Course Name: Mental Health / Psychiatric Nursing Course Number: NURS 214L Campus: Los Angeles Section A: Instructor’s Name Solomon Tan, MSN/Ed., RN-BC, PHN Sharlynn Bekkedahl, MN, RN Jusbinder (Jassy) Sodhi, MSN/Ed. , RN Pullukalayil, MSN, RN Ted Creekmur, BSN, RN Thompson Andreani, MSW, BSN, RN I. Instructor’s Contact Information, Course Pre and Co-Requisites Number: See Clinical Instructor E-mail: tan@westcoastuniversity.edu sbekkedahl@westcoastuniversity.edu jsodhi@westcoastuniversity.edu bpullukalayil@westcoastuniversity.edu Tcreekmur@westcoastuniversity.edu Office location: See Clinical Instructor Office hours: See Clinical Instructor Course Equivalencies: Course Prerequisites: NURS 100 and 101L Course Co-requisites: NURS 204 II. Mission and Outcomes University Mission: At West Coast University, we embrace a student-centric learning partnership that leads to professional success. We deliver transformational education within a culture of integrity and personal accountability. We design market-responsive programs through collaboration between faculty and industry professionals. We continuously pursue more effective and innovative ways through which students develop the competencies and confidence required in a complex and changing world. Program Mission: The mission of the College of Nursing is to provide evidence-based and innovative nursing education to culturally diverse learners; preparing nurses to provide quality and compassionate care that is responsive to the needs of the community and the global society. Program Learning Outcomes: Synthesize knowledge derived from liberal arts and sciences with a conceptual framework as a basis for professional nursing practice.
Hartford Institute for Geriatric Nursing (2010). Assessment Tools: Try this and how to try this resource. Issue 3 Mental Status Assessment of Older Adults: the Mini-Cog and video. Retrieved January 14, 2010, from . National Alliance of Mental Illness (2010). Mental Illnesses, Support and Programs. Retrieved January 14, 2010, from Course Catalog Description: Nursing care for adolescents, adults and older adults with psychiatric health problems. Practice in public and private clinical agencies and in community settings. This practicum course in psychiatric nursing focuses on identification, examination and application of psychiatric nursing theory, concepts, assessment and intervention with psychiatric clients. This course is taken concurrently with NURS 204 and integrates and applies diagnosis, management, and evaluation of clients with psychiatric disorders. Students apply the skills, therapeutic communication strategies and somatic treatments used in psychiatry and collaborate with other health care professionals in a multidisciplinary setting. During the practicum, students will be on a psychiatric unit applying psychiatric principles and delivering nursing care to individuals and groups of clients. They will be in community settings focusing on issues related to mental health. Course Learning Outcomes: Course outcomes are comprised of the knowledge, skills, values and/or behaviors that students should be able to demonstrate upon completion of the course. Course outcomes map to the Program Learning Outcomes Must be assessed in the course to determine if learning outcomes are met Upon completion of the course, the student will be able to: Demonstrate thorough, effective, and safe psychiatric assessment by using the nursing process according to Gordon’s 11 patterns of human functioning for clients with mental illness, their family and their community. Utilize proper documentation, and communication to members of pertinent data about the client's mental health and behavior including medications, treatments, diagnostic tests results and error prevention. Initiate therapeutic nurse-client relationship then analyze verbal and non-verbal interactions, defense mechanisms, and coping mechanisms Collaborate with staff members; follow the clinical agency's and university’s policies and procedures. Participate in all appropriate activities, conferences and meetings. Consult with faculty and staff to respond therapeutically to clients who are suicidal, violent, manipulative, frustrated, and dependent. Demonstrate professional accountability and demonstrate beginning management and leadership in a psychiatric setting. Identify of instruction needed by the client who is mentally ill that will aid in the development of health promotion and health maintenance of self-care activities.
