Psychiatric nursing in the community: What to expect
Working in the local community as a psychiatric nurse can differ from working in other settings, such as large hospitals in big cities. Community nursing is often more personal and has its own set of challenges and rewards. Here’s what you can expect and how to deliver the best service to those in your care:
Caring for patients
You will provide care and support for patients. This includes giving them medication at set times, taking blood samples, treating non-emergency wounds, and liaising with other professionals in the healthcare industry to ensure all their health needs are provided for and none of the medications or treatments counteract each other.
Also, as a psychiatric nurse, you care for the mental health of your patients just as much as their physical health. Both are connected, so the holistic approach has the best results. If you choose to enroll in an online RN to PMHNP (MSN) program at an institute such as Spring Arbor University, it will prepare you to deliver psychiatric healthcare in the community. The online route takes four years and gives you more control over your schedule. All your coursework can be studied remotely with the flexibility to choose when you log in. You also get a week off in between each 7-week course, which helps to give you a break before moving on to the next part of your learning. The added bonus when you graduate is having the potential to earn 50% more as a psychiatric nurse practitioner (PMHNP) than you currently do as an RN. While nursing is rarely chosen solely as a career for the money you can earn, it puts into perspective the cost of further education to advance in your career.
Building trust and professional relationships
Trust is important in all aspects of nursing, but even more so when dealing with vulnerable people in the local community. Many of these people have complex mental health issues. You need to possess the ability to communicate with them in a way they can understand, while getting to know them professionally and encouraging them to be open with you.
This takes time, but as a community psychiatric nurse, you get to work with the same patients repeatedly. It can be helpful for them to see a familiar face. Aside from not having to cover the same ground and spending time catching up on their past and present treatments and diagnoses, it’s reassuring for them to deal with the same person. It helps them to trust you.
One way to build trust is by involving them in decisions about their own care. This doesn’t mean going against your professional knowledge and experience, but if you can explain as much as possible to them in a way they understand, this is reassuring and provides a better understanding of their options and why you need to administer certain treatments. For example, they may hate needles, but if you explain why it’s important to carry out a blood test or give an injection to protect their health, they are more likely to cooperate. The more involved and informed patients feel, the more likely they are to trust your judgment, even if they don’t like the outcome.
Encouraging patients to improve their lifestyle
Another way to help your patients feel more involved in their healthcare is by encouraging them to improve their lifestyles. As we mentioned earlier, physical and mental health can be closely connected. So, although improving physical fitness won’t cure a mental health problem, it can ease some symptoms and make the patient feel more empowered.
One example of this is if you have a patient whose mental health causes them to limit their social interaction. You can encourage them to take small steps to start or increase their exercise, change their diet and cut out unhealthy habits, or socialize. Small steps might include cutting out an unhealthy food item they eat regularly, taking a walk to a nearby shop to pick up a copy of their favorite magazine, or inviting a close friend to visit for half an hour to have a coffee together. It doesn’t have to be anything too big, and with each milestone they complete, you and your patient see an improvement in their mental well-being. Changes that promote physical improvement can also boost their confidence and strengthen their resolve.
Mental illness can often leave patients feeling helpless, so any action they can take to make a direct or indirect improvement to their mental health or lifestyle helps them to regain some control in a positive way. It can be personally rewarding to you, to work closely with them and see these long-term improvements, even if their overall condition rarely changes.
Educating without preaching
Helping patients to help themselves can involve giving them a lot of information. It’s important not to overwhelm them or come across as preaching to them. Educating them on the ways they can take a more active role in their care is a long-term strategy. As a community psychiatric nurse, you have the benefit of working with patients and getting to know them. You can learn the best methods to communicate with them and what matters to them personally. This helps you deliver care and advice in a way that addresses their diagnosis and any concerns they have.
You will know how much information you can share with them before they switch off. Generally, small pieces of information are better than longer sermon-like speeches. If they ask questions, answer these openly in simple but non-patronizing terms, and offer gentle suggestions rather than insisting they must follow everything you tell them. Ask them questions to get a better understanding of any reluctance they have. This helps you explain and reassure them, and possibly make any changes to their care based on these concerns. Most patients want to get better or at least reduce some of the symptoms which limit their lifestyle.
Raising awareness of local support groups
Local support groups can also be an asset to your patients. Rather than being something separate from the care and services you provide, these are a great addition, to an environment where they get to put into practice some of the advice you may have given them, and connect with other patients who have similar mental health experiences. They also benefit from professional support from group leaders or facilitators who help to steer the group and its individuals to get the most out of these sessions.
At first, your patient may struggle to see themselves as someone belonging to a particular community group. They may also lack the confidence to attend or to join in if they do attend. Your role as a community nurse might not set guidelines to say you should encourage them to take part, but as part of your holistic approach to helping them, you may see benefits to them being part of a community support group and offer gentle encouragement to get them to give it a try. You may also be able to accompany them the first time, just to provide encouragement if they lack the confidence to go alone. Once they meet other people, they are more likely to feel able to attend alone, or have a friend drive them but wait outside or return later to drive them home.
Keeping in touch with patients
Checking in regularly with patients allows you to keep track of their progress, help them if they suffer setbacks, and make them feel they have the support they need. Even if they seem to be making significant improvements, short visits or phone calls between visits can help, especially if you start to see them more infrequently as their condition or symptoms improve. This helps to keep them on track and allows them to ask any questions or discuss any concerns they have. Problems can occur when patients are left to Google these. The results can be irrelevant to them, but cause anxiety, resulting in them taking steps that make things worse for their own health, and cause further confusion. Getting the answers from someone who knows them professionally and has helped to treat them is the better option. This is why your role as a psychiatric nurse is so important and can’t be replaced by technology alone.
If you’re thinking of making the switch from your role as an RN to becoming a psychiatric nurse, there is more work involved, but you also get to make a positive difference in the lives of people with mental illness and this includes treating their overall health too. You can build on your existing knowledge and gain new skills along the way. It’s a rewarding career path to pursue.