Integrating Family Nursing Into a Mental Health Urgent Care Practice Framework: Ladders for Learning

Abstract

Integrating family nursing into a busy mental health urgent care setting is a challenge given the high acuity of patients and the demands of delivering service 7 days/week, 14 hours/day. In this article, the authors describe the development of a Mental Health Urgent Care Practice Framework that incorporates four elements: mental health/psychiatric assessment, physical health assessment, family nursing, and integrated behavioral health care. Sample family nursing skills and ladders for mental health urgent care practice are highlighted.The framework and ladders have implications for recruitment and hiring, orientation, peer mentoring, performance appraisals, and continuing education and supervision. A clinical vignette illustrates sample conceptual/ perceptual and executive skills used to apply the framework and ladders in practice. Family nursing is conceptualized as an integral component of nursing care provided to individual and families in this unique setting.

Family interview guide: strategy to develop skills in novice nurses

“…In agreement with this, the literature shows that the acquisition of skills when working with families is enhanced by a process that requires the association of the theory of family nursing concepts with the clinical practice of nurses, requires the supervision and support of an experienced professional on this theme, and needs feedback about the actions performed, which in turn allows nurses to think about their performance and consolidate the skills acquired (10)(11)(12)(13)(14)(15) . Like this study, other studies show that using different pedagogical strategies during nurse training, such as role play involving situations with families, case studies and discussions, teaching of interview skills, reflective practices and communication training, provides the development of perceptual, conceptual, and executive skills to work with families (9,13,16) . The interviews conducted in this study through the Guide lasted 15 minutes on average, indicating that it is possible to perform family assessment and interventions in a short time and in a context as unusual as the emergency service.…”

Drawing forward family strengths in short therapeutic conversations from a psychiatric nursing perspective

“…Furthermore, results from multiprofessional efficacy studies on psychoeducational interventions and cognitive behavioral interventions for these distressed families, especially for families of schizophrenic, bipolar, and substance‐use disorder patients, have shown improvements in family functioning and better psychosocial outcomes for the patients when family interventions are being used . In spite of scientific evidence and clinical experience that family interventions have shown positive effects for the well‐being and functioning of patients and families, these programs, methods, and interventions have been a great challenge with systems barriers to implement into multidisciplinary everyday adult psychiatry …”

“…1 In Iceland, advanced practice and/or evidence and clinical experience that family interventions have shown positive effects for the well-being and functioning of patients and families, these programs, methods, and interventions have been a great challenge with systems barriers to implement into multidisciplinary everyday adult psychiatry. [14][15][16][17][18][19][20] Family members of psychiatric patients have often experienced emotional suffering long before their relative is admitted for the first time to acute psychiatry and often their caregiving attempts have been rejected by the patient. 21,22 These families are dealing with a complex situation that affects their behavior and expressed emotions that need to be viewed in that context.…”

Randomized, controlled trial of a brief family‐centred care programme for hospitalized patients with bipolar disorder and their family caregivers

“…Based on the CFIM, family interventions include highlighting the strengths of patients and family members, providing information and education, validating and normalizing emotions, encouraging family support and sharing the burden of care, managing respite or relief from care, maintaining family rituals, and staying flexible and responsive to unique family needs. Health professionals use therapeutic conversations and the therapeutic relationship with the family to encourage them to think about their health problems, discover the strengths of the patient–family collaboration, and develop effective strategies (Arango ; Leahey & Harper‐Jaques ). Lee et al .…”