Mentally ill

[apnurserock]

How do you feel about doing patient education with the mentally ill? Do you feel as though that all mental ill patients should have a guardian?

[taggart84]

Always presume competence. Not competence depending on a diagnosis, but competence because they are people first. If a patient of any diagnosis has a need for education above their competence level, provide resources to ensure health and safety are up to par in the community.

[Meriwhen, ASN, BSN, MSN, RN]

Mental illness does not always mean the patient is of low intelligence. Unfortunately, many nurses not familiar with psych--and some who are--tend to believe it does...and you have no idea how much this attitude offends a lot of psych patients.

Like you would with a non-psychiatric patient, tailor the education to the specific-learning needs of the patient and their family. Also consider the patient's CURRENT acuity when educating: your approach in educating a patient in a manic phase would be different once that patient is stabilized. And consider the patient competent until you are looking at a court order or other legal documentation indicating otherwise.

[hppygr8ful, ASN, RN, EMT-I]

As a nurse who practiced in an acute psychiatric setting for years I can say that those years were some of my best years in nursing. Mentally ill patients come from all walks of life and they are just in psych wards anymore. They are in every unit of the hospital and in our communities. Mental illness always exists on a spectrum from low to high functionality. A person with Bi-polar disorder who is low functioning meaning they lack the ability or cognitive capability to participate in their treatment may need a guardian, butt that's a legal question for the courts to decide and they don't get involved unless the patient persistently fall into one of three categories. Danger to self, Danger to others, or Gravely disabled by reason of mental illness. Since it appears you are a student you can use these terms in your school library's search engine to find scholarly references to the history of how mental illness is/was treated, who is considered a candidate for guardianship or commitment and who is not. Most psychiatrically ill patients around 85% are capable of functioning without a guardian but their are all kinds of mental illness so you are trying to cover a very big area with your question. I only saw two patients in 6 years that were remanded by the court to have a guardian both were schizophrenic and refused to stay on medication. Other than that I found that a vast majority really did want to get well just like any other sick person and when education was presented at their level of understanding it usually went quite well.

hppy

[Tenebrae, BSN, RN]

How do you feel about doing patient education with the mentally ill? Do you feel as though that all mental ill patients should have a guardian?

I have a diagnosis of major depressive disorder.

If you told me I needed a guardian, I would tell you where you could go

Valuable lesson. Blanket assumptions help no one.