CNA256 Mental Health
Question:
You are required to:
Discuss how an understanding of peoples’ lived experiences of a mental disorder can contribute to the development of person-centred mental health nursing practice.
Reflect on your own nursing practice and identify one aspect that requires some development for you to work collaboratively with people who have a lived experience of a mental disorder. With reference to relevant nursing literature, reflect on how you could develop this aspect of your own nursing practice. In this section of the discussion you can use the first person, ‘I’, when you are discussing your own practice development; however, you must also support this section of the discussion with references to relevant literature.
Answer:
Introduction
Nurses need to understand people who have lived experiences when providing mental disorder care to enhance person centred nursing practice. People’s lived experiences refer to a person’s past events or backgrounds that have impact to their mental health and make one vulnerable to stigma, exclusion, or shame (Slade et al., 2014). Nurses need to develop their skills to provide person centred care to patients with lived experiences of mental disorder. A nurse should be able to show empathy and relate to individuals of all backgrounds and ages. The following write up discusses how understanding people’s lived experiences of a mental disorder contributes to development of a person-centred mental health in nursing practice. The second part of the write-up is my reflection on own nursing practice and identification of an aspect that requires some developments to achieve collaboration when working with people who have lived experiences of a mental health. The write-up will uses evidence based nursing literature and literature of people who have experiences of living with effects of mental disorders.
Understanding of a person’s lived experiences of a mental health disorder contributes to development of person centred mental health. Understanding people’s lived experiences can be the first step to planning a personalized care. Planning a nursing care is an important process in nursing practice and provides direction of nursing care that a patient need. The care plan facilitates evidence based, holistic and standardized care to a patient’s needs. Lived experiences can help nurses in the development of care plan by enhancing understanding of patient’s unique needs. The care plan lists all the patient’s needs and effectively communicates a standard care for a specific patient. Shepherd, Boardman, and Slade, (2008) stated that understanding people’s lived experiences is the head start to planning for mental disorder care. According to Slade et al., (2014) mental disorder patients with lived experienced were excluded from treatment decisions hence undermining person centred care. In a similar findings, Barker and Buchanan?Barker (2011) noted that majority of mental disorder patients were not given adequate or sufficient information regarding their treatment. This show that lack of understanding people’s lived experiences excludes mental patients from being involved in developing their care plan. Therefore, understanding people who have lived experiences in mental disorders contribute to developing a care plan that is person centred for mental patient. Secondly, understanding people’s lived experiences with mental disorders contribute to building effective therapeutic and professional relationship. Therapeutic relationship is an important part of person centred care and it involves how a nurse and a client engage and effect beneficial changes to the client. Understanding people’s lived experiences establishes trust and enhances equal Partnership interactions that are important in providing mental care to patient. Gunasekara et al., (2014) found that people with lived experiences felt that they were patronized by health professionals that undermined person centred care. Understanding people’s lived experiences with mental disorders enhance therapeutic relationship by actively listening to the patient. This minimizes situations where mental disorder patients feel humiliations or patronized when accessing mental health care.
Another contribution of understanding people’s lived experiences for person centred nursing practice is respect for culture in nursing practice. Respect for culture refers to acknowledging beliefs, assumptions, tolerated behaviours, and values that have developed over time. People’s with lived experiences of mental is disorders develop beliefs, values, assumptions and tolerable behaviours that they think and feel are acceptable or not acceptable and nurses need to understand them when providing mental care. Understanding people’s lived experiences enable nurses develop cultural competence of the patient’s culture through direct interaction and engagement with the patient’s past events. According to Edvardsson, Winblad, and Sandman, (2008), a person centred care has to involve people’s values, desires, social circumstances, family situation, and lifestyles. To achieve, a person centred care, a nurse should provide mental care from a person’s point of view for improved health outcomes. Gunasekara et al., (2014) found that respect for culture is important for mental disorder patients with lived experience and enhances patient support to decisions made regarding their treatment. According to Dziopa, and Ahern, (2009) person centred care has to respect people’s values as they determine preferences and expression of needs when providing mental health care. Therefore, understanding people’s lived experiences with mental disorders enhances cultural awareness and respect for values, beliefs, behaviours and assumptions that are important contributions to attaining person centred mental care. Last but not the least, understanding of people’s lived experiences with mental disorders improves perceptions that contribute to provision of person centred care. People with lived experiences of mental health experience stigma and shame that have impact to their recovery process and acceptance of treatment. Livingston and Boyd, (2010), found in their research that people with lived experiences of mental disorders felt that they were being treated like children when undertaking treatment. They were perceived as helpless to their situation and not involved in planning for their treatment that undermines principles of person centred care. It is important for nurses to understand the people’s with lived experiences of mental disorders to shape their perception about the situation and design person centred mental health care plan. Therefore, understanding people’s lived experiences with mental disorders improves perceptions that enhance provision of a person centred mental care.
