Psychiatric Nursing
1880-1920
1920-1960
1960-2000
The New Millennium
References
Web Sites for More Information
1880-1920
1920-1960
1960-2000
The New Millennium
References
Web Sites for More Information
PSYCHIATRIC NURSING
This page will acquaint you with the history of Psychiatric Nursing in the United States from its beginning in the late 19th century to the present time. Search links at bottom of page for additional information.
If you would like information on the American Psychiatric Nurses Association, you can go directly to their web site by clicking on the "W" in "Welcome" up above on this page. You can also go directly to the American Academy of Child and Adolescent Psychiatry by clicking on the "me" in the word "Welcome" and their web site will provide information on the diagnosis and treatment of psychiatric disorders in children and adolescents.
Until the late 1800's, there were no formally trained psychiatric nurses in the United States. Although the need for psychiatric nurses was recognized, there was much resistance toward training women for care of the insane. Linda Richards, considered the first psychiatric nurse in the United States, opened Boston City Hospital Training School for Nurses in 1882 to train nurses specifically for care of psychiatric patients.
Although nurses could receive training for psychiatric care at schools based in psychiatric hospitals, the training was not required by all nursing schools. In 1913, Effie Jane Taylor initiated the first psychiatric nursing program of study within the curriculum of a nursing school. Gradually psychiatric nursing education was phased into all nursing schools in Canada and the United States. No longer needed, the programs offered at psychiatric hospitals were closed.
Psychiatric nursing content was eventually incorporated into all diploma and baccalaureate nursing programs. Graduate programs for Masters Degrees in psychiatric nursing were established in the United States following passage of the National Mental Health Act of 1946. This provided education for advanced practice. The first graduate program in Psychiatric Nursing was started by Hildegarde Peplau in l954 at Rutgers University.
The 1960's saw social changes that altered traditional nursing roles and influenced the development of new ones for psychiatric nurses. Expanded roles were developed in addition to the acknowledged role of patient care on in-patient units in hospitals. Nurses with advanced degrees were licensed by state boards of nursing to provide outpatient services. These services included counseling, private independent practice for psychotherapy, consultation-liaison services in general hospitals, and prescription of psychotropic medications along with the diagnosis and treatment of mental illnesses.
This expanded philosophy of psychiatric nursing practice was based on a systematic approach using scientific study and conceptualized in terms of nursing diagnosis, care and treatment. The most recent Standards of Psychiatric Mental Health Clinical Nursing Practice, published in 1994 by the American Nurses Association, defines and supports the expanded role of psychiatric nurses by differentiating between the generalist and the advanced practice nurse.
Nursing organization that continue to provide leadership in shaping mental health care include the American Psychiatric Nurses Association, the Association of Child and Adolescent Psychiatric Nurses, the Society for Education and Research in Psychiatric Mental Health Nursing, and the International Society of Consultation and Liaison Nurses.
The ANA and the National Institute of Mental Health joined together in 1994 to publish the Psychopharmacologic Guidelines for Psychiatric Mental Health Nurses. It is "a description of the basic knowledge needed in psychopharmacology practice of nurses and skill expectations related to neurosciences, psychopharmacology, and clinical practice" (Boyd & Nihart, 1998, pp. 106-107).
Current literature challenges advanced practice psychiatric nurses to maintain high standards of practice by demonstrating, among other skills, early identification of psychiatric illnesses and social problems. Davidson (2001) outlines the Advanced Nurse Practitioner's role in diagnosing and facilitating treatment of patients with Post-Traumatic Stress Disorder. The article includes specific references to the trauma experienced by many people in the United States on September 11, 2110.
Taking time to do a comprehensive assessment of domestic violence is encouraged by Parkinson, Adams, and Emerling (2001) who surveyed women in a pediatric clinic office. Their findings revealed more than 16% of the mothers had been physically abused during their lifetime. The study included 553 mothers who came to the clinic for a pediatric office visit and were unaccompanied by their domestic partners on the day they completed the questionnaire. The authors suggest that screening protocols for maternal domestic violence (MDV) be incorporated into all pediatric practice settings. Pediatric Nurse Practitioners are often one of the first healthcare providers to identify this sad but growing problem.
References
Boyd, M. & Nihart, M. (1998). Psychiatric Nursing - Contemporary Practice. Philadelphia, PA: Lippincott.
Davidson, M. (2001). The Nurse Practitioner's Role in Diagnosing and Facilitating Treatment in Patients with Post-Traumatic Stress Disorder. The American Journal for Nurse Practitioners, 5 (9), 10-17.
Parkinson, G., Adams, R. & Emerling, F. Maternal Domestic Violence Screening in an Office-based Pediatric Practice. Pediatrics [serial online]. September 2001; e43.