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Mental Health Consultation in a Nursing Home

Kennedy, Bernice PhD, RNC, CS; Covington, Karen MN, RNC, CARN, CS-ANP; Evans, Tempie MSN, RNC, CS; Williams, Carol A. DSN, RN

Patients and Clients

As the world's population ages, increasing numbers of people can anticipate spending their latter years in long-term care settings. Many of these nursing home residents will also present psychiatric illnesses as primary or secondary diagnoses. The resulting behavioral problems may present challenges to nursing staff that they are ill-prepared to meet. This article illustrates the application of the Blake and Mouton consultation model to a Veterans Administration (VA) nursing home situation by a team of psychiatric mental health nurse specialists. The consultation is described and interpreted in terms of the Blake and Mouton model. The focal conflicts addressed in the consultation included issues of morale/cohesion, power/authority, and norms/standards. Interventions used were acceptant, prescriptive, confrontation, and theories/principles. The model provided a useful structure for conceptualizing and organizing assessment and intervention in the consultation situation.

BERNICE KENNEDY is a geropsychiatric clinical nurse specialist. She is currently employed as a faculty member teaching baccalaureate nursing students at the South Carolina State University. When the consultation was conducted, she was employed at the Dorn V.A. in psychiatric home care and was an adjunct faculty member at the University of South Carolina College of Nursing.

KAREN COVINGTON is a psychiatric clinical nurse specialist and an adult nurse practitioner. She has had extensive experience in outpatient substance abuse treatment and is currently working as an adult nurse practitioner and a psychiatric specialist in the ambulatory care clinics of the Dorn V.A.

TEMPIE EVANS is a geropsychiatric clinical nurse specialist and coordinator/case manager of the outpatient psychiatric clinic. She holds an adjunct faculty position at the University of South Carolina College of Nursing.

CAROL A. WILLIAMS is an Emerita Professor in the College of Nursing at the University of South Carolina. She has had extensive experience teaching psychiatric mental health nursing in the baccalaureate and master's degree programs and holds an adjunct nurse researcher position at the Dorn V.A.

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