The Role of a Mental Health Nurse - Essay Example

? The Role and Responsibilities of a Mental Health Nurse in Taking Care of a Mentally Ill Patient who could No Longer Decide for His Preferred Care and Treatment Student’s Name Student Number Course Name and Number Name of Professor Date of Submission Number of Words: 2,042 Introduction Mental health nursing is a very complex profession which involves the caring of patients who are suffering from mental health illnesses which includes alcohol-use disorders, dementia, depression, psychosis, bipolar disorder, and schizophrenia (World Health Organization, 2003). In line with this, the World Health Organization (2003, p. 4) revealed that almost 450 million people around the world are suffering from either mental or behavioural health problems. Specifically in UK, 1 out of 4 British adults are experiencing at least one kind of mental health problem (Mental Health Foundation, 2011). Mental health nursing is a profession that focuses on providing treatment, caring, and strong support to patients who are experiencing severe mental, emotional, and psychological problems. In relation to mental health nursing, this report will focus on discussing the role and responsibilities of mental health nurses who are taking care of a mentally ill patient who could no longer decide for his own preferred care and treatment. In line with this, important factors that could guide the mental health nurses improve the quality of caring they deliver to their patients will be identified and tackled in relation to nursing ethics. Based on the gathered information, a list of recommendations together with the rationale behind each of the recommended solutions will be provided at the end of this report. Role and Responsibilities of Mental Health Nurses In general, the role and responsibilities of mental health nurses is very broad. In line with this, Foster (2001) revealed that mental health nursing as a profession requires each nurses to satisfy the role of a therapist and counsellor, educator, assessor, reflector, manager, supervisor, researcher, and a clinician. Considering the role and responsibilities of a mental health nurse who is assigned in taking care of a mentally ill patient who could no longer make his own decision for his preferred care and treatment, strategic ways on how a mental health nurse could deliver an effective patient care treatment will be tackled based on the nurse’s role as a therapist and counsellor, educator, assessor, reflector, manager, supervisor, researcher, and a clinician. Therapist and Counsellor Even though a mentally ill patient could no longer decide for his own preferred care and treatment, mental health nurses should always have in mind that the patient at this point can be very sensitive and emotional. Although the patient is not capable of communicating his preferred care and treatment, mental health nurses should still treat the patient with respect. To prevent the patient from experiencing high levels of anxiety and depression, mental health nurses should act as therapist and counsellor in order to give them a “sense of hope” and a reason to live (O'Neill, Moore, & Ryan, 2008). At this point, the patient may be limited in expressing his thoughts and feelings verbally but it is still possible for the patient to hear what the nurse is trying to communicate to them. Therefore, taking time to communicate with the patients could make the nurse develop a long-term nurse-patient relationship. In general, having a competitive social skills is required to enable mental health nurses established a good working relationship with patient. To establish a therapeutic relationship with the patients, mental health nurses should first establish and develop trust with the patients (Forster, 2001, pp. 65 – 66). Right after establishing the patient’s trust, mental health nurses should provide client-centered counselling each time this kind of caring intervention is necessary (Foster, 2001, p. 72). Since mental health nurses should provide holistic caring to the patients who are mentally ill, nurses should not only focus on providing emotional support to the patients but also to their family members and loved ones (Burkhardt, 2009; Brimblecombe et al., 2007). By extending emotional support to the patient’s family members and loved ones, mental health nurses could indirectly contribute towards the development of a more socially accepting environment for the patients since the patient’s family members will have a better understanding with regards to the health situation of the patient (Brimblecombe et al., 2007). Assessor, Reflector, Researcher and Educator Mental health nurse is responsible in providing health teaching to each person within and outside the community. For this reason, mental health nurses are considered as educators. According to Foster (2001, p. 59), psychosocial family intervention is necessary to reduce the re-admission rate of mentally ill patients. Since nurses are responsible in the provision of holistic caring, the mental health nurse should take time to encourage the patients’ family members and loved ones to participate in health teaching activities that are specially designed for the health condition of the patient (Brimblecombe et al., 2007; Forster, 2001, p. 54). Mentally ill patients have either cognitive, emotional or psychological problems. Since each patient is suffering from different levels of mental illness, the nurses should carefully assess the individual case of each patient (Forster, 2001, p. 27). Upon reflecting that the patient is no longer capable of communicating his thoughts either verbally or in writing, the mental health nurse should consider the intellectual capacity of the patient in terms of comprehending and fully understanding what the nurses are trying to teach concerning the patient’s individual health development (Forster, 2001, p. 38). Given that the patient has very low educational background, the mental health nurse should try to simplify or explain the caring procedure or health teachings in layman’s term. To ensure that mental health nurse is teaching updated nursing care intervention to the patient and the patient’s family members, continuous learning is necessary through a regular research work activities. Clinician, Supervisor and Manager By carefully observing the patient’s signs and symptoms of mental illnesses, mental health nurse clinicians are the ones who normally interview the patients by conducting psycho-social assessment and evaluate the levels of their mental illnesses (Mental Health Nurse Clinician, 1996). Based on the patient’s assessment and diagnostic results, mental health nurses are the ones who develop and implement appropriate treatment care plans. Eventually, it is the mental health nurses who would coordinate with other members of health care professionals concerning the care and treatment of each patient (ibid). Mental health nurse supervisor serves as the role model to his/her subordinates. Aside from being a role model, mental health nurse supervisor should be a good