together creates a definition of a person’s psychological and well-being of emotions. Each person’s definition may vary, but it boils down to the same raw meaning (Townsend, M. 2014). Mental health is evaluated at each doctor’s visit without the patient even knowing why the nurse or physician are asking certain questions. It is important to know in which state the patient’s emotions and mental health status is for their own safety.
Mental illness can vary from mild to severe cases, and can differ per illness. Anxiety, mood disorders, psychotic, and anorexia disorders are just a few classified as mental illnesses. There are early signs of mental illness that one could detect early enough to delay or get a better control on the illness. Withdrawal from others, heightened senses, no desire to have activities with others, extreme beliefs, nervousness, and appetite changes can be early signs of an illness. Many times it is the people surrounding the individual that notices a difference in their behavior (American Psychiatric Association, 2014).
Nobody will argue that mental health and mental illness are not closely related, they both talk about the persons mind, and the shape the mind is in. One can talk about mental health without mental illness being mentioned because everyone has mental health but not everyone has mental illness. Just the opposite for mental illness. It is not possible for one to say someone has a mental illness without stating their mental health status. Many people get these definitions confused. There are four phases of a therapeutic nurse-patient relationship: pre-interaction phase, orientation/introductory period, working, and termination phase (Townsend, M. 2014).
Rapport, empathy, trust, and respect and requirements for a productive therapeutic nursing-patient relationship. The nurse should build rapport and trust with the patient so they will feel comfortable with the nurse and be more likely to open up. The nurse can use many different communication techniques such as recognition, making observations, focusing, voicing doubt, and exploring just to name a few of the many therapeutic techniques. The nurse should avoid giving advice, probing, defending, or interpreting for the patient, this may cause the patient to shut down and all trust is gone (Bischko, D. 1998).
In everyday life we use a wide variety of defense mechanisms to protect our feelings, deflect unwanted situations, and hide our inner thoughts and feelings. Suppression may be felt when one is voluntarily denying unwanted feelings such as losing one’s job and not caring if the bills will be paid. Displacement is when a person’s unwanted feelings are targeted toward a person, situation or object; if a person is upset they may take their anger out on an object and feel better once it is destroyed. Dissociation, idealization, splitting, projection, and denial are also common forms of defense mechanisms (Sommer, S., Johnson, J. 2013).
Adaptation is when one can adapt to a situation over time and maladaptation is when adjustment to the situation is not adequate or appropriate. When someone’s mind is not in the best mental health, they may have issues with adaptation to situations or changes. A person with a healthy mind may have some issues coping with certain situations, and it could be assumed that one with a mental illness would have higher difficulty coping (Rippetow, P., Rogers, R. 2012).
The nurse-patient relationship should be an interpersonal ongoing relationship to assist the patient in a continuous healing and growing, healthy life. It is the nurse’s duty to help and guide the patient in recovering and be at their highest potential. Nurses must use therapeutic techniques and approaches to influence the patient and keep a healthy relationship (Therapeutic Communication, 2013).
Nurses must have their own philosophy of nursing and know their own beliefs and know not to push their own beliefs of a patient. The nurse must be self-aware when dealing with any patient, especially one with a mental illness. These patients do not always understand personal boundaries and the nurse needs to make sure these boundaries and rules are followed. The nurse needs to know what a patients actions mean even if they are minuet and may not seem like much (Bischko, D. 1998).
My idea of mental health is in which what state the person’s emotions, thoughts, and how it affects daily functions. Mental health is how one thinks, processes information and the actions in daily life. Anxiety, and stress are two major factors in everyday life and can affect ones mental health (Townsend, M. 2014). It is how each individual handles the stress of everyday life that can determines their mental health.
I consider the individual feeling confident, comfortable in their own skin, hard workers, and ones who socialize are qualities that attribute to mental health. Respecting others and understanding that each person has their own mind and the right to make their own decisions is not always easy to deal with but it is a quality that one will need to survive in life. Self-respect, dealing with the disappointments in life, trusting others, and take responsibility are also important qualities.
Mental illness is not different than any other illness or disease. It affects the body and makes it mandatory for medication to treat and if it goes untreated, it can cause damage to the body. Mental illness is not being able to handle everyday life such as stress, and can lead to anxiety, post-traumatic stress disorder, obsessive compulsive disorder, and depression. This illness can be treated by medication and therapy to help the patient cope and teach them how to handle and work through their issues (Townsend, M. 2014).
