WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client WEST COAST UNIVERSITY DEPARTMENT OF NURSING

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1 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client WEST COAST UNIVERSITY DEPARTMENT OF NURSING COURSE TITLE: MENTAL HEALTH/PSYCHIATRIC NURSING: PROMOTING WELLNESS IN THE MENTALLY ILL CLIENT COURSE NUMBER: NURS 204 COURSE PREREQUISITES: COURSE COREQUISITES: NURS 200, 210L, 100, 120, 201, 211L NURS 214L INSTRUCTOR NAME: DATE: CREDIT HOURS: CREDIT LENGTH: 2 units 9 weeks COURSE SCHEDULE: INSTITUTIONAL MISSION: West Coast University is a private, nonsectarian, coeducational institution. The mission of the University is to ensure provision of an innovative and relevant learning environment and to support the personal and professional development of adult learners in acquiring lifelong critical thinking and analytical skills. 01/2010 Page 1

2 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client NURSING PROGRAM MISSION: The Nursing Program s mission is to assist each student in the recognition of his/her individual abilities to progress and build competence in a chosen nursing educational goal. The mission is to prepare students to develop nursing competencies while building upon a liberal arts education that expands their worldview of the global community. COURSE DESCRIPTION: Knowledge for psychiatric nursing of adults and groups within a self-care framework. Students will examine mental health and methods for maintaining and improving mental health and promoting wellness in culturally diverse populations using Gordon's Functional Health Patterns, teaching/learning, evidenced based practice, therapeutic communication, role development, therapeutic nursing care and the nursing process. Class exercises will invite students to reflect on their own attitudes, values, coping strategies and stress management. The course content provides an overview of psychiatric assessment, the biobehavioral mental status examination, the standards of psychiatric nursing care, and facilitative communication. Students will also learn the characteristics of major psychiatric diagnoses as well as the therapeutic interventions, education and outcomes for those diagnoses. Case studies will introduce students to management of ethical and legal issues and common psychiatric emergencies. Although this course emphasizes mental health problems of adults in transition, students will also learn about the common psychiatric problems across the life span and in multiple settings. COURSE OBJECTIVES: On conclusion of the course, in order to provide nursing care related to promoting wellness in a culturally appropriate manner, the student will be able to: 1. Describe the ethical role of the nurse in the holistic care of the client who is mentally ill, including concepts of: client safety, confidentiality, advocacy, education of legal rights, informed consent, patient s rights and advanced directives. 2. Describe the theory and psychodynamics of stress, crisis, coping, group behavior, and anxiety. 3. Illustrate application of psychiatric nursing concepts to clients and their families utilizing the nursing process and Gordon' Functional Health Pattern and identify methods of promoting wellness. 4. Examine and compare standard psychiatric diagnostic systems. 5. Differentiate diagnostic criteria for children, teens, adults and elderly in selected diagnostic categories. 6. Identify appropriate psychiatric nursing role functions with clients/families within the interdisciplinary psychiatric health team. 01/2010 Page 2

3 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client 7. Analyze group and leadership dynamics and issues of multidisciplinary collaboration, and evaluate the effectiveness of group interactions. 8. Demonstrate knowledge of culturally sensitive management of clients with diverse psychiatric diagnoses, as related to continuity of care psychopharmacological, somatic treatments, and other therapies including. milieu, electroconvulsive therapy, individual, group, etc. 9. Describe the use of evidenced based nursing practice in the care of the mentally ill client and define reliability & validity of research information as used in evidence-based practice. Describe the methods a psychiatric nurse would use to locate evidence-based resources. 10. Describe nursing management in a psychiatric setting in regard to the following criteria: the organizational mission & values, the use of information technology, the ability to delegate according to scope of practice, the importance of a cohesive team, quality improvement, staff education, resource management, the establishment of priorities based on safe care and consultation and incident reporting, risk management, negligence, malpractice & security reporting. 11. Discuss how the nurse practice act defines the scope of practice for the psychiatric-mental health nurse. REQUIRED TEXT: Boyd, D., Hinds, M., Hyland, J., & Saccoman, E. (Eds.). (2008). Evolve reach comprehensive review for the NCLEX-RN examination (2 nd ed.). St. Louis, MO: Mosby Elsevier. Kneisl, C., Wilson, H., & Trigoboff, E. (2009). Contemporary psychiatric-mental health nursing (2 nd ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Wissmann, J. (Ed.). (2007). Mental health nursing RN edition 7.0: Content mastery series review module. Stilwell, KS: Assessment Technologies Institute, LLC. SUPPLEMENTAL READINGS: Journals, Websites: Goldberg, R. & Steury, S.(2001). Depression in the workplace: Costs and barriers to treatment. Psychiatric Services, 52(12), Keel, P. (2002) Predictions of treatment utilization among women with anorexia and bulimia nervosa. American Journal of Psychiatry, 159(1), Kennedy, C. & Pendley, A.(2002). Assessment and diagnosis of sexual addiction. Journal of the Psychiatric Nurses Association, 8(5), /2010 Page 3

