Repper, J. (2000). Adjusting the focus of mental health nursing: incorporating service users’ experiences of recovery. Journal of mental health, 9(6)575
Recovering mental health patients in the medical-surgical setting need to have a wide range of nursing approaches to choose from during their treatment; this means that they should be empowered to make decisions on their own. They also need to utilize skills that are not just associated with one particular nursing model. In this regard, the patient or the mental health service user needs to be included in his own care. This article revealed that most nurses are not informed about how they can empower mental health patients in the medical-surgical setting to make decisions about their own recovery. In other words, the major need identified in this article is the creation of a healthy and diverse environment for recovery. It can best be tested by analyzing the nature of the theories that a nurse utilizes during care provision. They need to be assessed for their hegemonic nature i.e. whether they involve a series of approaches and should be assessed for their ability to include the needs of the patient.
Barker, P. (2001), The Tidal Model: developing an empowering, person-centered approach to recovery within psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing, 8(5): 233–240.
Nursing needs may be prevalent within the surgical medical settings in a number of ways. Some are associated with the nature of skills needed in caring for the patient while some are related to the interpersonal settings undergone by these very patients. In this regard, there is a serious need for interpersonal relationships between the patient and the nurse in this situation. Failure to include this could lead to the disempowering of the concerned patients as the quality of psychiatric services offered to these patients within those settings is crucial to their recovery. The latter study illustrated that there was indeed a low prevalence of nursing model application in the field of mental health nursing and this is quite unacceptable. In order to test for the need, the tidal model can be utilized. It focuses on the use of interpersonal relationships as well as the processes needed to make the mentally ill patient more in control of his situation.
Nolan, P., Haque, M. S., Badger, F., Dyke, R. and Khan, I. (2001), Mental health nurses’ perceptions of nurse prescribing. Journal of Advanced Nursing, 36: 527–534
Within the medical-surgical setting, it is often necessary to prescribe medication for certain health conditions that may not be related to the primary problem of mental health disorders. Usually, this needs to be handled with utmost immediacy and should be done accurately so as to prevent any unwarranted results or relapses. In this article, the authors found that most nurses are not confident about their ability to prescribe medication because they felt like they lacked the knowledge needed to do so. The educational needs of prescribing can be tested using a number of factors. First, nurses need to be examined and assessed on whether they possess the right kind of training for it. They should be assessed for their degree of cooperation with doctors who need to supervise these activities and also the skills needed to prescribe should be analyzed. Once the gap has been identified then these very parameters need to be inculcated.
Secker, J., Pidd, F. and Parham, A. (1999), Mental health training needs of primary health care nurses. Journal of Clinical Nursing, 8: 643–652.
In the medical-surgical setting, most patients need to be placed in the hands of someone who is competent enough in terms of care provision. Such a person should be able to identify the roles of the surgeon, doctors and other caregivers in this setting. He or she should be in a position of carrying out those functions successfully. Furthermore, the nurse needs to be fully aware of the complications related to the patient’s mental condition and this should be handled while duly considering safety measures around caregiving. In other words, one of the ways of testing these learning needs is by looking at the ability of nurses to understand core mental health principles, health and safety practices as well as role boundaries.
Inuoye, S., Foreman, M., Mion, L., Katz, K., Cooney, L. (2001). Nurses’ recognition of delirium and its symptoms. Arch Intern Med, 161 (4), 2467-2473
Patients with diagnosed mental disorders are at risk of having delirium so it is always imperative for nurses to know how to detect it. This study involved an analysis of delirium detection by nurses among 797 patients and found that overly, delirium was not recognized as often as it should be in these patients. In fact, only nineteen percent of the actual cases were detected by the concerned nurses. What this means is that a vast number of the patients are going untreated because of the failure of these nurses. One of the ways of assessing for this learning need is by looking at the ability of nurses to make cognitive assessments of deliria such as dementia and vision impairment. If nurses fail in terms of these parameters then there is a learning need prevalent. Nurses clearly need to be educated about the most important delirium features and how to recognize them.
