Members of the Interdisciplinary Team
- Pharmacist: used when medications, side effects, and interactions with non-psychiatric medications are complex, or involve refractory symptoms.
- Psychiatrist: a physician certified in psychiatry by their respective board of psychiatry. In America, this includes a 3-year residency, 2 years of clinical practice, and completion of an examination. They diagnose mental disorders and prescribe medical treatments.
- Psychologist: an individual with a doctorate clinical psychology and is prepared to practice therapy, conduct research, and interpret psychological tests. They may participate in designing therapy programs for groups of individuals.
- Psychiatric Nurse: a nurse experienced in working with clients with psychiatric disorders after graduation from an accredited program of nursing and completion of the licensure examination. They should have a solid foundation in holistic health care.
- Evaluation of effectiveness of medical treatment, especially for medications
- Obtaining a master’s degree in mental health can classify a nurse as clinical specialists or licensed as advanced practitioners.
- Psychiatric Social Worker: often prepared at the master’s level, they practice therapy and hold the primary responsibility for working with families, community support, and referral.
- Occupational Therapist: either through an associate degree (certified occupational therapy assistant) or a baccalaureate degree (certified occupational therapist), individuals may focus on the functional abilities of the client and ways to improve client functioning, such as working with arts and crafts and focusing on psychomotor skills.
- Recreation Therapist: may be through experience or a baccalaureate degree; these therapists help the client achieve a balance of work and play in life, providing activities that promote the constructive use of leisure or unstructured time.
- Vocational Rehabilitation Specialist: may be through baccalaureate or master’s level, with varying levels of autonomy and program supervision based on education. This involves the determination of clients’ interests and abilities, and matching them with vocational choices. Clients are assisted in job-seeking, job-retention, as well as in pursuit of further education, if needed and desired.
Core Skills as an Effective Member
- Interpersonal Skills: tolerance, patience, understanding
- Humanity: warmth, acceptance, empathy, genuineness, and a nonjudgmental attitude.
- Knowledge: mental disorders, symptoms, and behaviors.
- Communication Skills
- Personal Qualities: consistency, assertiveness, and problem-solving abilities.
- Teamwork Skills: collaboration, sharing, and integrating
- Risk Assessment and Management Skill
There are four other well-defined and widely used traditional nursing care delivery systems:
- Functional Nursing is a task-oriented modality, where particular nursing functions are assigned to each nursing staff. The team leader identifies tasks to be done in a shift, and delegates the tasks among the members, assigning tasks relevant to each nursing specialty of the members. This modality has the advantage of being efficient in handling a large number of clients.
- Team Nursing is a care model utilizing a group of people, both professional and non-professional, led by a knowledgeable nurse (team leader), including RNs, LPNs, and NAs. They work together to identify, plan, implement, and evaluate comprehensive client-centered care. The entire group works together toward a common goal, providing qualitative, comprehensive nursing care.
- Primary Nursing: a system of nursing care delivery which emphasizes continuity of care, responsibility, and acceptance by having one RN, often teamed with a LPN and/or NA who, together, provide complete care for a group of patients throughout their stay in a hospital unit or department. This focuses on the therapeutic relationship between a patient and a nurse who assumes responsibility for a patient’s plan of care for their length of stay in a particular area. The patient knows their nurse, and the nurse can communicate the patient’s needs to the entire health team.
- Patient-Centered Care, also known as “Total Patient Care”, often used in the ICU and PACU. The nurse is fully responsible for organizing, planning, and performing all aspects of nursing care. This requires a high degree of autonomy, clear lines of responsibility and accountability, holistic patient care, and unfragmented care.
Principles of PMHN Collaboration
Psychiatric-Mental Health Nurses provide collaborative care. The ability to get both physical and mental health care at a familiar location is comfortable to patients and reduces duplicate assessments. Increase patient engagement oftentimes results in a better health care experience and improved patient outcomes.
Inter-agency and Intra-agency
Interagency Care is a system of care between agencies and families joining together for the purpose of interdependent problem solving that focuses on improving services to children and families. Intra-agency Care involve agreements between two or more agencies within the DHHS.
Multidisciplinary
There are many competencies required for implementation of psychiatric rehabilitation. Expert contributions of professionals and paraprofessionals who can individualize a comprehensive array of evidence-based services with competency, consistency, continuity, coordination, collaboration, and fidelity. It is important to involve clients, their relatives, and other supporters in setting personally relevant life goals. These teams are not limited to office-bound or hospital-bound clinicians. These include mobile educators, personal coaches, advocates, and community organizers.
Interpersonal Relationships in a Team
Interpersonal Relationships are the cornerstone of psychiatric nursing. Skillful management of interpersonal relationships is essential to psychiatric-mental health nursing.
- Observation, assessment, communication, and evaluation skills serve as the foundation for an interpersonal relationship.
- The most important skill is a basic understanding of self and what that individual brings to the relationship.
- Communication skill, both verbal and nonverbal is the second most important.
The cornerstone of all other components of nursing is a relationship with nursing. It is a primary goal regardless of the patient’s health status, ranging from well individuals living in the community to patients who are critically or terminally ill. The relationship is reflected and integrated into the plan of care for any patient. There are two nursing theorists that shaped psychiatric nursing practice:
- Hildegard Peplau, the author of “Interpersonal Relations in Nursing” in 1952, and Interpersonal Techniques: The Crux of Psychiatric Nursing in 1962, describing the therapeutic nurse-client relationship with its phases and tasks, and wrote extensively about anxiety.
- June Mellow is a psychiatric nursing theories who developed the client-centered psychiatric nursing approach, focusing on the client’s psychosocial needs and strengths.
Conflict Resolution
A conflict in a relationship (disagreements, arguments) can be extremely stressful, but may also result in a positive outcome by surfacing issues that require discussion. There are 9 steps in conflict solution (Indeed Editorial Team):
- Understand the conflict
- Explore alternatives
- Find a private, neutral place
- Communicate both sides: be an active listener. Rephrase statements in your own words; “So you’re saying that… Did I understand you correctly?“. Avoid forming assumptions, keep an open mind, ask questions, and gather information to understand each position.
- Be aware of body language: maintain eye contact, be conscious of your expression, relax your neck and shoulders, and use a neutral tone with moderate speed and volume. Avoid “absolute” words such as “always” or “never”.
- Identify a common goal
- Use a third-party mediator
- Brainstorm solutions
- Agree on a plan of action