4 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Lipman, E. (2002). Child Well-Being in single-mother families. Journal of the American Academy of Child and Adolescents Psychiatry, 41(1), McCurren, C. (2002) Assessment for depression among nursing home elders: Evaluation of the MDS mood assessment. Geriatric Nursing, 23(2), Pharris, M. & Natstad, S. (2002). Nursing care of adolescents who have been sexually assaulted. Nursing Clinics of North America, 37(3), Pomerleau, C. (2001) Emergence of depression during early abstinence in depressed and nondepressed woman smokers. Journal of Addictive Diseases, 20(1), Saur, C. (2002).Treating depression in primary care: An innovative role for mental health nurses. Journal of the American Psychiatric Nurses Association, 8(5), Teplin, L. (2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59(12), Wazana, A.& Primeau, I. (2002). Ethical considerations in the relationship between physicians and the pharmaceutical industry. Psychiatric Clinics of North America, 25, Wysoker, A. (2002). A conceptual model of weight loss and weight regain: An intervention for change. Journal of the American Psychiatric Nurses Association, 8(5), TEACHING STRATEGIES: Lecture, discussion, and role playing. Students will be encouraged to participate in classroom discussions, so proper time devoted to course preparation will be necessary to actively participate. EVALUATION METHODS / GRADING: Examination/Evaluations Two unit examinations (20% each) 40% Medication exam 10% Evolve Case Studies 5% Internet exercise & paper 5% 1 Hesi & 2 ATI unproctored 10% Final examination (HESI conversion score) 30% ATTENDANCE: The WCU Attendance Policy is in effect for all classes which means that absences in excess of 30% of any theory course may result in dismissal from the course, and the student may be required to repeat the course. If a theory course is dropped the corresponding clinical course must also be dropped per BRN regulations.. In addition: 01/2010 Page 4

5 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Students are expected to attend all lectures and complete all assignments and are held responsible for meeting the overall course and weekly objectives. In case of absence, it is the student s responsibility to obtain the information missed from another classmate or from the faculty. Not all reading assignments are covered in the lecture but the student is still responsible for knowing the material covered in the assignment. Students are required to make up all assignments and work missed as a result of absences. The Professor may assign additional make-up work to be completed for each absence. Hours of make-up work cannot be accepted as hours of class attendance. Students are required to be present when an examination is given. If unexpectedly absent for an emergency situation (i.e. death in the immediate family), it is the student s responsibility to arrange for a make-up date within 5 school days. Students who do not take the exam on the scheduled date and do not contact the instructor within 48 hours will receive a 0%. The highest score possible on a make-up examination is 76% (e.g., if a student obtained a perfect score (100%) in the make-up examination, the grade will still be recorded as 76%). ACADEMIC INTEGRITY: In its commitment to academic honesty and accurate assessment of student work, West Coast University uses a plagiarism-detection web-service to help prevent plagiarism. Consequently, instructors reserve the right to submit student assignments to the website to check for similarities between student submissions and the internet, various research databases, and the web-site s database of previous student submissions. Students may be required to electronically submit their work to the instructor or to the website, and by taking WCU courses, students agree that all assignments are subject to plagiarism detection processes and Academic Honesty policies. Assignments submitted to the website by the student or instructor will become part of the service s database and will be used for plagiarism prevention and detection. Student papers, however, will remain the intellectual property of the authors COURSE COMPLETION REQUIREMENTS: Participation includes being present in the class, participation in discussions, and engagement in the lecture/learning activities. Students must achieve a passing grade of C (76%) or above, submit all required exercises and projects, complete all required quizzes and examinations, and meet the standards of the school attendance policy. Quizzes: Unscheduled quizzes will be given periodically throughout the term. The quizzes will cover previous content and/or content to be covered during a particular class session. 01/2010 Page 5