Reflection
As a nurse, it’s essential for one to acquire excellent skills to collaboratively work with people who have lived experiences of mental disorder. People with lived experiences of mental disorder require understanding of their situation in order to deliver a person centred mental care. I have learnt that understanding people’s lived experiences with mental health contributes to development of person centred mental nursing practice in several ways. These contributions are enabling design of caring plan, building effective therapeutic and professional relationship, enhancing respect for culture and improving perception of the situation in nursing practice for people with lived experiences of mental disorders. A person centred mental nursing practice care lead to improved health outcome by making a client or patient to be at the focus of the health care. A nurse therefore needs to engage people with lived experiences of mental health to develop a care plan, have excellence therapeutic skills, and be culturally competent to deliver a person centred mental health care.
From the discussion and review of evidence-based literature on understanding people who have lived experiences of mental disorders, I feel there is need to improve the aspect of establishing therapeutic relationships. I need to improve my ability to establish and maintain therapeutic relationships that will effectively engage a mental patient with lived experiences and enhance my nursing practice toward provision of a person centred care. Establishing a therapeutic relationship is an important part to understanding a person lived experiences of mental disorders and how to enhance the working-relationship for the benefit of the patient. Therefore, there is a need for me to focus on how to improve my therapeutic aspect for establishing effective and professional relationships when working with people who have lived experiences of mental disorders.
A therapeutic relationship need to be a helping relationship between a nurse and a patient based on respect and mutual trust, sensitive to patients, nurturing hope and assisting a patient’s emotionally, spiritually and physically when delivery health care (Morgan, and Yoder, 2012). To develop my therapeutic aspect to deliver high quality and safe person centred mental care, I will need to work on improving communication with the patient and act appropriately for an effective therapeutic relationship. First, I will ensure I introduce myself to the patient and use their real names when talking to them. McCormack et al. (2010) noted that remembering a patient name and having a handshake quickly establishes respect and trust with the patient. Secondly, I will ensure I actively listen to my patients. Koren, (2010) stated that a nurse can enhance understanding patients’ concerns by restating them verbally. Edvardsson, Winblad, and Sandman, (2008) on the same account noted that a nurse should not restate too much as patients can perceive that they are not well listened to. Thirdly, I will maintain eye contact when engaging with patients. Though too much eye contact to patient can be intimidating, Morgan, and Yoder (2012) stated that an interval smile or nodding of head enhances engagement in a conversation. Another thing that I will do to develop my therapeutic relationship is maintaining professional boundaries. According to Koren, (2010), nurses should establish, sustain, and conclude relations in a manner that differentiates boundaries between personal and professional relationships. This will enable me to always respect and be objective to providing person centred care.
Therefore, I will work on developing the therapeutic aspect to enhancing my nursing practice when working with people with lived experiences of mental disorders. This will enable me understand their experiences and how I can collaborate with them to provide a person centred mental nursing practice.
Conclusion
From the discussion and reflection, it important for nursing practice to understand people’s lived experiences of mental disorders. Understanding people’s lived experiences contributes to establishing of effective therapeutic relationships, designing care plan, awareness of culture (respect) and improving perception that are important for aspects of person centred mental nursing practices. I found that I need to improve my establishment of therapeutic relationship to enhance my nursing practice as a person centred nurse. Therefore I will work on my introductory technique to the patient, listen actively, maintain eye contact and maintain professional boundaries for effective therapeutic relationships.
References
Barker, P. and Buchanan?Barker, P., 2011. Myth of mental health nursing and the challenge of recovery. International Journal of Mental Health Nursing, 20(5), pp.337-344.
Dziopa, F. and Ahern, K.J., 2009. What makes a quality therapeutic relationship in psychiatric/mental health nursing: A review of the research literature. Internet Journal of Advanced Nursing Practice, 10(1), pp.7-7.
Edvardsson, D., Winblad, B. and Sandman, P.O., 2008. Person-centred care of people with severe Alzheimer’s disease: current status and ways forward. The Lancet Neurology, 7(4), pp.362-367.
Gunasekara, I., Pentland, T., Rodgers, T. and Patterson, S., 2014. What makes an excellent mental health nurse? A pragmatic inquiry initiated and conducted by people with lived experience of service use. International Journal of Mental Health Nursing, 23(2), pp.101-109.
Koren, M.J., 2010. Person-centred care for nursing home residents: The culture-change movement. Health Affairs, 29(2), pp.312-317.
Livingston, J.D. and Boyd, J.E., 2010. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social science & medicine, 71(12), pp.2150-2161.
McCormack, B., Karlsson, B., Dewing, J. and Lerdal, A., 2010. Exploring person?centredness: a qualitative meta?synthesis of four studies. Scandinavian Journal of Caring Sciences, 24(3), pp.620-634.
Morgan, S. and Yoder, L.H., 2012. A concept analysis of person-centred care. Journal of holistic nursing, 30(1), pp.6-15.
Shepherd, G., Boardman, J. and Slade, M., 2008. Making recovery a reality (pp. 1-3). London: Sainsbury Centre for mental health.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S. and Whitley, R., 2014. Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 13(1), pp.12-20.
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