Recovery-oriented practices of psychiatric-mental health nursing staff in an acute hospital setting.

BACKGROUND: There is a national initiative to integrate recovery-oriented practices into the delivery of mental health services. Few empirical studies have been conducted to measure these practices in psychiatric-mental health (PMH) nursing, particularly in short-term acute hospital settings. OBJECTIVE: This study examined the reliability of the Recovery Self Assessment-Registered Nurse Version (RSA-RN) and explored recovery practices of PMH nurses and nursing staff in an acute treatment setting. DESIGN: A descriptive one-group design with convenience sampling was employed. One hundred and five participants completed the RSA-RN and the demographic data form. RESULTS: The RSA-RN full-scale instrument demonstrated excellent internal consistency, and the five subscales demonstrated acceptable internal consistency. Significant, favorable relationships were found between RSA-RN scores and nursing staff who (a) had formal education in mental health recovery, (b) considered themselves knowledgeable about recovery, and (c) considered their place of work to be "recovery-oriented." CONCLUSION: The RSA-RN is a useful tool in measuring recovery-oriented practice. Formal education should be considered as an intervention to increase recovery-oriented practices in PMH nursing.

Competency-based training for PMH nurse generalists: inpatient intervention and prevention of suicide.

Suicide is the tenth leading cause of death in the United States. Approximately 90,000 psychiatric mental health (PMH) nurse generalists work in hospitals in the United States, mostly on inpatient psychiatric units where the most acutely suicidal patients are hospitalized. Although competencies have been developed for mental health clinicians in assessing and managing suicide risk, there are no standard competencies for PMH nurse generalists. Widely accepted nursing practices do not meet suicide-specific standards of care or evidence-based criteria. Although both the Commission on Collegiate Nursing Education Essentials for Baccalaureate Education and the Quality and Safety Education for Nurses competencies stress the necessity for comprehensive assessment, safe clinical practices, patient-centered care, evidence-based interventions, and interprofessional communication and collaboration, there are no specific requirements for suicide prevention training in educational and clinical programs. The American Psychiatric Nurses Association has an opportunity to provide leadership in developing, implementing, and evaluating competency-based training for nurses and partner with the national effort to increase the competencies in suicide prevention in the behavioral health workforce.

New graduate orientation program in a geriatric psychiatric inpatient setting.

With the geriatric population increasing, so will their needs for mental health care. However, attracting nurses to work with mentally ill older adults can be challenging. This article describes and illustrates methods successfully used by one hospital to attract, orient, and mentor new graduate nurses to work in geropsychiatric nursing--the New Graduate Residency Program (NGRP). The importance of supportive collaborative roles within nursing leadership staff is emphasized. Although the NGRP is a viable option for meeting the needs of older patients, additional strategies are needed to increase the numbers of geropsychiatric nurses overall, and these are discussed.

Rapid change in status: the case of William.

In most geropsychiatric inpatient settings, the focus of care is reduction, management, or alleviation of psychiatric signs and symptoms through a combination of behavioral and pharmacologic interventions. However, unidentified or evolving medical conditions among frail older patients may precipitate rapid and unanticipated changes in status. The case of "William" illustrates how prompt adjustments in nursing care, collaboration within and between the geropsychiatric unit and other hospital services, and close working relationships with family may facilitate unexpected end-of-life decisions and promote quality of care.