The Nursing Process in Psychiatric/Mental Health Nursing

·       Mental Status Exam

o   Appearance

o   Behavior

o   Speech & language

o   Mood

o   Affect

o   Thought process

o   Thought content

o   Suicidal/homicidal

o   Cognition/dementia/I. Q.

o   Insight/judgement

·       Brief Mental status examination:

o   Orientation to time

o   Orientation to Place

o   Attention and immediate recall

o   Recent memory

o   Naming Objects 

o   Ability to follow simple verbal commands

o   Ability to follow simply written commands

o   Ability to use language correctly

o   Ability to concentrate

o   Understanding spatial relationships

·       Standards of practice

  • The nursing process is used for critical thinking and integrates professional standards

  • Counseling interventions are differentiated from psychotherapy (which is performed by advanced practice nurses)

  • Support use of the recovery model (we assist everyone in their own recovery journey)

·       Nursing Case Management

o   A model of care delivery that results in improved client care.

o   This type of health care delivery process serves to decrease fragmented care while also containing cost of services.

o   It can assist individuals in problem solving, improving their work and socialization skills, promotes activates, and enhancing their independence.

o   Managed Care

o   Case Manager

·       Critical Pathways of Care

o   Used as a tool for care in the case management system

o   An abbreviated care plan that provides guidelines for goal achievement within a designated length of stay

o   Improves quality and safety for the patient

·       Documentation in mental health nursing

o   Documentation is very important in nursing!

  • ALWAYS document on the patient's behavior

  • ALWAYS document on notifying the doctor of important information or issues

  • ALWAYS document signs and symptoms the patient is experiencing (hallucinations, SI/HI, etc.)

  • ALWAYS document skin assessments/contraband searches 

  • You can document what the patient tells you (Ex. Patient stated he is tired of this life).

  • “ADOPIE”