A regulated health professional means that a particular body or organization sets and oversees the practice of a particular professional in the healthcare industry (Tourangeau et al., 2005; Zhang et al., 2016). One of the crucial elements here is that the regulation of health professions ensures consistency, standards of practice, which consequently improves patient outcomes (Cleary et al., 2012; Lankshear et al., 2016). A second crucial element of regulation of health professionals is that it ensures that all practitioners work only within the scope of their practice and adhere to a specific standard of work ethic (Cleary et al., 2012). In other words, patients can be assured that their health practitioner has a proper set of skills, knowledge, and ethics specific to their employed area. Furthermore, a self-regulating profession means that the regulating body is composed of members of that same profession (Lankshear et al., 2012). This is important because members can closely supervise the work expectations and work standards of other members in the healthcare profession.
The purpose, and importance, of registration for nurses, means that they are qualified to work in the health care profession. In general, this means that each individual has exhibited the entry-to-practice skills and knowledge to care for patients (Cleary et al., 2012). In addition, there are different roles, responsibilities, and scopes of practice within the different hierarchies of nurses. For example, registered practical nurses (RPN) assist patients with general health conditions, registered nurses (RN) have more extensive knowledge of nursing and work with patients with more complex health issues, and nurse practitioners usually provide independent healthcare involving diagnosing complex health problems and prescribing medicine (College of Nurses of Ontario, 2021).
Regardless of the position, the College of Nurses of Ontario Practice Standards outline the expected roles, responsibilities, skillset, and ethical knowledge that nurses registered with the College are required to demonstrate at all times during their practice (Cleary et al., Lankshear et al., 2016). Even with respect to the roles and responsibilities of registered nurses, the College has roles and responsibilities expected of registered practical nurses (RPN).
Nursing Speciality and Role
Registered practical nurses work in various specialized roles, including mental health. As Gournay (2005) described, mental health has increasingly become an area of importance in various medical professions. The demand for psychologists and other therapists has increased significantly, and general practitioners have similarly seen an increase in patients reporting symptoms consistent with a range of mental health conditions (Gournay, 2005). Of course, the healthcare industry is no different in this regard. Nurses, including registered practical nurses, are increasingly tasked with assisting and supporting patients struggling with wide-ranging mental illnesses (Zhang et al., 2016).
Nurses have a crucial role to play in appropriately taking care of patients with such conditions. First, nurses need to be knowledgeable of the available therapies to effectively manage a range of mental health conditions they might encounter in their profession (Cleary et al., 2012). Second, nurses should also be cognizant of effective and appropriate interventions so that they can properly implement them in their practice to take care of patients with mental health illnesses (Cleary et al., 2012; Zhang et al., 2016).
Primary day-to-day activities and tasks that registered practical nurses involved in taking care of mental health patients might include triaging, checking the patient’s vital statistics, confirming the patient’s medication schedule, and ensuring the patient has an adequate supply of their medications (Zhang et al., 2016). Furthermore, they would regularly monitor each mental health inpatient (Zhang et al., 2016). This might mean ensuring the patient is moved around intermittently to avoid bed sores and ensuring the patient is not overly sedated or in delirium while being managed at the hospital. Registered practical nurses may also be tasked with ensuring that the patient is taken to the toilet and that the bed area is clean and dry since some mental health inpatients could display incontinence (Zhang et al., 2016). Additionally, they are responsible for ensuring that the patient is eating the prescribed diet since these particular patients are less likely to be willing to perform daily tasks and activities and eat a nutritious meal (Cleary et al., 2012). Of course, all of these tasks are in addition to ensuring the patient is safe and healthy (Cleary et al., 2012; Zhang et al., 2016).
This illustrates that registered practical nurses taking care of mental health patients are tasked with standard nursing services and a comprehensive list of tasks and duties they are expected to perform. The roles and duties of the registered practical nurse ensure that that the patient receives optimal care while they are an inpatient, and also enhances health promotion as well as the quality of life for the patient.
One of the most important ways that registered practical nurses would be expected to perform their duties and take optimal care of mental health patients would be to employ therapeutic communication. Arguably, therapeutic communication will be an invaluable skill for nurses working in the mental health specialty. This is because these particular patients require special attention and a unique management style (Tourangeau et al., 2005). Therefore, it is without a doubt that therapeutic communication is of utmost importance in taking care of mental health patients, especially in psychiatric nursing. This essentially means that therapeutic communication is an effective and important approach to building a positive, trusting relationship between the nurse and the patient (Tourangeau et al., 2005).
