Coordinating psychosocial nursing care across treatment settings

A criticism sometimes made of nurse practitioners is that they want to be or think they are doctors. Who has not heard a nurse administrator accused of having lost her nursing identity, or of a faculty person who no longer knows nursing? Before BSN degrees were common, there were stories of 4-year nurses who believed they were above providing direct care and identified only with the administrative roles on the unit. These criticisms have been made by nurses. It is only recently that nurses are recognizing that fragmentation of the profession along these and other lines disempowers us and may result in non-nurses delineating what our practice will be. Perhaps stimulated by the nursing shortage and an increased awareness of our collective power, nurses are more vocal and we are owning our identity as nurses. Psychosocial nurses, perhaps because of conflicts related to professional territory with psychiatry, psychology, and social work, or because of the ramifications of third party payments, are less likely to assume the generic title of "therapist" than in the past. More often, there seems to be a coming together of psychosocial nurses with each other and with the nursing community as a whole. This coming together enhances the potential for nurse-to-nurse communication and sets the stage to allow nursing to become the bridge needed by consumers of mental health services. I am hopeful that psychosocial nursing will meet this challenge.     

Poems, patients, and psychosocial nursing

1. Holism can prove just as elusive in psychosocial nursing as in any other specialty area. 2. Students in an undergraduate psychosocial nursing course used poetry to express the fullness of the situations in which they found themselves. 3. The poems touched a deeper and more complete sense of humanity than had been possible in other, more traditional, assignments.     

Homophobia: a challenge for psychosocial nursing

1. In 1975, the American Psychological Association stated that homosexuality was not a disorder and that homophobia was a form of prejudice based on stereotypes. 2. Because homophobia, like racism or sexism, is learned, it can be unlearned. 3. People who feel homosexuality is a choice hold more negative attitudes toward individuals who are gay, lesbian, bisexual, or transgendered. 4. Homophobia not only damages individuals who are gay, lesbian, bisexual, or transgendered, but also limits heterosexuals by locking them into rigid gender-based roles.     

Conceptualizing psychosocial nursing in the jail setting

1. The deinstitutionalization movement led to the release of thousands of mentally ill patients, many of whom were incarcerated as a way of dealing with their disturbed behavior. More restrictive civil commitment laws have also contributed to the number of mentally ill who are incarcerated. 2. Health care and security can be perceived as competing interests in the correctional institution. These competing interests may also be perceived as sources of conflict because each interest aims towards divergent goals that interfere with the other. 3. A problem central to the inadequate services for the mentally ill offender is that few people are aware of the poor conditions for this population. Correctional and mental health organizations must educate the public about the plight of the mentally ill offender.     

Sensitizing nursing home staff to residents' psychosocial needs

Most of the direct care of nursing home residents is provided by nursing aides. Aides generally have had limited training and experience working with the frail elderly and may not be attuned to residents' psychosocial needs. This can result in aides working at cross purposes with the social worker, producing a system that is counterproductive. This paper describes a situation where inservice training was utilized to help aides gain a greater understanding of the residents in their care. Advantages of using in-service are discussed, potential pitfalls are considered, and illustrations of in-service training techniques are presented.     

On public sector psychosocial nursing: a conceptual framework

1. Nursing practice is driven more by its environment than by knowledge provided by faculty or even strong relationships between faculty and staff. Because that environment is publicly supported, programs reflect changes in the ideological environment. 2. The psychosocial nursing specialty incorporates psychiatric/mental health nursing and social sciences to reduce the negative environmental influences while increasing the positive ones. 3. Public sector psychosocial nurses must be familiar with changing laws and regulations as well as the history of hospital and community programs for the mentally ill; understand the complexity of society and that the state hospital is only one component of a large system; and contribute to the development of their subspecialty.     

Reiki. A complementary therapy for nursing practice

1. Reiki is an ancient healing art involving the gentle laying on of hands. It can be practiced anytime and anywhere. 2. Reiki can be used as a complementary treatment to medical protocols. 3. Hand positions customarily correspond to the body's endocrine and lymphatic systems and major organs, focusing on seven main chakras. 4. More research investigating the effects of Reiki on persons with psychiatric and medical disorders is necessary.     

Using a model to structure psychosocial nursing [corrected]

1. Specifying a model to guide research projects helps clarify the study, permits several investigators to work in a coordinated fashion on large projects, and facilitates comparisons across studies. 2. This model is composed of seven domains and indicates some of the hypothesized relationships between domains. Adapting the model to individual studies may result in a different number of domains and in the specification of other hypothesized relationships. 3. When possible, researchers should make use of minimum data sets to enhance the comprehensiveness and generalizability of their research.     

A proposal for change to achieve competence in long-term psychosocial nursing care

Psychiatric nursing in a large institutional setting presents challenges to the nursing staff, who must remain competent in the specialized areas of psychiatric and medical nursing. Chronically mentally ill individuals present complex and continuing nursing care needs that must be addressed using a holistic approach to nursing assessment and care. The complex needs of nursing staff and patients in an institutional setting have been described. Methods of assisting the nurse to achieve competence using education and experience have been implemented and described with the goal of improving holistic nursing care to chronically institutionalized individuals.     