Gordon’s 11 Functional Health Pattern Health Perception / Health Management: Client's perceived pattern of health and well being and how health is managed. Self-Perception/Self Concept: Body comfort, body image, feeling state, attitudes about self, perception of abilities. Role-Relationship: Client's pattern of role engagements and relationships. Nutritional-Metabolic: Pattern of food and consumption relative to metabolic need and pattern; indicators of local nutrient supply. Value – Belief: Patterns of values, beliefs (including spiritual), and goals that guide client's choices or decisions for his/her care) Coping and Stress Tolerance: General coping pattern and effectiveness of the pattern in terms of stress tolerance. Sleep-Rest Pattern: Patterns of rest, and relaxation. Elimination Pattern: Patterns of excretory function bladder, and skin). Includes client's perception of a normal function. Activity-Exercise: Patterns of exercise, activity, leisure, and recreation. Cognitive-Perceptual: Sensory-perceptual and cognitive patterns. Sexuality-Reproductive:
Patterns of satisfaction and dissatisfaction with sexuality pattern; reproductive pattern. Mental Status Examination: Appearance: Speech: Eye Contact: Behavior & Activity: Mood & Affect: Orientation, Attention & Concentration: Cognitive Functioning & Memory: Thought Process: Thought Content: Insight: Judgment: Substance Abuse and other Addictions: (cigarettes, gambling, sex, shopping, smoking, internet) Substance: Amount / Frequency: Duration: Last Used: Withdrawal Symptoms: Blood Alcohol Level on admission: C.A.G.E. Questionnaire: Yes / No Other Addictions: None reported Risk Assessment: Suicide history, Self-Injurious Behavior, Hypersexual, Elopement, Fall, Homicidal, to treatment Multidisciplinary Client Outcome and Discharge Plans: Placement, outpatient treatment, partial hospitalization, sober living, board and care, shelter, long term care facility, 12 step program Teaching Assessment and Client Education: Include barriers to learning and preferred learning style Pertinent lab test (normal ranges in parentheses) & diagnostic reports (with dates) Include Rationale for Abnormal Labs Abnormal Involuntary Movements: Facial and oral movements, extremity movements, and trunk movements Level of participation in the program: attendance and milieu participation) adherence
Gordon’s Functional Health Pattern Rationale based on your client’s symptoms Nursing Diagnosis (NANDA) (Actual and/or potential) Minimum of 2 Include etiology and sign and symptoms Also include Definition of Nursing Diagnosis (Cite) Nursing Outcome Criteria (NOC) Measureable Goal during your shift Minimum 2 Implementations (Independent and collaborative nursing intervention include further assessment, intervention and teaching) Minimum 4 Rationale (Use APA citations) Evaluation Goal Met Goal not Met (If not met, what revisions would you make?)
Specific course activities outline the teaching strategies used Student assignments identify the learning and assessment requirements that students are to fulfill throughout the duration of the course. Date/Week Objectives Content Outline Specific Course Activity Student Assignments Weeks 1 & 2 CLO # 1, 2, 4, 7 Differentiate between mental health mental illness. Discuss the importance of physical assessment and mental status examination to determine the overall health care status of the mentally ill client. Assure safety of client/self through to organizational safety processes. Demonstrate knowledge of legal issues/policies in mental health regarding involuntary seclusion, safe application of restraints and medication administration. Examine personal assumptions and concepts about mental health and mental illness. Observe the influence of culture, age, sexual orientation, spirituality and family on a client’s psychiatric care. Increase awareness of personal feelings, values, beliefs, and fears about mental health and illness, and working in a psychiatric setting. Principles of mental health and mental illness. Physical and Mental Status Assessment. Safety and professionalism. Legal and Ethical Guidelines for Safe Practice. Personal assumptions when caring for psychiatric clients. Cultural Implications for Psychiatric Mental Health Nursing. Self-Awareness when caring for psychiatric clients. Milieu participation. Psychiatric scope of practice Schizophrenia and other psychotic disorders 1. Review hospital policy and procedures regarding student role in the clinical setting. 2. Identify patient behaviors a may encounter in the clinical setting. 3. Discuss personal feelings, values, beliefs, and fears while working in a psychiatric setting. 4. Perform physical and mental status assessment for clients with a diagnosis of Schizophrenia or other Psychotic Disorders. 5. Identify antipsychotic medications prescribed on your client and determine side effects, nursing considerations, and rationale for its use. 6. Identify your client’s legal hold status and discuss the basis and criteria. 9. Locate the list of patient rights, including the patient’s right to treatment, right to Week 1: Clinical Orientation Review Safety and Professionalism document and bring on the first day of clinical Medication Dosage Calculation Quiz Review HIPPA, National Patient Safety Goals, and Standard Precaution Week 2: Daily Charting (physical assessment and mental status examination), Include Medication List Role-play with classmate’s responses to anger and aggression and discuss how these responses can affect nursing interventions.