When someone has a mental illness it is not easy for them to work through even then smallest issues. The patient may resort to cutting their arms or any place on their body, take drugs, or drink alcohol. Sexual, mental, or physical abuse when someone was young could cause problems later in life and can affect their mental health and cause them to develop a mental illness (Townsend, M. 2014). Many people go undiagnosed with mental illness, it is more commonly treated now than it was a few years ago.
Every person goes through a mental health continuum, it just depends on the mental health status on how the individual handles the situation. Each person can and will have issues in their life with difficulties but are able to manage the stress that comes along with it. Many people make jokes that they cannot handle their life and they are going crazy but this usually only lasts a short amount of time. Ones with a mental illness do not have short term stress, it is long term and they need outside help to handle the situation (Rippetow, P., Rogers, R. 2012).
Freud talks about how childhood trauma, development, sexuality, talking therapy, and medication can affect ones mental health. Freud explains that when a child is sexually abused it can cause the child developmental issues. It leaves the child unable to cope with the guilt and shame, also it leaves the child angry and they may develop trust issues. Freud uses oral, anal, phallic, latency, and adolescent sexuality of phases of development. The individual must reach each phase and pass through the phase to grow and develop (Townsend, M. 2014). At one point and time, it was not acceptable for woman to have sexual thoughts or feelings. They were not allowed to express these feelings, and this could cause anxiety for the women.
Freud believed that if the patient could talk to someone they were able to handle the anxiety and stress in their life better. The therapist would listen and help the individual move past their trauma that occurred in childhood. Medication has played a huge role in mental health over the years. Freud had predicted that one day medicine would be discovered, and would help individuals with a mental illness. Many medications have now been discovered to help people whom suffer with mental illness. Medications are able to help these persons to get back to their normal daily life (Seven Counties Services, 2014). Nurses knowing and learning from Freud allows a better nurse-patient relationship. It allows the nurse to understand why a patient may feel the way they do and the nurse can better help the patient return to their life.
A therapeutic model that I believe would impact me during my practice as a mental health nurse would be Maslow’s hierarchy of needs. The top priority is the physiological needs of the patient, meaning the basic needs of life. Water, air, food, sleep, excretion, homeostasis and sex are the basic needs of life. When caring for any patient the nurse needs to make sure the patient has these basic needs of water, food, and air. Safety is making sure the patient is safe and secure. To the patient this could be security of their job, family, and health. Every individual needs that feeling of love and belonging by friends, family, and sexual intimacy. Self-esteem and confidence are very important but not as important as body homeostasis. The last level of Maslow’s hierarchy of needs is self-actualization such as morality, problem solving, and creativity. These are important to the patient but the least important for the nurse when caring for the patient (Townsend, M. 2014).
The nurse needs to acquire a healthy nurse-patient relationship to help guide the patient to grow and heal. The nurse needs to build rapport, trust and empathy with each individual patient. The nurse needs to realize that each patient is different and not every patient requires the same techniques. The nurse needs to be open-minded and respect the patient’s morals, culture, religion, and beliefs. From creating a secure nurse-patient relationship the nurse will accomplish a better recovery for the patient and a better plan of care (Therapeutic Communication 2013).
American Psychiatric Association, (2014). Warning Signs of Mental Illness. Retrieved September 21, 2014, from www.psychiatry.org Bischko, D. (1998). The art of nursing: the client-nurse relationship as a therapeutic tool. Olympia, Washington. Retrieved September 19, 2014, from www.pubmed.gov Rippetow, P., Rogers, R. (2012). Effects of components of protection-motivation theory on adaptive and maladaptive coping with a
health threat. Retrieved September 21, 2014, from www.psycnet.apa.org Seven Counties Services, 2014. Hope Happens Here: Mental Health in Older Adults. Retrieved September 21, 2014 from www.sevencounties.org Sommer, S., Johnson, J., Roberts, K., Redding, S. (2013). RN Mental Health Nursing-Foundations for Mental Health Nursing: Stress and Defense Mechanisms. P 29-32. Therapeutic Communication in Psychiatric Nursing. (2013). Retrieved September 21, 2014, from www.nursingplanet.com Townsend, M. (2014). Essentials of psychiatric mental health nursing: concepts of care in evidence-based practice. P. 3, 17-19. Philadelphia, PA.