leader in order to inspire and motivate the rest of the health care team to provide good quality service and care to mentally ill patients (Sloan, 1999). As a manager, mental health nurses should develop health care strategies that are based on the standard of caring protocol (Gourney, 1996). Important Factors that could Guide the Mental Health Nurses in Improving the Quality Care Delivered to the Patients At all times, mental health nurses should carefully observe nursing care ethics in order to avoid being accused and sued for nursing negligence. When playing the role as a mental health nurse therapist or a counsellor, it is important on the part of the nurse to observe the law of autonomous and informed consent when rendering care and treatment to mentally ill patients (Mental Capacity Act, 2005; DOH, 2001a). In line with this, mental health nurses should be aware that patients above 18 years of age has the right to voluntarily give their informed consent regarding their preferred care and treatment (DOH, 2001a, p. 4; DOH, 2001c, p. 7) Regardless of race, nationality, gender, and mental health condition, each patient who is already considered an adult has the legal right to decide their preferred care and treatment based on their personal and religious beliefs (DOH, 2001c, p. 3). Informed consent is a standard health care procedure stating that each patient should be well informed about the health care and treatment procedure even before the health care professionals would provide care and treatment to the patients (DOH, 2001a, p. 2; DOH, 2001c; p. 1). Given that a mentally ill patient refuses to give consent to be treated or be admitted to the ward, mental health nurses should respect the patient’s decision (ibid). Nurses should also observe the law of confidentiality. In line with this, mental health nurses should seek permission form the patient in case there is a need to share or disclose the patient’s personal information outside the health care team (NMC, 2008). In general, not all mentally ill patients are capable of making their own decision concerning their preferred care and treatment. In case the patient is no longer mentally capable of deciding for his/her own preferred treatment and care, mental health nurses should refer to the ‘Mental Capacity Act (2005)’ and/or Department of Health’s ‘Seeking Consent: Working with People with Learning Disabilities (2001)’ to ensure that the code of nursing ethics is being observed (Mental Capacity Act, 2005; DOH, 2001b). In relation to the law of beneficence, mental health nurses should avoid doing actions that could cause harm to the physical and emotional well-being of the patients. On the other hand, the law of non-maleficence explained that each nurse should not perform actions that could injure the patient whereas justice means being fair to all (Bailey, 2007; Tuckett, 2005). Not unless the patient has made a last will written contract with regards to do nor resuscitate (DNR) at the time he was still mentally capable of deciding for his preferred care and treatment, it is a standard operating procedure that the mental health nurse should perform actions that would promote the health and well-being of the patients in case of emergency (Mental Capacity Act, 2005; DOH, 2001c; p. 9). Conclusion and Recommendations Conclusion The nursing law serves as a statutory law that strongly defines and regulates nursing practices that are universally accepted within the nursing profession (Sia & Evangelista-Sia, 2006, p. 460). In line with this, mental health nurses should be aware of the nursing code of ethics to avoid facing the risk of being sued by the patients or the patients’ family members for possible nursing negligence. In case the mental health nurse is not familiar or unsure about the legal issues associated with a specific nursing care scenario, it is advisable for nurse to seek legal counsel or advice from the legal experts. Mental health nursing as a profession requires a wide-range of role and responsibilities. Aside from the need to deliver a holistic caring for the patients who are mentally ill and their family members, mental health nurses should perform the professional role of a therapist, a counsellor, an educator, a researcher, assessor, and reflectors. To ensure that a mental health nurse is capable of effectively and efficiently manage a private or public health care institution, mental health nurse should perform the role of clinician, supervisor, and a manager. For a mental health nurse to be able to successfully perform these roles and responsibilities, mental health nurses should be able to strengthen their leadership skills, communication skills, and social relationship skills. These soft skills are very important not only in enabling each of the mental health nurses to be able to establish trust and good working relationship with the patients but also when managing the rest of the health care team. Aside from becoming aware of the ethical theories behind autonomy, informed consent, non-maleficence, beneficence, and justice, mental health nurses should be aware of different cultural practices in order for them to know how to respond properly with regards to religious and cultural beliefs of each of the mentally ill patients. Recommendations Even though the law of autonomy may no longer be applicable in this scenario given that the mentally ill patient is not capable of making his own preferred care and treatment, mental health nurse should contact at least one of the family members of the patient to make important health care and treatment decision on behalf of the patient. At this point, the mental health nurse should observe the law of informed consent by carefully and clearly explaining all health care and treatment options to the patient’s family member including the benefit and consequences of each health care procedure. To improve the quality of patient care provided to a patient, the mental health nurses should always observe the law of confidentiality, beneficence, justice, and non-maleficence when caring for the patient. It means that the nurse should do only health care actions that could help improve the physical, mental, and emotional well-being of the patient. *** End *** References Bailey, G., 2007. NASW Standards for Social Work Practice in Palliative and End of Life Care. National Association of Social Workers. [online] Available at: [Accessed 4th February 2011]. Brimblecombe, N., Tingle, A., Tunmore, R., and Murrells, T., 2007. Implementing holistic practices in mental health nursing: A national consultation. International Journal of Nursing Studies , 44(3), pp. 339-348. Burkhardt, M., 2009. Commentary on “Existential and Spiritual Needs in Mental Health Care: An Ethical and Holistic Perspective”. Journal of Holistic Nursing , 27(1), pp. 43-44 . DOH, 2001a, March. Reference Guide to Consent Examination or Treatment. [Online] Available at: [Accessed 4th February 2011]. DOH, 2001b, November. Seeking Consent: Working with People with Learning Disabilities. 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