Maltreatment of Patients in Nursing Homes: There Is No Safe Place (Religion and Mental Health)
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During this time, attendants primarily kept the facilities clean and maintained order among the patients. They also carried out orders from the physicians. In , President John F. Kennedy accelerated the trend towards deinstitutionalization with the Community Mental Health Act. Also, since psychiatric drugs were becoming more available allowing patients to live on their own and the asylums were too expensive, institutions began shutting down. Expanded roles were also developed in the s allowing nurses to provide outpatient services such as counseling, psychotherapy, consultations, prescribing medications, along with the diagnosis and treatment of mental illnesses.
The first developed standard of care was created by the psychiatric division of the American Nurses Association ANA in This standard outlined the responsibilities and expected quality of care of nurses. In , the government published a document called "Better Services for the Mentally Ill" which reviewed the current standards of psychiatric nursing worldwide and laid out better plans for the future of mental health nursing.
Global health care underwent huge expansions in the s, this was due to the governments reaction from the fast increasing demand on health care services. The expansion was continued until the economic crisis of the s. In , the Area Health Authorities was terminated.
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In , better structure of hospitals was implemented. General managers were introduced to make decisions, thus creating a better system of operation. However a new training syllabus was introduced in , which offered suitable knowledgeable nurses. The s have seen major educational upgrades for nurses to specialise in mental health as well as various financial opportunities. Nursing interventions may be divided into the following categories: .
Psychiatric medication is a commonly used intervention and many psychiatric mental health nurses are involved in the administration of medicines, both in oral e.
Nurse practitioners can prescribe medication. Nurses will monitor for side effects and response to these medical treatments by using assessments. Nurses will also offer information on medication so that, where possible, the person in care can make an informed choice, using the best evidence , available. Psychiatric mental health nurses are also involved in the administration of the treatment of electroconvulsive therapy and assist with the preparation and recovery from the treatment, which involves anesthesia.
This treatment is only used in a tiny proportion of cases and only after all other possible treatments have been exhausted. A patients consent to receive the treatment must be established and defended by the nurse.
Along with other nurses, psychiatric mental health nurses will intervene in areas of physical need to ensure that people have good levels of personal hygiene, nutrition, sleep, etc. Psychosocial interventions are increasingly delivered by nurses in mental health settings. These include psychotherapy interventions, such as cognitive behavioural therapy , family therapy , and less commonly other interventions, such as milieu therapy or psychodynamic approaches. These interventions can be applied to a broad range of problems including psychosis, depression, and anxiety.
Nurses will work with people over a period of time and use psychological methods to teach the person psychological techniques that they can then use to aid recovery and help manage any future crisis in their mental health. In practice, these interventions will be used often, in conjunction with psychiatric medications.
Psychosocial interventions are based on evidence-based practice , and therefore the techniques tend to follow set guidelines based upon what has been demonstrated to be effective by nursing research. There has been some criticism  that evidence based practice is focused primarily on quantitative research and should reflect also a more qualitative research approach that seeks to understand the meaning of people's experience. The basis of this approach is to look at mental illness or distress from the perspective of a spiritual crisis.
Spiritual interventions focus on developing a sense of meaning, purpose, and hope for the person in their current life experience. This may be a religious or non-religious experience depending on the individual's own spirituality. Spiritual interventions, along with psychosocial interventions, emphasize the importance of engagement, however, spiritual interventions focus more on caring and 'being with' the person during their time of crisis, rather than intervening and trying and 'fix' the problem.
Spiritual interventions tend to be based on qualitative research and share some similarities with the humanistic approach to psychotherapy. As with other areas of nursing practice , psychiatric mental health nursing works within nursing models , utilising nursing care plans , and seeks to care for the whole person. However, the emphasis of mental health nursing is on the development of a therapeutic alliance.
The most important duty of a psychiatric nurse is to maintain a positive therapeutic relationship with patients in a clinical setting. The fundamental elements of mental health care revolve around the interpersonal relations and interactions established between professionals and clients.
Caring for people with mental illnesses demands an intensified presence and a strong desire to be supportive. Understanding and empathy from psychiatric nurses reinforces a positive psychological balance for patients. Conveying an understanding is important because it provides patients with a sense of importance.
