I am just a nurse. Answers. Peter Demarco Boston writer. Objectives. Psychiatric Mental Health Nurses: Inspiring Leadership Every Day

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Psychiatric Mental Health Nurses: Inspiring Leadership Every Day Mary Ann Nihart MA, APRN, PMHCNS BC, PMHNP BC President, Clinical Director / Chief Nurse, Ambulatory Care Community Based Outpatient

1 Psychiatric Mental Health Nurses: Inspiring Leadership Every Day Mary Ann Nihart MA, APRN, PMHCNS BC, PMHNP BC President, Clinical Director / Chief Nurse, Ambulatory Care Community Based Outpatient Clinics (CBOCs) & Chief Nurse, Mental Health Services and Telephone Linked Care San Francisco Veterans Affairs Health Care System Associate Clinical Professor, University of California, San Francisco maryann.nihart@va.gov Answers Wanted to help people Money was good My mother, sister, friend etc. is a nurse One of the only two things women could do Wanted medicine, but didn t want medical school I could work any time I wanted Easy to find a job OR It is an amazing education with tons of opportunity, advancement, wide recognition, and the most trusted profession of all Objectives Identify the many paths each of us can chose for professional leadership as a psychiatric mental health nurse. Examine the characteristics of leadership Develop a plan to identify, support and mentor ways in which each of us can lead. Peter Demarco Boston writer Thank you letter published on the New York Times website October 6, y/o wife died after severe asthma attack Cared for at Cambridge Hospital in ICU He thanked all who cared for her but most significant was his thank you to two nurses, Donna and Jen letter to the doctors and nurses whocared for my wife.html?_r=0 MAN1 Why did you choose nursing as a career? Right now Quickly Gut response Don t think First thing that comes to mind I am just a nurse Seven words or less Turn and tell your neighbor Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 1

Images of Nurses Redefining our image Professor L.D.

Take themselves seriously and dress the part Recognize the value of what they do Believe in themselves and their colleagues.

Topping the list every year since they were added in 1999, except for 2001 when firefighters were named most trustworthy People

Perceptions are based on available information. In the absence of information we assume.

2 Images of Nurses Redefining our image Professor L.D. Andrews of Rogers State University says to create a new image of nursing, nurses must Value nursing and project that image daily Take themselves seriously and dress the part Recognize the value of what they do Believe in themselves and their colleagues. Yet where are we? Topping the list every year since they were added in 1999, except for 2001 when firefighters were named most trustworthy People tend to have more trust in those who care for them directly Perception is the Editor of Reality What is perceived is. Perceptions are based on available information. In the absence of information we assume. Behavior, no matter how crazy, has a logical basis. Health Economist, Paul Keckley said You are always talking about getting a seat at the table worry about physicians and what they are doing. There are 3.4 million of you They can t do health care without you Don t get a seat at the table Set the table! NOA Fall Summit, Nov 2015 Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 2

3 Henry Ford said You don t have to hold a position to be a leader! Nursing It s the person, not the disease People do not live in isolation Nursing Theories, based on: Adaptation Self-Care Modeling Systems Relationship And more Orem s Theory of Self Care Can you articulate what is Nursing? Can you tell others? Conditioning Factors R Self Care Agency R Self Care Nursing Agency R R Self Care Demands Conditioning Factors Hartweg, D. (1991). Dorothea Orem: Self Care Deficit Theory. Thousand Oaks, CA: Sage. Florence Nightingale in Crimea Integral Nursing She found horrid conditions; hospital sat on top of a large cesspool Established: Laundry Fresh air Light Rodent control Clean water Bathing Library Compassion/Empathy Nurse Person(s) Healing Health Environment Reduced the hospital s death rate by 2/3rds Dossey, B. (2008). Theory of Integral Nursing. Advances in Nursing science, 31, E52 E73. Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 3

Hildegrade Peplau Interpersonal Theory of Nursing Nurse Values Culture Beliefs Past Experiences Expectations Preconceived Ideas Nurse Patient Relationship Patient Values Culture Beliefs Past

A Thank You from Therese Borchard Therese at Laurel Hospital asked me the typical questions but she asked them with a disarming compassion that helped mitigate my shame.

For months I had been holding in my hand as my security blanket a medal of St. Therese, whom I had been praying to with all my might. I m named after the Little Flower (St.

4 Hildegrade Peplau Interpersonal Theory of Nursing Nurse Values Culture Beliefs Past Experiences Expectations Preconceived Ideas Nurse Patient Relationship Patient Values Culture Beliefs Past Experiences Expectations Preconceived Ideas Peplau, H. (1952). Interpersonal Relations in Nursing. A Thank You from Therese Borchard Therese at Laurel Hospital asked me the typical questions but she asked them with a disarming compassion that helped mitigate my shame. I didn t feel as pathetic as a suicidal woman with cereal all over herself would. And here s how I know she was some kind of messenger sent from God. For months I had been holding in my hand as my security blanket a medal of St. Therese, whom I had been praying to with all my might. I m named after the Little Flower (St. Therese), too, she said to me so sweetly at the end of all the questions. Now let s go upstairs, she said, and get you well. I started crying. She gave me the ounce of hope that I needed borchard sanity break/theresa nursewont forget thank you/ Nurses Lead Everyday Leadership What is Your Vision for Psychiatric Mental Health Nursing? Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 4

