Past, Present, and Future Impact of Psychiatric Nursing – Care Example

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"Past, Present, and Future Impact of Psychiatric Nursing" is an outstanding example of a paper on care. The term “ to nurse” is derived from the Middle English word's notice and notice. This term is defined as “ a person who nourishes” (Klainberg, 2010). Care of diseased and sick people is not a new phenomenon or practice but rather its roots go back to ancient times. But the care of patients suffering from mental disorders has greatly changed over the years. Mental illness has always been responded to by society as a highly dreaded phenomenon and society has adapted ways to change the behavior of persons with mental illness.

During ancient times, mentally ill individuals were either subjected to religious practices or abandoned if no improvement was observed. During the Roman and Greek eras, the treatment fluctuated from human care to bleeding, purging, and bleeding. Even during the Middle Ages, no significant improvement regarding psychiatric medicine and patient care was observed. It was only through the eighteenth and the nineteenth century that gradual advancements in the form of recognition of psychiatric conditions and the provision of improved care to the patients were achieved (O'Brien, Kennedy, & Ballard, 2013).

The advent of advanced practice nursing in the field also added to the betterment of the patients suffering from psychiatric illnesses. Advanced practice nursing has gained the attention of the general public after the modern health reforms and the registered titles for the nurses are gaining recognition, which includes nurse practitioner, clinical nurse specialist, nurse anesthetist, and the nurse-midwife (Moller & Haber, 1997). Psychiatric nursing is a dorm of advanced practice nursing that has developed through history into a well-recognized field of health care.

However, certain aspects would have to be emphasized for the preservation and improvement of psychiatric nursing care. It was in the 18th century that for the first time that psychiatric illness was considered as a mental weakness which could be corrected through “ moral therapy” . In 1792, Philippe Pinel introduced this therapy on the basis that mental illness was the result of an immoral upbringing or originated from the immorality of the individual himself. The moral therapy was dependant on the attendants who took care of the patients.

These attendants could achieve optimal results by treating the patients with kindness, keeping them busy with positive diversions such as work, music, or games. The dependence on the health attendants for the care of the mentally ill patients was the beginning of the current field of mental health nursing care. In 1844, the Association of Medical Superintendents was originated due to the development of psychiatry as a profession and was retitled later as the American Psychiatric Association in 1921. This was a great breakthrough for the field of psychiatry as it was officially marked as a disease entity that required proper attention and treatment (O'Brien, Kennedy, & Ballard, 2013). Florence Nightingale was one of the leading nurses of the 19th century and she is referred to as the pioneer of modern nursing.

Although she is not referred to as a psychiatric illness nurse, however, she established the basis of human interaction of kindness and sensitivity. Her recommended interactions with the patients form the initiation of contemporary psychiatric nursing and the therapeutic communication for the mentally ill patients (Klainberg, 2010; Boyd, 2005).

Psychiatric nursing developed gradually over the past years. The first training school for psychiatric nursing was established in 1882 and it was also the first program to admit men. This meant that a proper force for the management of psychiatric patients was being developed. In 1913, the first nurse-organized program of study for psychiatric training was conducted at the Johns Hopkins Phipps Clinic. This was followed by the implementation of the National Mental Health Act of 1946. This act was passed by the National Institute of Mental Health in order to provide training funds for undergraduate nursing programs.

The Act focused on including the mental health concepts throughout the nursing curriculum. The Act also provided a graduate program in psychiatric nursing which was a pioneering step, as this was the only nursing specialty which required a Master’ s degree (Moller & Haber, 1997). The evolvement of nursing through the years has also been influenced by the role of women in the professional world. During the Cowles’ era, it was believed that the nurses had to work as helpers of the male physicians.

They were considered to work only quietly with the physicians and only assist them. This attitude of society was an obstacle in allowing the nurses to attain complete mastery or professional qualifications in order to treat their patients (Boyd, 2005). Regardless of social hindrances, the role of nurses in psychiatric health continued to develop. Currently, very few diploma schools of nursing are present in the United States and have been mainly replaced by the associate degree or the baccalaureate programs. Most nursing education programs today are associated with community colleges (Klainberg, 2010).

Psychiatric health nurse generalists and advanced practice nurses work both in the outpatient and inpatient departments. It is currently believed that the therapeutic nurse-patient relationship in the psychiatric health setting forms the basis of psychiatric nursing (O'Brien, Kennedy, & Ballard, 2013). The psychiatric health nurses practice at two levels, basic and advanced. They use their expertise to assist the patient in engaging in daily activities and cope with the environment in accordance with their mental condition. They work collaboratively to maintain an environment that is therapeutically suitable for the patients. It is important to emphasize psychiatric health nursing as a major part of the nursing body because of the current gradual decline in the new admissions for the graduate programs.

The enrolments in the graduate programs are low and opportunities for the psychiatric health nurses are also declining (McCabe, 2000). Many explanations have been put forward for the decline in the profession which includes the incompatibility of the profession to meet the current alterations in the psychiatric health environments. Psychiatric nurses have also been observed to show high burnout levels which include high emotional exhaustion, depersonalization, and low levels of personal accomplishment.

This has been associated with, in some cases, the over-representation of males (Kilfedder, Power, & Wells, 2001). Some of the arguments put forward include the reconceptualization of the core of the psychiatric nursing profession, standardization of the clinical outcomes so that nurses could measure the impact the effect of therapy on their patients, and establishment of research programs which would allow the psychiatric nursing profession to broaden its horizon of knowledge and competency (McCabe, 2000).

It is important to understand the difficulties and complexities encountered by the psychiatric health nurses as well as the obstacles and deficiencies in the mental health nursing profession, which would require interventions at both individual and organizational levels.


Boyd, M. A. (2005). Psychiatric nursing: contemporary practice. Philadelphia: Lippincott Williams & Wilkins.

Kilfedder, C. J., Power, K. G., & Wells, T. J. (May 01, 2001). Burnout in psychiatric nursing. Journal of Advanced Nursing, 34, 3, 383-396.

Klainberg, M. B. (2010). A Historical Overview of Nursing. In M. B. Klainberg, & K. M. Dirschel, Today's nursing leader: managing, succeeding, excelling (pp. 21-40). Sudbury, Mass: Jones and Bartlett Publishers. Print.

McCabe, S. (2000). Bringing psychiatric nursing into the twenty-first century. Archives of Psychiatric Nursing, 14, 3, 109-16.

Moller, D. M, & Haber, J. (1997). Advanced Practice Psychiatric Nursing: the Need for a blended Role. The Online Journal of Issues in Nursing. Retrieved from:

O'Brien, P. G., Kennedy, W. Z., & Ballard, K. A. (2013). Psychiatric mental health nursing: an introduction to theory and practice. Burlington, Mass: Jones & Barlett Learning.

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