Introduction
Mental health conditions ranging from depression and anxiety to personality and eating disorders, including drug addiction, have surfaced to be a burden to public health globally (Kazdin et al., 2017). The mental health nurses are directly involved in offering care for such conditions. They are specialized in supporting and promoting the recovery of those above by encouraging them to have more control and involvement over their chronic conditions. Insofar, this essay seeks to deploy theoretical principles and concepts attributing to mental health nurses' role in caring for people with a mental health condition as per the case scenario provided. The essay will explore the core professional standards and values of mental nurses and their impact on mental health services. It will also discuss relevant legal and ethical frameworks in such care environments and how they are applied. Further, it will also explore the knowledge and skills necessary for recovery, support therapeutic collaborative relationships during care, and finally illustrate the strategies for actualizing safe and effective care by the mental health nurse.
The case scenario in reference is of Violet, a 57-year-old Italian lady separated from her husband and has no child. She was diagnosed with type 2 diabetes that has been managed effectively. However, she is currently depressed with signs of confusion and anxiety amid withdrawal and weight loss. With her consent, she has since been referred to a community mental health unit for cognitive assessment regarding her safety.
According to the NMC code of conduct (2018) and The Code (2018), there are core values that a mental health nurse requires to demonstrate during care service. The mental nurse care providers are mandated to care for the patients their primary concern, treat them as individuals with autonomy and respect their dignity (Plunkett and Kelly, 2021). Like other patients with mental illness, patients with type 2 diabetes are usually hit with depression when they are at the peak of their stress levels, making them anxious and confused to make sound decisions regarding their medication needs and choices. All the same, as in Violet's case, it's mandated that the nurse meet both her emotional, social, health, and spiritual needs. In giving her autonomy, the nurse must treat her with respect and dignity without any discrimination. The nurse treated Violet with kindness and compassion and became her advocate by referring her to a mental health assessment facility.
Moreover, the nurse has a role in respecting the patient's confidentiality and only disclosing the information if the patient is in danger (Eckerstrom et al., 2019). The standards of practice also demand that the nurse maintain competency by working with others to promote and protect the patients' health and wellbeing, their families, and the community at large (Cusak et al., 2017). In this regard, the nurse served in an effective team's best interest by referring the patient for mental assessment after diagnosis. It was considered the best option for Violet's condition's safety.
Violet's diagnosis of anxiety and depression is associated with a cognitive disturbance which subjects her to hopelessness, feeling of worthlessness, and loss of interest in hobbies, suicidal thoughts, panic, restlessness, lack of sleep, fatigue, and lack of concentration, which generally affect her memory, orientation and thinking (Royal College of Nursing, 2021)). It's for the nurse to draw to ethical theories, professional standards, and legal frameworks while providing care to Violet, and be careful not to generalize her risk behaviors or cognitive incapability.
Patient safety is multidimensional thus considered to be grounded in both legal and ethical imperatives. From a moral perspective, patient safety aims to protect and promote human dignity, alongside its positive health outcomes and benefits. According to the principle of non-maleficence in medical ethics, ensuring patients' safety and preventing any damage or injury is a significant priority for any healthcare provider (McClellan, 2019). For mental patients' care, there is two specific legislation that is critical on how care and treatment are administered to those with mental conditions. The first is the Mental Health Act (MHA) 1983 that outlines how the patient can be admitted, detained, and treated in a health facility against their wishes and details on safeguarding the patient's rights. In this case, the mental health nurse had a duty to earn Violet's trust to assure that the treatment under the Mental Health Act is fully compliant with the act and that the patient's safety standards are as per the Code of Practice (Cummins, 2020). The Mental Capacity Act 2005 is another legal policy framework that enables someone to make decisions in the patient's best interest that is fully compliant with the act. Since Violet was highly stressed and anxious, the nurse acted within the Mental Capacity Act's jurisdictions to refer her for mental assessment due to safety concerns.