5 Mental Health By the Numbers In the US 3.5 million people with schizophrenia 16.1 million with one major depressive episode 10.3 million with MDE with severe impairments Serious Mental Illness 9.8 million adults 6.4 million receive treatment Any Mental Illness 43.4 million adults 18.6 million received mental health services Maybe that is Why??? Stigma remains a huge problem Suicide a Public Health Crisis Delays in receiving care Huge impact on our Emergency Departments Increased Homelessness Large numbers treated in prison And.we ll come back to this Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA , NSDUH Series H 51). Retrieved from Who is Caring? 14,780 APNs certified in psych mental health According to ANCC certification Approx. 130,000 PMH Nurses total 49,079 psychiatrists According to the Association of American Medical Colleges 28,250 actively practicing in the specialty according to the licensure boards AMA.org 83,000 psychologists actively practicing According to the APA.org Community Survey Social workers, counselors, peer support specialists and more So what did Paul Keckley Say??? They Can t Do It without Us And We can t do it without ALL of us! Think About it If one in five is the real lifetime prevalence 318,900,000 population of the U.S then 63,780,000 will need our services Leadership Creates an inspiring vision of the future. Motivates and inspires people to engage with that vision. Manages delivery of the vision. Coaches and builds a team, so that it is more effective at achieving the vision. Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 5

6 Inspiring Vision See Feel Understand Embrace The Most Compelling Visions are Personal Mayor of Pacifica Population 38,000 Compelling Image of an Achievable Future 2014 So what is Your Vision? Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 6

7 3/18/2014 Nurses are Answering the Call Christina Goias called 911 with concern about her son Errol who is staying at his father s home in Pacifica Christina tells the dispatcher: He has paranoia and he s thinking people are wanting to assassinate him, and now he doesn t trust anyone, Then: Facebook posts: What s going on on Pedro Point? Why can t I get to my house? Why are all the police here? What s going on? What begins as a Call for help after 6 hours ends with Nurses take the Front Office Nurses in the U.S. Congress Lavall Hall, 25 And Hundreds more Wilfredo Justiniano, 41 Dontre Hamilton, 31 Yanira Serrano Garcia, 18 Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 7

Nurses in State Legislatures Opioid Prescriptions Dispensed by US Retail Pharmacies 62 Nurses Currently hold State Legislative Office Elected in 34 States 19 States have more than one nurse

8 Nurses in State Legislatures Opioid Prescriptions Dispensed by US Retail Pharmacies 62 Nurses Currently hold State Legislative Office Elected in 34 States 19 States have more than one nurse legislator Minnesota has 6 nurse legislators Many more Nurses are in Local (County & City) Governments nida/legislative activities/testimony to congress/2015/americas addiction to opioids heroinprescription drug abuse. Accessed January 29, 2016 Sites, B. D., Beach, M. L., & Davis, M. (2014). Increases in the Use of Prescription Opioid Analgesics and the Lack of Improvement in Disability Metrics Among Users. Regional Anesthesia and Pain Medicine, 39(1), APNA Fosters Leadership Our Organizational Structure Institutes Safe Environments Mental Health Advocacy Councils Addictions Forensic Administrative Recovery APRN Research Child and Adolescent Education Decreased Opiate Prescriptions, Increased Use of Heroin nida/legislative activities/testimony to congress/2015/americas addiction to opioids heroinprescription drug abuse Accessed January 29, 2016 APNA Partnerships APNA Commitment: Leadership for Change Nurses have been described as the backbone of the Opioid Treatment Program system of care, APNA has therefore committed to develop, provide, and disseminate educational interventions on the treatment of opioid use disorder. This continuing education will be offered at no cost to our more than 10,000 members and beyond in webinar and/or interactive format. See more at: hash.s7cstmk5.dpuf Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 8

APNA Answered the Call Discover Your Passion Share Your Vision Find Your Voice All 3.4 million RNs Psychiatric Mental Health Nurses Advanced Practice Nurses You Can Lead!

example Do What s Next! References American Psychological Association (2015). Demographics of the U.S. psychology workforce: Findings from the American Community Survey. Washington, DC: Author.

org/certification/facultyeducators/facultycateg ory/ Statistics/2015 ANCC Certification Statistics.pdf Association of American Medical Colleges.

org/download/426248/data/thecomplexitiesofphysiciansup plyanddemandprojectionsfrom2013to2.pdf Center for Behavioral Health Statistics and Quality. (2016).

9 APNA Answered the Call Discover Your Passion Share Your Vision Find Your Voice All 3.4 million RNs Psychiatric Mental Health Nurses Advanced Practice Nurses You Can Lead! Become a Leader Examine your own beliefs Recognize your vision Share your vision with others Find others who share your vision Celebrate their successes Encourage them and all around you Lead by example Do What s Next! References American Psychological Association (2015). Demographics of the U.S. psychology workforce: Findings from the American Community Survey. Washington, DC: Author. American Nursing Credentialing Center (2015) ANCC certification data. ory/ Statistics/2015 ANCC Certification Statistics.pdf Association of American Medical Colleges. The Complexities of Physician Supply and Demand: Projections from 2013 to 2025: Final Report. Retrieved from plyanddemandprojectionsfrom2013to2.pdf Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA , NSDUH Series H 51). Retrieved from Leadership Built on those who Come Before humble leaders do not stand alone, but rather on the shoulder of others who have gone before, and that they move upward only with the help of others. Stephen M. R. Covey Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC 9

Trends, Tasks, and Teamwork

Nurses in the Behavioral Health Workforce: Trends, Tasks, and Teamwork National Forum of State Nursing Workforce Centers Conference June 8, 2017 Angela J. Beck, PhD, MPH, Director Clinical Assistant Professor