Psychiatric Nursing: An Integration of Theory and Practice

By Stuart, Gail W. Phd, Rn | Journal of Cognitive Psychotherapy, January 1, 2000 | Go to article overview

Psychiatric Nursing: An Integration of Theory and Practice


Stuart, Gail W. Phd, Rn, Journal of Cognitive Psychotherapy


Psychiatric Nursing: An Integration of Theory and Practice P. G. O'Brien (Ed.), W. Z. Kennedy, and K. A. Ballard (Ed.). New York: McGraw Hill (www.mcgraw-hill.com). 1999, 632 pp., $39.95 (softcover).

This is an ambitious contributed book written to be a basic text for undergraduate nursing students and a reference text for nurses practicing in a variety of clinical settings. The editors, who wrote 12 of the 30 chapters, are experienced psychiatric nurses who bring with them years of clinical, administrative, and policy expertise. As such, they have included a wide range of clinical problems and content areas in this text. The chapter on self-help groups makes a unique contribution to the field, the references cited are timely, and the thinking reflected throughout the text is consistent with current practice parameters in psychiatry.

That being said, however, the text struggles to make a unique contribution to the field and to claim an audience for its readership. In the preface the editors make clear that the book was not written to be a comprehensive text, yet they then try to cover so much content that the overall discussions are superficial and so concise that students will struggle to master the necessary material. It would have been better if the section on special populations had been omitted and more space given to the unit on mental health disorders and conditions, since these are the basics of what nurses need to know in providing psychiatric nursing care. Specifically, issues such as suicide, violence, crisis intervention, prevention, and community care need more attention in the text, given the critical part they play in current psychiatric nursing practice.

In many ways, the weaknesses of the text are a result of having so many different authors contribute chapters which present content in different styles and from individual frames of reference. As a result, there is a certain amount of repetition and no organizing framework for the text. Most unfortunately, the very important mental health disorder chapters are organized in different ways. For example, some of them use the medical model and describe differential diagnoses, clinical presentation, and treatment, while others are written around the nursing model and describe assessment, treatment, and nursing interventions. This is confusing for the reader who must assimilate what is clearly a vast amount of information but does not have a consistent conceptual framework for doing so. It was also surprising to see that only two of the contributors were not nurses and that neither one was a physician, since the medical approach is so dominant throughout the text. In fact, nurses may have a hard time understanding the nature of their role and activities in providing care to psychiatric patients, since most treatment sections of the text identify the patient's need for psychotherapy and medications, and then conclude with a paragraph or two on nursing interventions that are often custodial in nature. Neither the types nor processes of psychotherapy are described, although essential information related to medications is included. …

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