The Mental Health Nurses are presumably oriented to promote recovery and support for the mentally ill patients due to their unique set of values and skills and their capacity to establish a therapeutic relationship with the patients. The therapeutic relationship is the focused relationship between the caregiver and the patient that is channeled towards achieving the best patient outcome, which generally demands patient-centered care. Therefore, the core values are anchored in the 6Cs framework that simplifies care, compassion, competence, communication, courage, and commitment (NHS Constitution for England, 2012). Nonetheless, diabetic and developing mental conditions need a patient-centered approach for an excellent therapeutic relationship to enhance their recovery. The ethical principle of veracity demands that the nurses be at the center stage of being truthful as an essential for integrity for a cordial therapeutic relationship. In handling Violet's case, being that she had no close family, the nurse had to enable her to talk openly and confidently of their problems, and also accord the patient individuality by acknowledging that she had her own needs, identity, choices, wishes, and beliefs (Foundation, 2014). The nurse's prominent role would be to support the patient to make their choice of care and support. The other value element is the independence that demands that the patients get empowered to have the confidence to feel in control of their actions. Most notably would be giving the patients privacy and respect to their feelings, emotions, or thoughts.
One primary strategy of assuring a convincing therapeutic alliance between the mental nurse and the patient is ensuring effective communication. Communication might not be so easy for persons with mental conditions. The nurse must deploy all forms of communication techniques, verbal and non-verbal. In this way, the nurse finds it easy to give the client personalized centered care based on dignity, coordination, empowerment, compassion, and respect. Most psychiatric regard person-centered care as an essential component of quality care that involves a holistic approach and respecting individuals in their unique experiences and needs of care in a recovery-oriented system. Generally, mental health refers to an individual's emotional and cognitive wellbeing based on their thoughts, feelings, and behaviors (Marti-Vilar et al., 2019). In Violet's case, poor mental health impacts a person's daily functioning, physical health, relationship, and ability to live and enjoy life. Depression and anxiety alongside withdrawal, personality, and eating disorders are equally mental conditions that warrant a specialized treatment.
In such cases, recovery does not necessarily attribute to instant cure. Hence, there are fundamental ways that the mental health nurse can use to support and enhance the recovery of such patients. Taking into account that these patients need personalized care is vital. Therefore, a person-centred approach that acknowledges that people have autonomy and independence of their choice of treatment would be fundamental towards their recovery. Thus, the nurse has a role of being collaborative, informative, and supportive to give the patients the confidence to manage their own health needs; and this includes allowing them to have independence and make their own choice about their care and support ((Mental health nursing - The Nursing and Midwifery Council, 2021). In this sense, the nurse would have shown empathy and gave the patient identity, which is critical for a collaborative approach towards their recovery.
In the concluding remarks, this essay has contributed to a deeper understanding of the fundamental theories and principles that guides nursing practice in mental health scenarios, which are significant in enhancing the recovery process in nursing care. It has highlighted some of the professional standards and code of practice demanded of a mental health nurse or practitioner and the code of behaviours and their impacts on the mental health recovery process.
Further, the essay explored the legal and regulatory frameworks like the Mental Health Act and the Mental Capacity Act that are equally significant during a mentally ill patient's care. On the same end, the significance of a strong therapeutic alliance between the caregiver and the patient has also been discussed, which attributes to the importance of effective communication and understanding of the patient's condition to enhance a collaborative care approach that meets the needs choice of the patient. Finally, the essay has identified a patient-centred approach as key for the patients' mental health's enhanced recovery process.
Take a deeper dive into Role in Safeguarding Public Health during the COVID-19 Pandemic with our additional resources.
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Eckerström, J., Allenius, E., Helleman, M., Flyckt, L., Perseius, K.I. and Omerov, P., 2019. Brief admission (BA) for patients with emotional instability and self-harm: nurses' perspectives-person-centred care in clinical practice. International journal of qualitative studies on health and wellbeing, 14(1), p.1667133.
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