When subjected to fierce personal attacks, the psychiatric nurse retained the desire and ability to understand the patient. The ability to quickly empathise with unfortunate situations proves essential. Involvedness is also required when patients expect nursing staff to understand even when they are unable to express their needs verbally.go to site
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Individualised care becomes important when nurses need to get to know the patient. To lives this knowledge the psychiatric nurse must see patients as individual people with lives beyond their mental illness. Seeing people as individuals with lives beyond their mental illness is imperative in making patients feel valued and respected. Psychiatric nurses spoke of the potential to 'bend the rules', which required an interpretation of the unit rules, and the ability to evaluate the risks associated with bending them. Successful therapeutic relationships between nurses and patients need to have positive support.
Different methods of providing patients with support include many active responses. In order to make patients feel more comfortable, the patient care providers make themselves more approachable, therefore more readily open to multiple levels of personal connections. Utilisation of the quality of time spent with the patient proves to be beneficial. By being available for a proper amount of time, patients open up and disclose personal stories, which enable nurses to understand the meaning behind each story.
Such a request or notice must bear a certificate of service identifying the name and address of the person to whom the request or notice is served, the date of the request or notice, and the manner of service thereof. An offer shall be deemed rejected unless accepted by delivery of a written notice of acceptance. Upon stipulation of the parties, this day period may be extended and the statute of limitations is tolled during the mediation and any such extension.
At the conclusion of mediation, the claimant shall have 60 days or the remainder of the period of the statute of limitations, whichever is greater, within which to file suit. In actions where it can be shown that fraudulent concealment or intentional misrepresentation of fact prevented the discovery of the injury, the period of limitations is extended forward 2 years from the time that the injury is discovered with the exercise of due diligence, but in no event more than 4 years from the effective date of this section.
Discovery of financial worth may not proceed until the pleading on punitive damages is approved by the court.
Three times the amount of compensatory damages awarded to each claimant entitled thereto, consistent with the remaining provisions of this section; or. Four times the amount of compensatory damages awarded to each claimant entitled thereto, consistent with the remaining provisions of this section; or.
Long-Term Care Homes Act, 2007, S.O. 2007, c. 8
All findings by the trier of fact which support an award of punitive damages under this paragraph shall be admissible as evidence in any subsequent civil or criminal proceeding relating to the acts giving rise to the award of punitive damages under this paragraph. In the final judgment, the court shall order the percentages of the award, payable as provided herein. For purposes of this paragraph, a proportionate share is a percent share of that percentage of the settlement amount which the punitive damages portion of the verdict bore to the total of the compensatory and punitive damages in the verdict.
Such payments are made to the Chief Financial Officer and deposited in the appropriate fund specified in this subsection. The trust fund shall be funded through proceeds generated pursuant to ss. These funds must be utilized in accordance with federal requirements. Failure to make such payment shall result in additional grounds that may be used by the agency for revoking a license or for denying a renewal application or a related party change of ownership application as provided in this section.
The agency shall develop a standard document to be used by all facilities licensed under this part for purposes of notifying residents of a discharge or transfer. In addition to any other pertinent information included, the form shall specify the reason allowed under federal or state law that the resident is being discharged or transferred, with an explanation to support this action. Further, the form must state the effective date of the discharge or transfer and the location to which the resident is being discharged or transferred. When requested by a resident to review a notice of discharge or transfer, the local ombudsman council shall do so within 7 days after receipt of the request.
Failure to forward the request within 24 hours after the request is submitted shall toll the running of the day advance notice period until the request has been forwarded. The facility may not take action, and the resident may remain in the facility, until the outcome of the initial fair hearing, which must be completed within 90 days after receipt of a request for a fair hearing. This notice shall be given before the transfer, if possible, or as soon thereafter as practicable.
The State Long-Term Care Ombudsman Program or a local ombudsman council conducting a review under this subsection shall do so within 24 hours after receipt of the request. If the notice is not given in writing, written notice meeting the requirements of subsection 8 must be given the next working day. If requested, the State Long-Term Care Ombudsman Program or the local ombudsman council shall assist the resident with filing an appeal of the proposed discharge or transfer.
Income information received from the Social Security Administration or the Internal Revenue Service must be safeguarded according to the requirements of the agency that furnished the data.
Psychiatric and mental health nursing
These procedures shall be equivalent to the procedures used for fair hearings for other Medicaid cases, chapter , part VI, Florida Administrative Code. The burden of proof must be clear and convincing evidence. A hearing decision must be rendered within 90 days after receipt of the request for hearing. Any aggrieved party may appeal the decision to the district court of appeal in the appellate district where the facility is located. Review procedures shall be conducted in accordance with the Florida Rules of Appellate Procedure. However, such facility or institution shall comply with all applicable laws and rules relating to sanitation and safety.
A license issued by the agency is required for the operation of a nursing home in this state.