The primary reason that therapeutic communication is invaluable is because mental health patients are in urgent need of appropriate communication. Otherwise, they are prone to misconstrue and misunderstand verbal and nonverbal communication (Tourangeau et al., 2005). This is especially true for mental health patients suffering from anxiety and depression, bipolar disorder and schizophrenia (Donovan, 2007; Konstantinou et al., 2018). Moreover, this particular cohort of patients suffers from mental health problems which actually generates barriers in the manner in which they show their symptoms and health status to healthcare providers (Donovan, 2007). Therefore, these communication deficiencies and nuances observe in mental health patients create a problem for nurses taking care of these patients. Thus, this highlights the importance of building an effective relationship dynamic between nurses and mental health patients to foster optimal patient care.
Patient-centered care again means putting the patient’s needs and requirements at the forefront. In this setting, it might mean both evaluating and attending to their biomedical problems and their social and psychological concerns (Tourangeau et al., 2005). Patient-centered care also means respecting the autonomy and cultural sensitivities of the patient and incorporating those aspects in providing optimal patient care (Konstantinou et al., 2018). Often in clinical practice, patients do not receive optimal care because their mental health, psychological and social health and cultural background are not taken into account (Konstantinou et al., 2018). These factors can contribute to patients putting up barriers.
Education & Employment
In Ontario, entry-level education for a registered practical nurse is an Ontario College Diploma, or an equivalent, from a certified and recognized institution (Cleary et al., 2012). This is in addition to passing a registration exam from the Ontario College of Nurses (Cleary et al., 2012). Registered practical nurses can work in various areas, such as long-term care, internal medicine, and specialty areas such as mental health and oncology (Lankshear et al., 2016). Ontario registered practical nurses can often be paid up to $30.00 an hour, with the funding coming from the provincial government (Lankshear et al., 2016).
As with any health profession, intra-professional collaboration is key in providing optimal patient care and treatment. Thus, registered practical nurses need to collaborate with other nurses, allied health workers, and clinicians to provide optimal patient care (Cleary et al., 2016; Tourangeau et al., 2005). Finally, registered practical nurses also collaborate with other allied health workers when the patient is being admitted, in transition, and during discharge processes of the hospital (Tourangeau et al., 2005).
Cleary, M., Horsfall, J., O-Hara-Aarons, M., Jackson, D., & Hunt, G.E. (2012). Mental health nurses’ perceptions of good work in an acute setting. International Journal of Mental Health Nursing, 21(5), 471-479. doi:10.1111/j.1447-0349.2011.00810x
College of Nurses of Ontario. (2021). Expanding RPN scope of practice. https://www.cno.org/en/learn-about-standards-guidelines/scope-of-practice–proposed-changes/faqs-expanding-rpn-sop/
Donovan, M.O. (2007). Implementing reflection: Insights from pre-registration mental health students. Nurse Education Today, 27(6), 610-616. doi:10.1016/j.nedt.2006.09.001
Gournay, K. (2005). The changing face of psychiatric nursing. Advances in Psychiatric Treatment, 11, 6-11.
Konstantinou, A.K., Bonotis, K., Sokratous, M., Siokas, V., & Dardiotis, E. (2018). Burnout evaluation and potential predictors in a Greek cohort of mental health nurses. Archives of Psychiatric Nurses, 32(3), 449-456. doi:10.1016/j.apnu.2018.01.002
Lankshear, S., Rush, J., Weeres, A., & Martin, D. (2016). Enhancing role clarity for the practical nurse: A leadership imperative. Journal of Nursing Administration, 46(6), 300-307. doi:10.1097/NNA.0000000349
Tourangeau, A.E., Coghlan, A.L., Shamian, J., & Evans, S. (2005). Registered and registered practical nurse evaluations of their hospital practice environments and their responses to these environments. Nursing Leadership, 18(4), 54-69. doi:10.12927/cjnl.2005.17835
Zhang, Y., Punnett, L., Mawn, B., & Gore, R. (2016). Working conditions and mental health of nursing staff in nursing homes. Issues in Mental Health Nursing, 37(7), 485-492. doi:10.3109/01612840.2016.1162884