Participate in appropriate unit activities. Analyze the moral, legal, and psychiatric implications of involuntary commitment, including the issues of assessing a client’s dangerousness and freedom of choice. refuse treatment, and right to informed consent. 10. Perform 1:1 interaction with a client utilizing therapeutic communication techniques. 11. Utilize the ISBAR format when reporting on your client to staff and instructor. Limit 2500 Characters Role-play intervening with a patient who is hallucinating, delusional, and exhibiting disorganized thinking. Weeks 3 & 4 CLO# 2, 3, 6, 8, 9 Identify composition and scope of practice of the multidisciplinary team involved in psychiatric care. Discuss accepted theories of mental illness (including behavioral, stress management, crisis intervention & grief and loss) and relate these theories to the client’s psychopathology and nursing approaches in the care of the psychiatric client. Define the following Incompetence, confidentiality, privileged communication, and malpractice. State the nature and goal of therapeutic communication in the therapeutic nurse-client relationship. Ethics, client’s rights and legal issues in nursing practice continues. Therapeutic relationship and communication Personal qualities of a psychiatric nurse. Understanding response to stress and develop therapeutic strategies. Application of nursing informatics in the care of psychiatric clients. Nursing care for clients with Mood disorders, Grief/Loss, Suicide and behavior Describe the components of Self- Concept and identify 1. Perform1:1 interaction with a client utilizing therapeutic communication techniques. 2. Identify and give rationales for suggested (a) setting, (b) seating, and (c) methods for beginning the nurse-patient interaction. 3. Perform a psychosocial assessment, including brief cultural and spiritual components. 4. Assess a patient with a mood disorder, including major depression, bipolar disorder, cyclothymic and Week 3: Daily Charting Medication List Conduct a mental status examination (MSE). Construct an interpersonal process recording IPA (1) (Due week 4) Post-Conference Week 4: 1st IPA due Nursing Care Plan: Create a nursing care plan that incorporates interventions for key
Describe the responsibility of the psychiatric mental health nurse in regard to incident reporting. 7. Develop a teaching plan for patients taking anxiolitics and hypnotics. 8. Review hospital policy for reporting incident report or unusual occurrences. 7 & 8 CLO# 1, 2, 3, 6, 9 Describe the various of coping. Relate the phases of the relationship to the nursing process. Identify qualities of effective psychiatric nurse; observe and analyze therapeutic communication strategies. Demonstrate skill in assessing the mental health and overall health status of an assigned client and prioritize nursing diagnoses. In simulated patient situations, identify a therapeutic response by the nurse. Demonstrate the application of the nursing process to psychiatric clients. Demonstrate increase autonomy/accountability in the initiation of a therapeutic 1:1 interaction with client. Therapeutic relationship and communication Nursing care of clients with eating disorder: Anorexia Nervosa, Bulimia Nervosa and Binge-eating disorder Nursing care of children, and adolescence with mental illness Complementary and alternative healing in Psychiatric and Mental Health Discuss psychopharmacology in Children and Adolescence 1. Assess a patient with an eating disorder (a) Anorexia Nervosa, (b) Bulimia Nervosa, and (c) Binge eater, and be alert to possible behavioral and cognition dysfunction as well as physical symptomology. 2. Identify nursing care of children, and adolescence with mental illness 3. Discuss psychopharmacology in Children and Adolescence 4. Assess a patient with a sleep disorder and identify cognitive and physical dysfunctions. Week 7: 2nd IPA due Daily Charting Medication List Post-Conference Week 8: Community Experience Paper due. Construct and role-play a patient care assignment for the assigned unit Post-Conference
Describe confusion and disorientation; define and employ psychiatric terms. Identify and discuss general treatment modalities for mental illness. Discuss nurse leader roles and impact on care. Identify DSM IV and nursing diagnoses. Identify developmental states and tasks of individual and family life cycles. 5. Discuss complementary and alternative medicine in the psychiatric hospital setting Week 9 CLO# 1, 5, 6, 9 Recognize the psychiatric nurse’s role in data collection, diagnosis, planning, implementation, evaluation and accountability. Define an ethical dilemma and discuss one that arises in psychiatric nursing practice. Discuss the characteristics of an effective manager in a mental health setting; include: decision making, problem solving, and delegation and supervision strategies. Nursing process in the psychiatric mental health nursing. Bioethics Nurse leaders Psychiatric Community health nursing Discharge planning and referrals Issues and trends Requirement in psychiatric admissions. Patient’s Rights 1. Identify and discuss hospital policy in client documentation 2. Discuss a possible ethical dilemma in the clinical setting 3. Identify nurse manager role and responsibilities 4. Identify of a psychiatric nurse in the community setting. Week 9: Daily Charting Medication List Post Conference Construct and role-play a patient care assignment for the assigned unit Clinical Evaluation: Evaluate experience in the psychiatric setting.
Identify ways nurses can serve as leaders in community and hospital mental health settings. Describe various models of community mental health nursing and the process of referrals. Identify the means by which collaboration and conflict resolution occurs and observe roles of multidisciplinary team in psychiatric settings. Identify the trends and challenges facing mental health care State the admission and discharge procedures, and the status of civil rights as they pertain to voluntary and involuntary admission of a client to a psychiatric hospital. Identify the common and personal rights retained by psychiatric clients. 5. Discuss criteria for routine discharge and homeless discharge. 6. Discuss issues and trends in psychiatric mental health nursing 7. Review patient’s rights and discuss how clients are informed about their rights.