Vitebsk. The Life of Art

Deych, Genrich M., Putevoditel. Arkhivnye dokumenty po istorii evreev v Rossii v XlX‐nachale XXw. (A Research Guide to Materials on the History of Russian Jewry (Nineteenth and Early 20th Centuries) in Selected Archives of the Former Soviet Union.? Edited and introduced by Benjamin Nathans. (Moscow: Blagovest n.d., xii +149pp.)

Elyashevich, Dmitry A., compiler, Dokumentalnye materialy po istorii evreevv arkhivakh SNG i stran Baltii (Documentary Sources on Jewish History in the Archives of the CIS and the Baltic Countries) (St Petersburg: Acropolis 1994,134pp.)

Elyashevich, Dmitry A. and Kelner, Viktor, compilers, Literatura o evreyakh na russkom yazyke, 1890–1947: knigi, broshyury, ottiski statey, organy periodicheskoy pechati. Bibliografichesky ukazatel (Russian‐Language Literature on the Jews, 1890–1947: Books, Brochures, Reprints of Articles, Periodical Editions. Bibliographical Index) (St Petersburg: Humane Agency Academic Project 1995, 679pp.)

Freeze, Gregory L. and Mironenko, Sergey V. (eds.), Putevoditel. Tom I. Fondy Gosudarstvennogo arkhiva Rossiyskoy Federatsii po istorii Rossii XlX‐nachala XXw. (Research Guide. Volume I. Collections of the State Archive of the Russian Federation on the History of Russia in the Nineteenth and Early‐Twentieth Centuries) (Moscow: Blagovest 1994, xviii+394pp.)

Sallis, Dorit and Web, Marek (eds.), Jewish Documentary Sources in Russia, Ukraine and Belarus: A Preliminary List (New York: The Jewish Theological Seminary of America 1996, vii+164pp.)

Seriya ‘Evreysky arkhiv’. Obshchestvo ‘Evreyskoe nasledie’ (Jewish Archive Series, Jewish Legacy Society) (Moscow 1994)

Sobolev, V. S., editor and Anferteva, A. N., compiler. Gebraistika i istoriya evreyskoy kultury v Rossii. Tematichesky ukazatel dokumentov po fondam Sankt‐Peterburgskogo Arkhiva Rossiyskoy Akademii nauk (Hebraistics and the History of Jewish Culture in Russia. A Thematic Guide to Documents in the Collections of the St Petersburg Archive of the Russian Academy of Sciences). 2 volumes. (St Petersburg 1994–5, 42pp.+30pp.)     

A process-oriented approach. Selecting a nursing model for psychiatric nursing.

The nursing literature is replete with articles and books that describe nursing conceptual frameworks and models and encourage their use in clinical, education, and research activities. Although much information exists on the content of nursing models, less has been written about how a model is to be chosen and the process that may facilitate the choice of a model. This article reviews potential benefits and limitations of nursing models and conceptual frameworks and describes a three-phase process for selecting a model for psychiatric nursing practice.     

Borderline personality disorder: nursing interventions using dialectical behavioral therapy

Psychotherapeutic treatment of people with borderline personality disorder (BPD) is one of the greatest challenges confronting mental health professionals today. Clients with BPD are often difficult for nurses to work with, perhaps due to a lack of understanding of the underlying dynamics of the disorder. This article describes effective treatment strategies for BPD with a central focus on dialectical behavioral therapy (DBT). In typical mental health settings, nurses can effectively implement interventions using the concepts of DBT to help people with BPD build effective coping strategies and skillful behavioral responses for improved quality of life.     

Seclusion. The nursing challenge.

The research to date shows that there is not much data to guide nursing decisions about the use of seclusion. The justification for its use is not always as clear as one might hope. Although many patients are secluded for violence against themselves or others, there are others who have not been violent who are secluded. There may be justification for secluding violent patients, but, as indicated earlier, it may reinforce the behavior it is designed to stop. There probably is no justification for secluding patients who make loud noises, refuse to take medication, or refuse to participate in activities. In addition, it is disconcerting that a large percentage of patients are secluded for "escalating agitation," that is, they have not acted violently against themselves or others. What is problematic is that staff are undoubtedly predicting violent behaviors in these patients--predictions that might be erroneous. Thus, there is ample room for injustice to occur. The potential for injustice is even greater if certain patients are singled out for seclusion or if patients are secluded longer than they or the staff think that they need to be, as is indicated in some of the studies to date. Moreover, if unit variables are associated with seclusion activity, this too, may be indicative of decision making at certain times of the day or by certain staff members that may not be in the best interest of the patient. What seems fairly clear is that secluding a patient is a distressing event for staff and is viewed extremely negatively by some patients and as a reward by others.(ABSTRACT TRUNCATED AT 250 WORDS)