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Acute Inpatient Psychiatric/Mental Health Nursing: Lessons Learned and Current Developments

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European Psychiatric/Mental Health Nursing in the 21st Century

Part of the book series: Principles of Specialty Nursing ((PSN))

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Abstract

For acute psychiatric wards that host mainly involuntary clients, establishing and maintaining therapeutic engagement may face some difficulties. One of the impeding factors is that clients in the peak of a psychotic crisis temporarily lose psychological insight (Pini, Cassano, Dell’Osso and Amador 2001). On the other hand McEnvoy et al. (2006) found that ongoing attempts to invest during this crisis phase in therapeutic engagement can work once the symptoms are in remission. During an acute admission, client and P/MH nurses are deemed to each other and face multiple conflicts during the crisis phase. These aspects will be briefly discussed followed by evidence-informed therapeutic approaches to provide P/MH nursing care in the least restrictive fashion. The management of violence towards others is addressed in other chapters in this book (see Chaps. 25 and 33). In this chapter the options to foster a therapeutic alliance in psychiatric wards in different risk areas will be discussed. An example of co-creation of inpatient therapeutic care is the way how service user and carer umbrella organizations, nurses and doctors form a new consensus framework for high and intensive care (van Mierlo et al. 2014) by means of mapping methodology (Trochim 1989). In the Netherlands this consensus process was followed by several pilots and factor analysis rounds that eventually resulted in the national validation of a high and intensive care accreditation evaluation scale. Below, an overview on how these criteria may be transferred to 21 essential competences that P/MH nurses based should demonstrate in such settings.

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Authors and Affiliations

  1. Institute of Nursing Studies, Utrecht University of Applied Sciences, Utrecht, The Netherlands

    Roland van de Sande

  2. Parnassia Psychiatric Institute, The Hague, The Netherlands

    Roland van de Sande

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  1. Roland van de Sande
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  1. Escola Superior de Enfermagem de Coimbra, Nursing School of Coimbra, Coimbra, Portugal

    José Carlos Santos

  2. Cutcliffe Consulting, Kingston, Canada

    John R. Cutcliffe

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van de Sande, R. (2018). Acute Inpatient Psychiatric/Mental Health Nursing: Lessons Learned and Current Developments. In: Santos, J., Cutcliffe, J. (eds) European Psychiatric/Mental Health Nursing in the 21st Century. Principles of Specialty Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-31772-4_13

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