Bergeron, N., Dubois, M., Dial, D. & Skrobik, Y. (2000). Intensive care delirium screening checklist: evaluation of new screening tool. Intensive care medicine, 27(5), 859
Many individuals in the medical-surgical setting are vulnerable to delirium. This is especially so when the concerned individual possesses a mental health complication. To this end, it then becomes critical to establish easy and efficient ways of detecting the condition. One such method is through the use of a screening tool that contains eight items that need to be analyzed. Some of them include inattention, hallucination, sleep disturbance and others. Such a tool would quicken the detection process. There is a lack of awareness on the part of nurses on how to use such a tool. They need to be trained on all eight parameters and hence be empowered to carry on their tasks.
Borus, J., Howes, M., Devins, N., Rosenberg, R. & Livingston, W. (1988). Primary health care providers’ recognition and diagnosis of mental disorders in their patients. General hospital psychiatry, 10(5), 317-321
Mental health problems are normally detected at first by nurses and physicians. Furthermore, in the medical-surgical setting, this may still be done by the concerned nurses and physicians and the earlier they detect it, the better it is for them. it should be noted that those patients with diagnosed mental health problems prior to entry into the surgical setting can still be vulnerable to yet another psychiatric complication. This particular study found that nurses were confident in their ability to assess mental disorders yet this did not concur well with the structured clinical interview for DSM 3 R standard. In fact, these nurses were only able to detect a sixth of anxiety disorders in these patients and a seventh of depression disorders. There is a clear learning need in this area and the pretest of the educational needs should comprise of assessments of the diagnostic abilities of nurses. Discrepancies in actual occurrence can necessitate training.
Oladeji B.,& Gureje O. (2008). Mental health morbidity and impact. International encyclopedia of public health, 384
The latter article talks about the profound and difficult circumstances of living with a mental disorder. It identifies some of the challenges that patients go through like coping with health risks from secondary diseases as they are quite vulnerable to them. Nurses who are aware of these risks and difficulties can improve the care they provide their patients by detecting comorbid factors as early as possible; this can be seen immediately after a surgical procedure. A possible learning gap, therefore, crops up at this point when nurses are unable to detect some of these underlying illnesses.
Kesler, R. (2004). Comorbidity. International encyclopedia of social and behavioral sciences, 2389
This article stresses the importance of early interventions with regard to comorbid factors. It discusses the ways in which primary disorders in mental patients are linked to secondary factors and how interventions can prevent these primary disorders from causing comorbidity. Nurses who are unaware of these differences do possess a learning gap that they need to work on.
Wittchen, H. (2004). Mental illness: epidemiology of. International encyclopedia of social and behavioral sciences, 2389
Nurses have a difficult time understanding the interaction of several risk factors among mentally ill patients. This prevents them from amply preventing the occurrence of multiple mental disorders. In other words, in the medical surgical setting, nurses need to ensure that the interactions of those factors do not lead to any sort of complication in the future. One way of testing whether there is a learning gap is by testing the understanding of these interactions amongst nurses.
References
Repper, J. (2000). Adjusting the focus of mental health nursing: incorporating service users’ experiences of recovery. Journal of mental health, 9(6)575
Barker, P. (2001), The Tidal Model: developing an empowering, person-centered approach to recovery within psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing, 8(5): 233–240.
Nolan, P., Haque, M. S., Badger, F., Dyke, R. and Khan, I. (2001), Mental health nurses’ perceptions of nurse prescribing. Journal of Advanced Nursing, 36: 527–534
Secker, J., Pidd, F. and Parham, A. (1999), Mental health training needs of primary health care nurses. Journal of Clinical Nursing, 8: 643–652.
Inuoye, S., Foreman, M., Mion, L., Katz, K., Cooney, L. (2001). Nurses’ recognition of delirium and its symptoms. Arch Intern Med, 161 (4), 2467-2473
Bergeron, N., Dubois, M., Dial, D. & Skrobik, Y. (2000). Intensive care delirium screening checklist: evaluation of new screening tool. Intensive care medicine, 27(5), 859
Borus, J., Howes, M., Devins, N., Rosenberg, R. & Livingston, W. (1988). Primary health care providers’ recognition and diagnosis of mental disorders in their patients. General hospital psychiatry, 10(5), 317-321
Oladeji B.,& Gureje O. (2008). Mental health morbidity and impact. International encyclopedia of public health, 384
Kesler, R. (2004). Comorbidity. International encyclopedia of social and behavioral sciences, 2389
Wittchen, H. (2004). Mental illness: epidemiology of. International encyclopedia of social and behavioral sciences, 2389