Patients may be stressed and anxious because of their illnesses, or these symptoms may be present as part of a mental illness. Nurses strive to relieve patient stress and anxiety through assessment, diagnosis, counselling and direct contact and care with patients and their families. At the basic level, mental health nursing is characterised by interventions that promote and foster health, assess dysfunction, assist clients to regain or improve their coping abilities and prevent further disability, according to Nurses for a Healthier Tomorrow. These nurses where many hats in the care of patients with stress and anxiety.
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Triage and Referral
Triage and referral nurses may be the first point of contact for an anxious and stressed-out patient. Triage and referral nurses assess whether physical or mental illness is causing the anxiety and stress, according to the American Psychiatric Nurses Assocation (APNA). These nurses decide on the level of patient care needed through face-to-face or telephone interviews with the patient. They then refer the patient to the appropriate care provider which could be a psychiatrist, social worker or patient educator in a treatment centre or based in the community.
Case management is often provided by psychiatric nurses who assess patients and develop a patient diagnosis as part of a psychiatric team, said the APNA. They develop patient treatment plans aimed at reducing the patient's stress and anxiety levels. Case management nurses coordinate psychiatric care resources and manage other nurses who provide direct patient care.
Direct care for anxious and stressed patients can include administering pain management drugs to reduce physical discomfort that may be causing patients anxiety and stress. Direct care nurses also administer psychotropic drugs to suppress patient anxiety and to reduce stress. These nurses ensure that the medications are taken, document which medications were taken when and any changes in the patient's behaviour, according to the APNA. Nurses may also verbally soothe the patient and try to change the patient's environment to make her feel more comfortable and less anxious. Environmental changes may include dimming the lights in the patient's room, adding a blanket or pillow to the patient's bed or changing the bed position.
Nurses also play a direct role in patient education. They may describe a patient's illness, mental or physical and treatment, letting a patient and his family know what to expect and what potential outcomes may be to try to reduce patient stress and anxiety. Nurse patient educators, said the APNA, may be responsible for illness prevention, outreach to ill and anxious, stressed patients and basic patient care education.
Utilisation reviews take place in a managed medical care setting, as stated by the APNA. These reviews assess a patient's diagnosis, treatment plan, case management, allocation of medical resources, direct care and potential outcomes. The utilisation review nurse performs these assessments to ensure that medical resources are allocated and used correctly for positive patient outcomes such as reducing patient anxiety and distress.
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