Week 2 Flashcards
several factors influenced a shift in mental health care, closing of asylums, and a vision of community-based care. which was most significant in this shift?
- intro of anti-psychotic meds
what is self-stigma
- negative thoughts of yourself bc of association w a stereotype
what is Hildegard Peplau’s contribution to mental health care
- took students to asylum, focused on communication
- created the theory of nurse-pt relationship, therapeutic relationship
what is the mission of the Manitoba Department of Mental Health, Wellness, and Recovery ?
- to provide access to mental health & addictions supports and treatment that improve life outcomes for Manitobans in their journey thru recovery & healing
describe the concept of recovery
- is a process, a way of life, an attitude, way of approaching the day’s challenges
- not a linear process
- at times the course is erratic, falter, then need to slide back, regroup, and start again
- the need to meet the challenge of disability & to re-establish new & valued sense of integrity and purpose within and beyond the limitations of disability
- aspiration is to live, work, love in a community in which one makes a difference
describe attributes of recovery (4)
- experience isolation, hopelessness, and suffering
- discovery of the inner self & intrinsic value of life motivated by hope
- comes from the individual in an incremental manner according to one’s sense of self
- perseverance, resilience, fighting spirit q
what are some guiding principles of recovery (6)
- coming to terms w mental illness
- restoration of hope (clinicians initial emphasis on hope & optimism influences recovery)
- not linear, takes time
- consider individual’s needs, goals, interests, strengths
- clinicians & individuals work collaboratively to develop a recovery mngmt plan
- involves holistic approach
how does family involvement impact recovery
- may enhance recovery –> v imp, source of support
describe the process of recovery
- changes from illness taking over the person –> illness part of life but not taking over
what is considered w recovery oriented practice?
- how to inspire hope, empowerment, resilience?
- how to work in partnership?
- how to promote empowerment?
- resources needed to support recovery & full range of services? options?
- consideration of social determinants of health to support holistic approach
- hear people’s stories and lived experiences
what are the 3 themes of recovery-focused practice in mental health
- hope
- person-centered care
- consider “service users’ opinions on the experience of care”
what is a tool used to support/facilitate recovery
- recovery plans (aka WRAP - Wellness Recovery Action Plan)
what are various components of recovery plans (5)
- plan for pursuing dreams & goals
- wellness plan
- plan managing ups and downs (what helps, triggers, etc.)
- plan for managing crisis (signs of, how to prevent)
- plan for after a crisis
use of a wellness planner was shown to increase (4)
- client’s sense of empowerment
- client’s perceived QOL
- client’s satisfaction w mental health care services
- client’s perception of continuity of care
what are some factors that hinder recovery (7)
- no support
- isolation
- stigma
- bias of healthcare providers
- no access to resources
- discrimination
- no money for funding for programs
describe the importance of therapeutic communication in mental health care
- in mental health care, nursing intervention primarily takes place thru nurse-pt interaction = communication & development of nurse-pt relationships essential
what is therapeutic communication
- an interpersonal exchange, verbal & nonverbal, where someone is helped to overcome stress, anxiety, fear, or distressing emotional experiences
- expresses support, hope, provides info & feedback and corrects distortions
- conscious intention of helping
what are 5 components of a therapeutic relationship
- respect
- empathy
- trust
- power
- professional intimacy
describe the respect component of a therapeutic relationship
- responsibility to understand & respect the dignity and rights of the pts
describe the empathy component of a therapeutic relationship
- the expression of understanding, validating, and resonating w the meaning that the health care experience holds for the client
describe the trust component of a therapeutic relationship
- necessitates the nurse to act in the client’s best interest
describe the power component of a therapeutic relationship
- there is an imbalance of power favoring the nurse
describe the professional intimacy component of a therapeutic relationship
- client discloses personal info, therapeutic closeness
describe self-disclosure in mental health care
- can be challenging
- can share general info (fav sports team, etc.)
- should not share personal info (where live) or traumatic personal experiences (takes away from pt’s experience, may cause pt to feel need to support nurse)
what are the 3 phases of a therapeutic relationship
- orientation phase
- working phase
- resolution phase
(see text pp. 88-90 for more info)
describe the orientation phase of a therpeutic relationship (5)
- first meeting
- involves getting to know the pt
- ensure confidentiality
- set boundaries
- establish trust
describe the working phase of a therapeutic relationship (3)
- involves identifying & working on problems
- outcomes & interventions planned
- goals developed
describe the resolution phase of a therapeutic relationship (2)
- allows the client to depend on his or her own strengths –> become independent
- relationship ends
what are powerful tools for therapeutic communication (4)
- individuality
- providing support
- being present/accessible
- reflect & validate feelings
(see table 10-2 on text for more therapeutic communication techniques)
describe individuality r/t communication
- see clients as individual people beyond their mental illness
- demonstrate respect
describe providing support r/t communication (3)
- convey support, hope, concern
- help clients feel safe & comfortable
- be genuine
what is an imp consideration r/t listening
- looking like your listening is not enough
describe validating r/t communication (2)
- identify, acknowledge, and normalize the feeling expressed
- involves clarifying the nurse’s understanding of the situation
why is it important to use validating in therapeutic communication
- validating a person’s experience and feelings helps them to feel that their emotions are not wrong
- helps facilitate connection
what are some examples of validating statements (4)
- “you’re feelin rlly sad rn”
- “it makes sense that you’re angry”
- “being afraid in these situations is not uncommon”
- i can hear how much distress this incident has caused you”
describe the 5 steps to a problem-solving approach
- define the problem
- analyze the nature of the problem or conflict (how do you view this? what resources do you have?)
- consider alternatives and their consequences (brainstorming)
- weigh the advantages & disadvantages of each alternative (to guide, so the pt can learn the problem-solving process)
- take action on the decision (client’s course of action)
describe the 5 steps to a problem-solving approach
- define the problem
- analyze the nature of the problem or conflict (how do you view this? what resources do you have?)
- consider alternatives and their consequences (brainstorming)
- weigh the advantages & disadvantages of each alternative (to guide, so the pt can learn the problem-solving process)
- take action on the decision (client’s course of action)
define communication difficulties (2)
- inability to communicate effectively
- disturbances in perceptions, processing, and/or expression
communication is influenced by? (5)
- moods, feelings, attitudes
- context of the interpersonal relationship
- sensory distortion
- selective inattention
- language and cultural differences
what is reflective practice? (2)
- ongoing process throughout your career
- involves developing self-awareness & thinking about your perceptions
what is involved in reflective practice (4)
- self examination –> knowing the self
- feedback from others
- thinking about beliefs, bias, limits
- consider how your beliefs, experiences, and culture influence your perception of the world?
what facilitates recovery (3)
- mental health nurses & reflective practice
- think about your own perceptions
- understanding recovery as a process
describe the therapeutic use of self (2)
- you are the means, the vehicle for helping & creating a safe enviro to assist clients to overcome their difficulties
- everyone uses their personality and ways of being in a different manner in the helping process
