Summary Advanced practice psychiatric nursing

When I fi nished reviewing the copious materials for this text, I was reflecting on my own history. More than 60 years ago I fi nished my required 1,095 days and learned everything there was to know about nursing in that length of time. But what was clear from my reminiscence was how much our field of practice has changed in the past six decades. A certain amount of change has to be expected, but the rate of change has expo- nentially increased in the past decade. And it is these changes that have led to the production of this compendium of information about the field of advanced practice psychiatric-mental health nursing. This impressive text leans on the scope and standards documents developed by the specialty psychiatric-mental health nursing associations (the American Psychiatric Nurses Association and the International Society of Psychiatric- Mental Health Nurses) in collaboration with the American Nurses Association. In the 1960s, Hildegard Peplau introduced the advanced prac- tice role and emphasized psycho-therapeutic relationships. Prior to that, the roles in psychiatric- mental health nursing were largely concerned with developing administrative and teaching skills. However, it is important to acknowledge FOREWORD TO THE FIRST EDITIONThis is a sample from ADVANCED PRACTICE PSYCHIATRIC NURSING: INTEGRATING PSYCHOTHERAPY, PSYCHOPHARMACOLOGY, AND COMPLEMENTARY AND ALTERNATIVE APPROACHES ACROSS THE LIFE SPAN, SECOND EDITION Visit This Book’s Web Page / Buy Now / Request an Exam/Review Copy © Springer Publishing Company xx FOREWORD TO THE FIRST EDITION It is important to note that each of the chap- ters in this text represents a subfield of practice. I would predict that each of these will become full-fledged specialties with their own scope and standard statements in the near future. It would seem to be inevitable if not inescapable that one cannot become a master of all of the areas listed in the text. Thus, to some extent the book serves as an introduction to areas of subspecialization. The authors have carefully included references and citations to all the various sources for the rules and regulations that govern advanced prac- tice. The references alone in this text provide a rich source for further exploration in any one of the subfields. As we move forward in this new era of health care that is conceptualized as being more inte- grative than anything we have seen before, this text provides a road map for the path ahead. What is remarkable here is that it is patently clear that advanced practice psychiatric nursing is useful, and indeed needed, in every field of health care. To the end that the collective mis- sion in nursing is to keep and honor the social contract with the public, it is imperative for each of the subspecialties delineated in this text to become well populated with highly compe- tent, very skilled advanced practice nurses. Grayce M. Sills, PhD, RN, FAAN Professor Emerita The Ohio State University Columbus, Ohio N O T E O N S E C O N D E D I T I O N Dr. Grayce M. Sills died in April 2016 and, thus, was not able to review this second edition of Advanced Practice Psychiatric Nursing. Dr. Sills is revered in the psychiatric-mental health nurs- ing community, serving for more that 60 years as a leader in the field and as a mentor to hundreds of graduate students and faculty. Dr. Sills was known internationally for her contributions to the psychiatric-mental health field. She was a founding member and presi- dent of the American Psychiatric Nursing Association, president of the American Nurses Foundation, a founding member of the American Nurses Association Commission on Human Rights, a fellow of the American Academy of Nursing, and recognized as an Academy Living Legend in 1999. She chaired the Study Committee on Mental Health Services for Ohio and, in 1986, was chosen as a Woman of Achievement by the Columbus, Ohio, YWCA. We, the editors, believe that Dr. Sills’s Foreword captures the essence of this second edi- tion as much as the first. Honoring her memory, we have chosen to include her words here so that the reader appreciates the leap forward that we as authors and editors have taken to advance the discipline. Kathleen R. Tusaie Joyce J. FitzpatrickThis is a sample from ADVANCED PRACTICE PSYCHIATRIC NURSING: INTEGRATING PSYCHOTHERAPY, PSYCHOPHARMACOLOGY, AND COMPLEMENTARY AND ALTERNATIVE APPROACHES ACROSS THE LIFE SPAN, SECOND EDITION Visit This Book’s Web Page / Buy Now / Request an Exam/Review Copy © Springer Publishing Company Integrating Psychotherapy, Psychopharmacology, and Complementary and Alternative Approaches Across the Life Span; with the goal of assisting in the organization of the thinking while broad- ening