Mental Health Nursing
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General Principle #1
Individuals are confronted by a constantly changing world; therefore their adaptive responses are at the highest possible level for that specific time.
General Principle #2
There is inherent in every person a potential for growth, change and movement toward health. It is important for the nurse to view the client as a unique human being who is responsible for his/her own feelings, actions, and behaviors and who has the potential to function as a problem solver
General Principle #3
Cultural variable bring about differences that are significant in planning care; however, human beings have the same basic needs
General Principle #4
In order to understand the person in a holistic way, the nurse must look at the various internal and external factors involved and constantly assess the interactions of these factors within the individual at any given time
General Principle #5
The nurse provided only the care for the client that he/she cannot provide for themselves at that time
General Principle #6
Behavior may be defined as all the activity involved in living; this includes feelings, thoughts, perceptions (personal meaning of life), and actions
General Principle #7
Perception is the basis for reality; it is basic to behavior and influences emotions, attitudes, beliefs and values. Our experiential world is composed of emotional, cognitive, spiritual and sociocultural aspects
General Principle #8
Client’s behavior must be accepted and not judged. To accept a person does not mean that we sanction or approve his/her behavior. We simply acknowledge the fact, by our attitude that the person’s behavioral response is in some way adaptive for him/her at this moment.
General Principle #9
Effective nursing care must focus on the person as a unique individual and not on the control of behavioral symptoms
General Principle #10
Staff expectations exert on influence on client behavior. Although what is expected of one is not the final determinant of what one will do, it often has an important impact. Values, concepts of personal potential, the level at which help is offered, and ultimately the belief in human worth and dignity all influence expectations. The importance of seeing the potential for change in every person and of the active seeking of the person’s strengths and resources is obvious
General Principle #11
Healing is facilitated in an environment which accepts and encourages the expression of strong emotions. Some segments of our culture place a premium on avoiding the expression of strong emotions. Many people feel uncomfortable or are uncertain about their actions when such emotions are expressed. These emotions, withheld and kept out of awareness, are potentially explosive and dangerous. Strong emotions are often displayed symbolically in various behaviors (temper tantrums, destructive behavior, excessive aggressiveness, etc.). A frank expression of strong emotion is healthy, especially when it is calmly accepted.
General Principle #12
Any effort to use intellect and/or reason in dealing with a person’s ideas of beliefs that have a strong emotional component must be avoided. The major focus in psychosocial nursing is upon the feeling aspect as it relates to self-messages and perceptions. A problem exists because most of us have learned to believe that change in behavior is easily produced by the use of reason. All of us have our ‘blind spots’ in which a cherished belief or an altered perception of meaning in life overrides all facts and all reason. The more such beliefs are challenged, the more vigorously they are defended
General Principle #13
Reassurance must be specific and expressed in a manner acceptable to the person. All of us need reassurance at one time or another and the emotionally disturbed person needs it almost constantly. Reassurance must be more specific than telling the person that he/she will be fine, that his/her fears are groundless, that he/she has a good doctor, that his/her feeling are the same as many other persons, etc. Verbal reassurance is effective when it does not contradict a false concept the person needs and is based on specific data or experience.
General Principle #14
Nursing staff is responsible for assessing and altering situations in the environment that produce or increase an individual’s anxiety. Very often fear and anxieties are already problems produce with which the person has been unable to cope. Careful observation and assessment of the person’s behavior can be used to predict the kinds of situations that produce or increase anxiety for the person. The withdrawn and depressed person may feel very anxious if the staff insists that he/she participate in activities. The person who is experiencing hyper-active behavior will feel extremely anxious if he/she must sit for long periods or be confined in a small area or is exposed to a stimulating environment.
General Principle #15
Planned objective observation of behavior is essential for planning helpful nursing intervention. All behavior has purpose. Effective observation of behavior is necessary in order to discover repeated patterns of behavior, and the unmet needs, which the particular behavior is attempting to meet. Understanding why a person behaves in a certain way is much easier if the nurse can view the behavior objectively. Objectivity is the ability to evaluate a situation on the basis of what is really happening, rather than judgments made on the basis of one’s personal beliefs or values. Because of the danger that intimate, social relationships with patients have such a great potential for exploitation of the patient to meet the nurse’s own emotional needs, they can seldom be considered helpful.
General Principle #16
Unless given specific directions to the contrary, the interpretation of his/her behavior to a person should be avoided. Interpretation is defined as telling the person about the meaning of his/her behavior or explaining his/her unconscious motives. The ideal goal of therapy is to help the person to such a degree of emotional security that he/she can develop and use an understanding of his/her behavior, insight, or the understanding of one’s motivation and behavior, can be an extremely painful experience. Insight can be a threat or a help, depending upon the course of the person’s illness and his/her readiness to deal with insightful understandings. None of us begin working on problems until we are ready. This readiness occurs at different times and at different rates. It is the responsibility of the nurse to acquire perceptiveness to this phenomenon and the self-discipline to ‘wait’ and not ‘push’
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