PSYCHIATRIC-MENTAL HEALTH NURSE
The need for psychiatric mental health nursing has its roots near the end of the 19th century when it was believed that patients in mental hospitals should receive nursing care. Psychiatric mental health nursing has since come a long way, with psychiatric-mental health content incorporated into all diploma and baccalaureate nursing programs. As new needs for services developed in the health care arena, the role and function of the psychiatric-mental health nurse expanded, leading to advanced practice registered nurses in psychiatric-mental health nursing (APRN-PMH). Psychiatric-mental health nurses are a rich resource as providers of psychiatric-mental health services and patient care partners for the consumers of those services.
The clinical practice of psychiatric nursing occurs at two levels - basic and advanced. At the basic level, registered nurses work with individuals, families, groups, and communities to assess mental health needs, develop diagnoses, and plan, implement, and evaluate nursing care. Basic level nursing practice characterized by interventions that promote and foster health, assess dysfunction, assist clients to regain or improve their coping abilities, and prevent further disability. These interventions focus on psychiatric-mental health clients and include health promotion, preventive management of a therapeutic environment; assisting client with self-care activities; administering and monitoring psychobiological treatment regimens; health teaching; including psychoeducation; crisis intervention and counseling and case management.
Registered nurses who seek additional education and obtain a masters or doctoral degree can become advanced practice nurses in the specialty (Psychiatric-Mental Health Clinical Nurse Specialists or Psychiatric Nurse Practitioners). After post-master's supervised clinical practice, they can become certified as specialists in adult, or child and adolescent psychiatric-mental health nursing. In addition to the functions performed at the basic level, these advanced practice nurses assess, diagnose, and treat psychiatric disorders and potential mental health problems. They provide the full range of primary mental health care services to individuals, families, groups and communities, function as psychotherapists, and in some states they have the authority to prescribe medications. Psychiatric-mental health nurses in advanced practices are qualified to practice independently to offer direct care services in settings such as agencies, communities, homes, hospitals, and offices. Some psychiatric-mental health clinical nurse specialists practice consultation/liaison nursing, delivering mental health services to physically ill patients or consultation to staff in general medical settings.
Because of their broad background in biological, pharmacological, sociological, and psychological sciences, psychiatric-mental health nurses are a rich resource as providers of psychiatric-mental health services and patient care partners for the consumers of those services.
Psychiatric nursing sub-specialties include, but are not limited, to child, adolescent, adult, geriatric, consult/liaison, substance abuse, eating disorders, forensic. Certification in a sub-specialty is possible through ANCC and various sub-specialty organizations.
A psychiatric-mental health nurse must possess the following knowledge: Biologic and psychological theories of mental health and mental illness, psychotherapeutic modalities,
substance abuse and dual diagnosis, care of populations at risk, community milieu as a therapeutic modality, cultural and spiritual implications of nursing care, family dynamics in mental health and illness, psychopharmacology, legal and technical factors, including documentation specific to the care of those with a mental illness.
A psychiatric-mental health nurse must possess the following skills: Comprehensive biopsychosocial assessment, interdisciplinary collaboration, identification and coordination of relevant resources for clients and families, use of psychiatric diagnostic classification systems, therapeutic communication, therapeutic use of self, psychoeducation with clients and families, and administering and monitoring psychopharmacologic agents.
Psychiatric-mental health nurses work in a wide array of inpatient and outpatient such as full or partial hospitals, community-based or home care programs, and local, state, and federal mental health agencies. Other settings include: School/college of nursing, private practice, military, primary care office, prison/jail, home health agency, behavioral care company/HMO.
A psychiatric-mental health nurse - basic (RN) level national annual salary range: $25,000-$47,000 (dependent on geographical location).
A psychiatric-mental health nurse - advanced (APRN-PMH) level national annual salary range: $50,000-$70,000.
A generalist PMH nurse holds either a BSN, AD, or diploma.
An advanced PMH nurse (APRN-PMH) holds a masters or doctoral degree, is ANCC certified, and has an advanced practice license from the state in which he/she practices.