CPD practice profile
Mental health emergencies I gained experience of psychiatric assessment in previous roles when working in a secure psychiatric ward and within the prison service. Although I have often performed mental state assessments and assessments of suicidal intent as part of my work, I read the CPD article to refresh my knowledge in this area. Mental health emergencies occur when a person’s mental or emotional state deteriorates to such an extent that he or she is no longer able to cope, resulting in a crisis situation. A mental health emergency is often a life-threatening situation, and may include individuals acting on a suicide threat, displaying homicidal or threatening behaviour, committing self-injury that requires immediate medical attention, being severely impaired by drugs or alcohol, and/or displaying highly erratic or unusual behaviour that indicates unpredictability or an inability to self-care. About one in four people will experience a mental health crisis during their lifetime. It is important that nurses caring for such patients demonstrate respect, dignity and trust, particularly during assessment and management. In emergency situations, it is impossible to undertake comprehensive psychiatric assessments. To exclude a physical explanation for symptoms, investigations such as blood tests for anaemia, vitamin B12 deficiency and syphilis serology may be required, depending on presenting evidence. In the emergency department nurses need to know how to communicate with people with mental health needs, help reduce the distress experienced by such
NURSING STANDARD
SPL
A CPD has reinforced Anita Skinner’s knowledge of assessment of individuals with mental health needs
Appearance and atmosphere – what is the nurse’s first impression of the individual? Behaviour – what is the individual doing? Communication – what is the individual saying and how? Danger – is the individual at risk or are his or her actions putting others at risk? Environment – where is the individual situated and is anyone else there? Experience makes it easier for the nurse to identify non-verbal cues, such as lack of self-care and/or hygiene and a reluctance to make eye contact.
Sharing information
people, and share information about these individuals with mental health specialists. It was interesting to read about the Public Psychiatric Emergency Assessment Tool (PPEAT), a commonly used tool that helps healthcare professionals to record their observations of mental health service users objectively and accurately. Practitioners can use the tool to organise and structure the information they acquire during patient assessments. The tool prompts nurses to ask questions related to:
This practice profile is based on NS665 Wright K, McGlen I (2012) Mental health emergencies: using a structured assessment framework. Nursing Standard. 27, 7, 48-56.
The PPEAT can also be used by nurses to elicit information from police officers or paramedics, who are often the first professionals to have interaction with the person experiencing a mental health crisis. Using the tool in these situations, nurses can gauge any variations in the person’s behaviour, be it improvement or deterioration. Good information generated by observant informants is central to accurate and well-informed assessments of individuals with mental health needs. Nurses can then share relevant information with mental health specialists to comprehensively assess the patient and formulate a treatment plan NS Anita Skinner is deputy matron/manager at Lourdes Community Nursing Home in Westgate-on-Sea, Kent
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 52 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php march 5 :: vol 28 no 27 :: 2014 61
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Mental health emergencies I gained experience of psychiatric assessment in previous roles when working in a secure psychiatric ward and within the prison service. Although I have often performed mental state assessments and assessments of suicidal intent as part of my work, I read the CPD article to refresh my knowledge in this area. Mental health emergencies occur when a person’s mental or emotional state deteriorates to such an extent that he or she is no longer able to cope, resulting in a crisis situation. A mental health emergency is often a life-threatening situation, and may include individuals acting on a suicide threat, displaying homicidal or threatening behaviour, committing self-injury that requires immediate medical attention, being severely impaired by drugs or alcohol, and/or displaying highly erratic or unusual behaviour that indicates unpredictability or an inability to self-care. About one in four people will experience a mental health crisis during their lifetime. It is important that nurses caring for such patients demonstrate respect, dignity and trust, particularly during assessment and management. In emergency situations, it is impossible to undertake comprehensive psychiatric assessments. To exclude a physical explanation for symptoms, investigations such as blood tests for anaemia, vitamin B12 deficiency and syphilis serology may be required, depending on presenting evidence. In the emergency department nurses need to know how to communicate with people with mental health needs, help reduce the distress experienced by such
NURSING STANDARD
SPL
A CPD has reinforced Anita Skinner’s knowledge of assessment of individuals with mental health needs
Appearance and atmosphere – what is the nurse’s first impression of the individual? Behaviour – what is the individual doing? Communication – what is the individual saying and how? Danger – is the individual at risk or are his or her actions putting others at risk? Environment – where is the individual situated and is anyone else there? Experience makes it easier for the nurse to identify non-verbal cues, such as lack of self-care and/or hygiene and a reluctance to make eye contact.
Sharing information
people, and share information about these individuals with mental health specialists. It was interesting to read about the Public Psychiatric Emergency Assessment Tool (PPEAT), a commonly used tool that helps healthcare professionals to record their observations of mental health service users objectively and accurately. Practitioners can use the tool to organise and structure the information they acquire during patient assessments. The tool prompts nurses to ask questions related to:
This practice profile is based on NS665 Wright K, McGlen I (2012) Mental health emergencies: using a structured assessment framework. Nursing Standard. 27, 7, 48-56.
The PPEAT can also be used by nurses to elicit information from police officers or paramedics, who are often the first professionals to have interaction with the person experiencing a mental health crisis. Using the tool in these situations, nurses can gauge any variations in the person’s behaviour, be it improvement or deterioration. Good information generated by observant informants is central to accurate and well-informed assessments of individuals with mental health needs. Nurses can then share relevant information with mental health specialists to comprehensively assess the patient and formulate a treatment plan NS Anita Skinner is deputy matron/manager at Lourdes Community Nursing Home in Westgate-on-Sea, Kent
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 52 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php march 5 :: vol 28 no 27 :: 2014 61
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
