Mental Health Care for Nurses: Applying Mental Health Skills in the General Hospital

Foreword......Page 9
Editors......Page 11
Contributors......Page 12
Acknowledgements......Page 13
Terminology......Page 15
Structure of the book......Page 16
References......Page 18
Part 1 The Principles of Mental Health Care in the General Hospital......Page 19
Introduction......Page 21
The focus of nursing and its relationship to holistic care......Page 22
The context of care: mental health in the general hospital......Page 24
The impact on nurses of meeting the mental health needs of the patient......Page 27
Overview of mental health problems commonly encountered in the general hospital......Page 29
Mental health assessment......Page 36
The nurse–patient relationship......Page 39
Effective use of interpersonal skills and therapeutic communication......Page 40
Support mechanisms for nursing staff and other clinicians......Page 44
References......Page 45
Websites......Page 49
Introduction......Page 50
Influences upon health and ill health......Page 51
Personal beliefs, understandings and interpretations of health and illness......Page 52
Coping and adaptation to illness and injury......Page 55
Acute stress reactions......Page 58
Impact of illness on families and carers......Page 59
Nursing priorities in the provision of psychological care......Page 61
Dealing with emotions......Page 62
References......Page 65
Introduction......Page 67
The ethical and professional context......Page 68
The legal context: decision-making, capacity and competence......Page 71
Consent......Page 73
Duty of care......Page 74
The Mental Health Act 1983......Page 78
References......Page 80
Introduction......Page 82
The nature of challenging behaviours......Page 83
Causes and triggers of disturbed behaviour......Page 87
What is it that challenges us?......Page 89
The patient, the institution and the situation......Page 92
An organisational response to challenging behaviours......Page 93
Working with people who challenge us......Page 95
Conclusions......Page 97
References......Page 98
Introduction......Page 100
What is bad news?......Page 101
Issues of grief and loss......Page 102
How people ‘hear’ what is said and ‘understand’ – the difference between being told something and understanding......Page 104
Preparing to provide information......Page 105
Impact on practitioners......Page 109
Conclusions......Page 110
References......Page 111
Introduction......Page 113
The development of mental health liaison practice......Page 114
The role of the mental health liaison team......Page 118
The process of referral......Page 121
References......Page 124
Part 2 Mental Health Care in the General Hospital......Page 127
Introduction......Page 129
Terms used to describe the various types of mood disorder......Page 130
Recognising depression......Page 132
Anxiety......Page 133
Panic attacks......Page 136
Assessment......Page 137
Physical treatments......Page 139
Combination of physical and psychological treatments......Page 141
Planning care for the person who is depressed or anxious......Page 142
Responding to the person’s care needs......Page 143
Conclusions......Page 145
References......Page 146
Introduction......Page 148
Incidence of self-harming and suicidal behaviour......Page 149
‘Causes’ of self-harming behaviour......Page 152
Attitudes......Page 154
Risk assessment......Page 155
Medium-term risk assessment......Page 157
Initial assessment......Page 160
Pre-discharge care......Page 162
Conclusions......Page 163
References......Page 164
Introduction......Page 166
Policy and professional context......Page 167
Prevalence of perinatal mental health problems......Page 168
Common perinatal mental health problems......Page 169
Postnatal depression......Page 170
Puerperal psychosis......Page 175
Breast feeding and the use of psychotropic medication......Page 178
Principles of effective perinatal mental health care......Page 179
References......Page 181
Introduction......Page 184
Schizophrenia......Page 185
Bipolar affective disorder......Page 187
Factors that contribute to poor physical health......Page 188
Assessment......Page 190
Antipsychotic medication......Page 191
Mood stabilisers......Page 193
Principles of caring for a person with a serious mental illness......Page 194
Conclusions......Page 196
References......Page 197
Introduction......Page 199
Acute intoxication......Page 200
Harmful use......Page 201
Dependency......Page 202
Withdrawal......Page 203
Commonly misused illicit drugs......Page 205
Assessment......Page 206
Clinical management of alcohol withdrawal......Page 208
Clinical management of opiate dependence during hospital admission......Page 210
Mental health promotion......Page 212
Conclusions......Page 213
References......Page 214
Introduction......Page 216
The impact of ageism......Page 217
Assessment......Page 218
Dementia......Page 221
Nursing interventions......Page 223
Acute confusion (delirium)......Page 227
References......Page 230
Introduction......Page 233
Impact of changes in the NHS on nursing......Page 234
Holistic care and the expanding role of the nurse......Page 235
Difficulties encountered by contemporary nurses in the provision of holistic care......Page 237
Achieving holistic care for the patient in the modern NHS......Page 240
References......Page 241
Website......Page 242
Index......Page 243