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CNL Role in Psychiatric Department
Never has it been more critical to provide high quality care in the hospital while being cost effective. The American Association of Colleges of Nursing (American Association of Colleges of Nursing [AACN], 2005) has created the Clinical Nurse Leader (CNL) role to introduce lateral integration of care for specified groups by creatively and intentionally using a variety of health care resources (AACN, 2005). The CNL’s purpose is to aid in various departments of the health care system including the psychiatric department. Although there is continuous tension between medical care and psychiatric care and choosing which is more important for a patient, the Clinical Nurse Leader is intended to bridge the gap between the two.
The goal in creating the position of Clinical Nurse Leader in inpatient psychiatric facilities is to reorient the health care system to reduce medical errors, increase patients’ safety, and improve health outcomes (Seed, Torkelson, & Karshmer, 2009). The CNL is not common in the psychiatric care setting right now because the role is fairly new (Seed, Torkelson, & Karshmer, 2009). However, the role has impacted other departments greatly and has the capacity to do the same in inpatient psychiatric care. Through describing the relevance and importance of the CNL role within the Medince/Psychiatric (Med/Psych) department, what the team would look like (the integration of the two departments), and future implications of the nursing profession, there will be a better understanding of the impact of the evidence-based model implemented through future CNL’s.
Relevance of the CNL Role to the Psychiatric Department
Although the CNL role is fairly new to the health care system, it has impac...
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... Torkelson, D. J., & Karshmer J. F. (2009). The clinical nurse leader:
Helping psychiatric mental health nurses transform their practice. Journal of the American psychiatric Nurses Association, 15(2), 120-125. doi:
10.1177/1078390309333063
Sprayberry, L. D. (2014). Transformation of America’s Health Care System:
Implications for Professional Direct-Care Nurses. MEDSURG Nursing. 23(1),
61-66. Retrieved from http://eds.a.ebscohost.com/
Stanley, J., Gannon, J., Gabuat, J., Hartranft, S., Adams, N., Mayes, C., Shouse, G. M.,
Edwards, B. A., & Burch, D. (2008). The clinical nurse leader: a catalyst for improving quality and patient safety. Journal of Nursing Management. 16,
614-622. doi: 10.1111/j.1365-2834-2008---899.x
University of Pennsylvania. (2014, April 15). Inpatient and Assessment services.
Retrieved from https://www.med.upenn.edu/psych/inpatient.html
Angela Burke who was a patient admitted to the psychiatric ward for suspected mental health issues required care. When working with mental health patients, it is necessary to use a patient centered care approach which emphasizes on each individual’s personal preferences and needs (Bromley, 2012). The main goal of this is to empower patients so that they can participate and become active in their care and allowing them to have a sense of control of their life (Bromley, 2012). For this to happen, it is essential for Authorised Mental Health Practitioners (AMHPs) to work together in collaboration using the NMBA’s Nursing Practice Decision Making Framework Tool in order to develop an efficient and effective patient centred care plan using goals to avoid or minimise potential risks in a ward setting. This paper will also discuss the different appropriate delegation, supervision and mentoring strategies which can be used amongst the inter-professional in order to create an effective shared
Studies indicate that nurse case management has reduced patient readmissions to the hospital and improved patient’s overall health. Case management uses assessment, planning, facilitation, coordination, and advocacy to meet the needs of the patient and family/caregiver (CMSA, 2014). Using a holistic and patient-centered approach, case managers can address each patient’s specific needs. Communication is vital between the patient/family, physician, case manager, and others departments involved in the care. The five principles that case management functions under include: 1) focus on the patient and family, 2)
Harvey, P. D., Moriarty, P. J., Friedman, J. I., White, L., Parrella, M., Mohs, R. C., & Davis, K.
Rather than preparing graduates in education or consulting as previous graduate nursing programs had done, this program educated psychiatric-mental health nurses as therapists with the ability to assess and diagnose mental health issues as well as psychiatric disorders and treat them via individual, group, and family therapy (ANA, 2014). Thus, the Psychiatric Mental Health Clinical Nurse Specialist (PMH-CNS), one of the initial advanced practice nursing roles (Schmidt, 2013), was born. After Community Mental Health Centers Act of 1963 led to deinstitutionalization of individuals with mental illness, PMH-CNSs played a crucial role in reintegrating formerly institutionalized individuals back into community life (ANA, 2014). PMH-CNSs have been providing care in a wide range of setting and obtaining third-party reimbursement since the late 1960’s. In 1974 a national certification for PMH-CNSs was created (APNA, 2010). Subsequently, PMH-CNSs began to be granted prescriptive privileges in the Pacific Northwest in the late 1970s, that practice has now spread to 37 states and the District of Columbia (APNA,
9.Wang, P. S., Gruber, M. J., Powers, R. E., Schoenbaum, M., Speier, A. H., Wells, K. B., &
Murphy J, Quillinan B, Carolan M. "Role of clinical nurse leadership in improving patient care." Nurs Manage 16, no. 8 (2012): 26-28.
