As a nurse, you already know you need to deal with various kinds of patients, from those who have physical limitations up to those diagnosed with mental illnesses. Learning how to best handle these patients will help you grow into a more professional nurse with the aptitude to manage multiple patient conditions. Part I of this article will provide some pointers on handling psychiatric patients. Part I of this article will provide some pointers on handling psychiatric patients.

Patients with psychiatric challenges

Psychiatric nursing or mental health nursing is the specialty of nursing that cares for people of all ages with mental illnesses, such as schizophrenia, bipolar disorder, depression or dementia. Specifically, nurses in this area will be trained in building a therapeutic alliance, to be acquainted with psychological therapies, as well as administering psychiatric medication and dealing with challenging behaviour.

Be understanding, empathetic and genuine with patients

Caring for patients with psychiatric disorders requires the nurse to maintain a positive therapeutic relationship in the clinical setting. When you show understanding and empathy, it will reinforce a positive psychological balance for patients. This could be due to the fact that conveying an understanding and empathy provides patients with a sense of importance.

This is significant as it helps them to recover closer to their condition prior to the onset of the disorder. Nurses should also be natural in communicating with patients - Genuine reactions trigger honesty and thus facilitates a therapeutic relationship. Building an effective interpersonal relationship requires understanding, empathy and being genuine.

Get to know the psychological therapist very well

Being acquainted with the psychological therapist in the psychiatric department is mandatory. Unlike other therapies, psychological therapies are designed for psychiatric illnesses when patients are non-adherent to medications. The psychological therapist will determine the appropriate therapies after taking into consideration the patient’s health and medical condition.

The most common therapy for mental illnesses, psychotherapy is often the first form of treatment recommended, particularly for those with depression and anxiety as it was found to be effective in reducing the patient’s depressive symptoms. There are also other treatments for specific mental disorders, such as transcranial magnetic stimulation, deep brain stimulation and vagus nerve stimulation. With such differences in treatment methods and also having to take individual differences into account, nurses should be closely acquainted with the psychological therapist to better support any psychiatric patient’s treatment.

Emotional and spiritual support for patients

Compared to physical support, patients with mental disorders need more reassurance, emotional, and spiritual support from their nurses. Make your patient feel your and their presence by being available for them, as you make yourself more amicable approchable. By being available for a certain amount of time, you encourage patients to share their stories and facilitate a better understanding of their actual situation. Sometimes, supporting spiritual needs through encouraging religious orientation, praying and meditation would also be helpful in developing the patient’s sense of meaning, purpose and hope.

Light nursing care of non-severe patients

For non-severe mental illness patient, nursing care is usually implemented similar to that of other patients. Things to be extra careful about are administering medications, charting interactions and informing the psychiatrist immediately if you see any adverse side effects. Psychiatric nurses should also be actively helping the doctor and other staff to make objective decisions concerning that patient's care, to ensure the best care possible.

Risk of being harmed by maniac patients

Though only a few cases of the violent behavior of psychiatric patients have been reported, some studies found that psychiatric patients who have psychoses, especially schizophrenia, substance abuse and non-adherence to treatment, are at a greater than normal risk of being violent (Rueve, & Welton, 2008). Handling maniac patients also puts the nurse in danger, as patients can be extremely aggressive and violent. It is ordinary to see maniac patients attempt self-directed violence, especially those in the severe phase with suicidal ideations, and these dangers translate over to the nurses caring for them as well. Thus, always remember to keep your own safety in mind too when you are handling psychiatric patients.

In Part II, the article will examine another type of patient – those with physical disabilities – in more detail. MIMS

Read more:
Nurses: handling patients with challenging conditions – part II
Malaysia’s MOH plans community-based approach for psychiatric nursing homes
Pros and cons of working as a Psychiatric Nurse

Sources:
Psychotherapy to Treat Depression. (n.d). retrieved from http://www.webmd.com/depression/psychotherapy-treat-depression#1
Rueve, M.E., & Welton, R.S. (2008). Violence and Mental Illness. Psychiatry (Edgmont), 5(5), 34–48.
General Information on Physical Disabilities (n.d). retrieved from http://hwa.org.sg/news/general-information-on-physical-disabilities/