Art therapy. Enhancing psychosocial nursing

1. The creative process can be a means of reconciling conflicts and increasing awareness. 2. Art provides a permanent representation of clients' internal states and reflects the changes seen in the therapeutic progression. 3. Many psychological states lend themselves to a much greater extent to graphic representation, as opposed to verbalization. 4. Art holds the potential for enhancing the quality of therapy for clients by increasing expression and facilitating insight.     

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.     

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.     

The challenge of the medical setting for the clinical specialist in psychiatric nursing

The purpose of sharing these ideas about the role of the psychiatric clinical specialist in the medical setting has been threefold: first, to stimulate the interest of others by communicating the needs for and the value of such a role in improving health care; secondly, to convey the variety of potential opportunities available in the role; and third, to share some ideas about specific activities which can be pursued in such a role. The clinical specialist who chooses to work in the medical setting will discover opportunities to develop creativeness, to explore innovative ideas, and to utilize the variety of one's personal resources and past learning experiences. It affords one with opportunities to serve as a change agent, to influence the quality of patient care, and to stimulate the growth of other nurses. It allows for on-going contact and exchange with other professional groups comprising the health care team, and finally, it provides the nurses with a high level of autonomy and challenge in defining their own roles.     

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.     

The accomplishment of intimacy in the jail visiting room

An essential feature, and perhaps the harshest reality, of incarceration is the physical separation of the prisoner from those with whom he or she would ordinarily interact—a separation which often puts familial and friendship ties in jeopardy. In light of this, prison administrators, citizens' advisory commissions and government agencies have become aware of the rehabilitative benefits of prisoner contact with outsiders. Despite such thinking and the institution of various forms of visitation, effective procedures are difficult to attain in large metropolitan jails. This paper, based on observations in a county jail located in a large, western city, argues that the desired level of intimacy exhibited during a visitor-prisoner conversation is directly related to the importance of the visitor-prisoner relationship as a topic of conversation. Furthermore, the conversation itself becomes an effective experience for those visitors and prisoners for whom their sexual relationship becomes a topic of high priority. The author wishes to thank Murray Davis, Bennett Berger and Fred Davis for helpful comments on an earlier draft of this paper.     

Providing nursing leadership in a community residential mental health setting

The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies.     

Conceptualizing Variation in the Experience of Time*

This paper presents a theoretical model that identifies and accounts for the full range of variation in the experience of duration. The model has been generated through inductive theory construction, using empirical materials drawn from the triangulation of qualitative methods. Its central proposition is that variation in the perceived passage of time reflects variation in the density of conscious information processing per standard temporal unit.     

Ethical considerations when conducting ethnographic research in a nursing home setting

In this article I provide an overview of ethical concerns when conducting ethnographic research in nursing home settings where participants are vulnerable and submissive to authority, and I consider how particular research methodologies may benefit the participants. The focus of the article is primarily on the issues of privacy and autonomy and the relationship between the researcher and the participant. My own experiences of doing research in a nursing home will be woven throughout the article, as will the accounts of other researchers who have studied life in nursing homes. In reflecting on my work as a researcher I have come to a deeper understanding of the ethical issues involved in doing research in a nursing home and of the importance of ethically sound research.