Charge nurses are usually not in a defined permanent charge nurse role as delineated by a job description, but rather rotate through if assigned for their shift (Krugman & Smith, 2003). Additionally, many charge nurses enter their role through default (because they are the most experienced or tenured on their shift) and without formal training (Sherman, 2005). Research conducted by Sherman (2004) indicates that it is becoming more difficult to convince nurses to step up to the plate to assume leadership responsibilities even at the charge nurse level. Additionally, the lack of well-prepared charge nurses may lead to increased nurse dissatisfaction, increased nurse turnover, litigation (Mahlmeister, 1999), decreased patient satisfaction, and potential for increased error. Nurse leaders who are now examining leadership effectiveness at every level have found that charge nurses not only need clinical expertise but effective leadership skills as well (Connelly, Yoder, & Miner-Williams, 2003; Turner, 2005).
The Psychiatric Mental Health Nurse Practitioner (PMHNP), role and job description is providing primary mental health care services, to those with mental health problems, or psychiatric disorders. The PMHNP is required to assess, diagnose, provide treatment plans, prescribe medication therapy, and offer counsel across the lifespan. The PMHNP provides care in a wide range of settings to children, adolescents, adults, the elderly, and their families. This mental healthcare takes place in the primary care settings, emergency rooms, hospitals, outpatient mental health clinics, senior living communities and in private practices. Being culturally competent to care for the ever changing demographics of the United States is necessary. The PMHNP assess and treats in a holistic manor and utilizes evidenced based practice. Regardless of race, gender, age, religion, sexual orientation, political persuasion, or socio economic standing the PMHNP is there to treat. The PMHNP role also includes establishing a therapeutic relationship, being sensitive to many abnormal behaviors, and caring for those frequently distressed emotionally. Collaboration and the ability to make referrals are essential for the PMHNP. Patients present with undiagnosed problems and establishing the proper diagnosis by a qualified PMHNP begins with the initial assessment interview (Gilfedder, Barron, & Docherty, 2010).
In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also positively influences teams and individual nurses” (Malloy & Penprase, 2010.) Let’s explore two different leadership styles and discuss how they can enhance or diminish the nursing process.
This article was written by several well educated professionals in the nursing field. The article appears in a peer reviewed nursing journal that covers topics in psychiatric and mental health nursing that has a 37-year history. The sources history, along with the use of various references from other professional sources establish the journal entries
Hospital administrators will charge nurse leaders with ensuring that patient positive outcomes prevail while also controlling overhead. Nurse leaders are specially trained just for this task. Clinical Nurse Leaders are the experts that America’s patients will rely on to keep them safe and healthy in hospital settings.
Stuart, G. W. (2009). Principles and Practice of Psychiatric Nursing (9th ed. pp 561). St. Louis, MO: Elsevier Mosby.
In 2003, leaders in North Carolina’s healthcare field realized they needed to bring about changes to the services they provided in their community’s mental healthcare programs (McLaughlin & McLauglin, 2008). The North Carolina Science to Service Project (NCS2S) was implemented to bring more coordinated, quality healthcare services to their mental health patients (McLaughlin & McLauglin, 2008). The goals of the project were to better match healthcare services to their mental healthcare patient population, apply evidenced-based practice guidelines in their mental health practice, ensure proper resources were allocated for the services, and begin state-wide training programs to their healthcare professionals (McLaughlin & McLauglin, 2008). This case study examines the integration of mental healthcare services into the community setting, the use of evidence-based practice guidelines, the effect on the stakeholders, and the role of healthcare professionals in implementing change.
Whelan, R., Conrod, P. J., Poline, J., Lourdusamy, A., Banaschewski, T., Barker, G. J, Bellgrove, M. A.,
Psychiatric and mental health nursing is a unique specialty of nursing that strives to promote the mental health of clients. Psychiatric mental health nurses work in partnership with their clients to manage their mental illness. In Canada psychiatric mental health nursing is guided by seven standards of practice, which provide guidance for nursing practice to ensure that safe, competent, and ethical services are delivered to the clients (Canadian Federation of Mental Health Nurses [CFMHN], 2006). Of these standards, standard five, which addresses the nurse intervening through the teaching-coaching function, will be the focus of this paper. The purpose of this paper is to identify standard five from the Canadian Standards of Psychiatric and Mental Health Nursing (2006), describe five of the indicators within that standard, apply them to clinical practice and reflect on the importance of each indicator through literature.