the perspective of practitioners, teachers, and students in advanced practice psychiatric nursing. Since the publication of the fi rst edition of Advanced Practice Psychiatric Nursing: Integrating Psychotherapy, Psychopharmacology, and Complementary and Alternative Approaches Across the Life Span, there has been increased research examining the onset and course of many psychiatric illnesses with the hope of increasing effectiveness of treatment as well as prevention. Combining this research with feedback from readers propelled the development of this sec- ond edition. We were fortunate that most of the senior authors continued with this edition and we also added several new stellar clinicians and educators. This second edition continues to meet the practice standards developed by the American Psychiatric Nurses Association, International Society of Psychiatric-Mental Health Nurses, and American Nurses Association, which require all PMH-APRNs to have skills in psychotherapy, psychopharmacology, and holistic assessment. Psychiatric-mental health advanced practice reg- istered nurses (PMH-APRN) are like water— they are flexible, fluid, and go where they are needed. Deinstitutionalization of psychiatric patients resulted in not only more community- based treatment, but also new and expanded outpatient roles for psychiatric nurses. Now, in addition to employing them for outpatient needs, our society is seeking PMH-APRNs to pro- vide treatment in nursing homes and prisons. Although it is controversial to have so many people with psychiatric needs in these institu- tions, PMH-APRNs are stepping forward to practice in these settings. This need for APRNs is reflected by the U.S. Bureau of Labor Statistics, which predicts a 31% growth in the number of all APRNs from 2014 to 2024, while the predic- tion for all other occupations is only a 7% increase. Furthermore, in an ever-increasing number of states, APRNs are able to independently func- tion within their full scope of practice. Graduate psychiatric-mental health nursing programs have rapidly expanded and struggled to increase the knowledge and skill base while main- taining the core of their specialty—interpersonal, psychodynamic concepts within a holistic frame- work. These forces were the impetus for the fi rst edition of Advanced Practice Psychiatric Nursing: PREFACEThis is a sample from ADVANCED PRACTICE PSYCHIATRIC NURSING: INTEGRATING PSYCHOTHERAPY, PSYCHOPHARMACOLOGY, AND COMPLEMENTARY AND ALTERNATIVE APPROACHES ACROSS THE LIFE SPAN, SECOND EDITION Visit This Book’s Web Page / Buy Now / Request an Exam/Review Copy © Springer Publishing Company xxii PREFACE Each chapter reflects not only state-of-the- art knowledge, but decades of clinical wisdom. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is not ignored; we are grateful for its value in organizing our thinking and con- sider it a valuable resource. However, our text draws its focus from commonly seen clinical con- stellations of symptoms, by which we mean that symptom clusters determine both the initiation of treatment and strategic choices we face in clin- ical practice. As in the first edition, personality disorders are not in a separate section, but dis- cussed within the continuum of system clusters. Personality of the client (as well as the clinician) is always a consideration in treatment, but does not become a focus of treatment until severity interferes with functioning. Furthermore, the management of symptom clusters is presented as an integration of psychotherapy, psychophar- macology, and complementary/alternative strat- egies across the life span. Most APRNs will inevitably find themselves in a systemic culture of orthodoxy. While few systems willfully exclude any effective interven- tion, all systems seek to gain efficiency and cohe- sion. This principle discourages the exercise of broad thinking. It is therefore the purpose of this book to validate and encourage PMH-APRNs to draw from as wide an information base as possible during clinical practice. This text has been written by and for PMH- APRNs, and it provides a veritable buffet of valuable interventions from which clinicians and clients can co-create the most effective, individualized interventions. The book is divided into five sections: • Section I: The Dynamic Nature of Advanced Practice Psychiatric-Mental Health Nursing provides an overview of the theoretical and evidence base for practice and an exploration of the concept of shared decision making and reaching concordance between clinicians and clients. • Section II: Foundations for Integrated Practice explores the foundations necessary for the practitioner to implement integrated practice. In this section, the synergistic effects of integrating practice concepts...