6 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Students are required to be present when an examination is given. If unexpectedly absent for an emergency (i.e. death in the immediate family), contact the professor as soon as possible to arrange a make-up examination. Students who do not take the exam on the scheduled date and do not contact the instructor within 48 hours will receive a 0%. Lack of preparation at the scheduled exam time is not an acceptable excuse for not taking an examination or quiz. In the following Nursing theory courses the HESI (or ATI equivalent) computerized examination is required to be taken and passed with a specific score in order for the student to pass the course and for the other course grades to be considered for a final grade for that class. HESI will convert the raw score to a percent score for use in calculating the final course grade. The raw score does not automatically convert to a percent score as it depends on the number of easy verses difficult questions that were answered correctly. This is like the NCLEX where questions that are more difficult receive a higher weighting. The examination is a computerized tests based on national nursing standards but specific to the objectives for the specific course so the questions, content and method of testing is not arbitrary but based on evidenced based research related to nursing practice and NCLEX type questions. The instructor does not have access to HESI or ATI test questions. In order for students to be successful, they need to use the various course related books, review books, CD s, DVD s, on line sample tests and remediation offered from the on line and faculty sources. The score of 850 is statistically associated with passing the NCLEX 90% of the time on the first attempt. Therefore, we encourage students to achieve as high a score as possible from the beginning in order to be successful with each course and later in the program. Course NURS 100, 120, 200, 280 NURS 201, 202, 204, 205, 206, 207 NURS 203, 340, 220 Minimum Passing Score 750 raw score 800 raw score 850 raw score The final HESI examination is required to be taken to pass the course. It will include cumulative information related to the objectives of this course. When a student successfully passes the HESI or ATI final examination, the raw score is converted to a percentage, which will represent 30% of the total course grade. Therefore, it is an important component of the course evaluation. To pass the course the students must maintain at least a 76% average overall on didactic examinations and non-didactic material (papers, presentations, etc.) according to the Evaluation Method. Student Papers: Unless designated as a Group Project by the instructor, all student papers and assignments must be completed by the individual student and represent the student s own original work. Group projects are designated as such so that all other assignments are individual assignments and are to be completed by the student and NOT as a group assignment or submitted as a group assignment. Any submitted papers that are not the student s original work will be considered plagiarism, in violation of the Academic Honor Code. For clarification of plagiarism, please refer to the RN Student Handbook, WCU Catalog, Dean or instructor. 01/2010 Page 6

7 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Each student is responsible for his or her own learning which includes all aspects of the work required for a class. In order to maintain security, student assignments must be submitted directly to the instructor via the method(s) approved by the instructor. Do not fax papers to the school. Do not papers to instructors without written permission from the instructor. Grading Scale as Follows: Grade Points Nursing Numerical Score A B C 2 (minimum passing grade) D F 0 less than 63 TC N/A Transfer Credit W N/A Withdrawal IN N/A Incomplete CR N/A Credit (75 or higher) *Minimum passing grade for all nursing classes is a 76%. MAKE UP WORK POLICY: The WCU attendance policy is in effect for all classes. In addition: Students are required to be present when an examination is given. If unexpectedly absent for an emergency situation (i.e. death in the immediate family), contact the professor as soon as possible to arrange a make-up examination. Exceptions must be negotiated with the instructor. Students who do not take the exam on the scheduled date and do not contact the instructor within 48 hours will receive a 0%. Lack of preparation at the scheduled exam time is not an acceptable excuse for not taking an examination or quiz. If a student is late for an exam the student will not be allowed extra time to complete the exam. Students are expected to attend all lectures and are held responsible for content presented. In case of absence, it is the student s responsibility to obtain the information presented from another classmate or the instructor. Not all reading assignments are covered in the lecture. Lecture content is intended to highlight important points the instructor wishes to convey to the student. There are no make-up tests for final examinations; if the student is absent from the scheduled final examination, a zero will be given for this test. Students are required to maintain satisfactory attendance, absences in excess of 30 % may lead to dismissal from the class and the student may be required to repeat the class. 01/2010 Page 7

8 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client You are only allowed to repeat a nursing class one time and to repeat a maximum of 2 nursing classes total in the program. For each absence a 5 point deduction from the final grade will be applied. If a student is 15 mins late or leaves 15 mins early for class this will count as an absence. CLASSROOM / CLINICAL POLICIES: Students are expected to dress professionally during class time. A student who acts in an unethical or unprofessional manner on a test or an assignment will receive a grade of 0 for that test or assignment. A second incident of unethical or unprofessional behavior may result in administrative termination from the college. No children are allowed in class Use of cell phones in the classroom during class time is not allowed and if they go off in class the faculty member can interpret this as disruptive and ask the student to leave and meet with the Dean. Laptops will be used at the instructor s discretion. Student Papers/Written Assignments: In order to maintain security, student papers or written assignments must be handed to the instructor, sent through the mail, or placed in the lock box in an envelope. This will minimize losses. Do not fax papers to the department. Do not papers to faculty. Mailed papers are acceptable and need to arrive by due date. All assignments are to be submitted to the instructor in class on the date the assignment is due. No excuses are acceptable. Late papers will be marked 5 points off for each week it is late. ACADEMIC DISHONESTY: Written assignments and all other documentation: The University considers plagiarism and falsification of documents, including documents submitted to the University for other than academic work, a serious matter that may result in a failure in the class or dismissal from the program. All student work is to be submitted to faculty and represent the student s original work. All students are required to follow the American Psychological Association (APA) writing guidelines. All sources used as references must be identified Plagiarism-detection website: In its commitment to academic honesty and accurate assessment of student work, West Coast University uses a plagiarism-detection web service to help prevent plagiarism. Consequently, instructors reserve the right to submit student assignments to the website to check for similarities between student submissions and the internet, various research databases, and the website s database of previous student submissions. Students may be required to electronically submit their work to the instructor or to the website, and by taking WCU courses, students agree that all assignments are subject to plagiarism detection processes and Academic Honesty policies. Assignments submitted to the website by the student or instructor will become part of the service s database and will be used for plagiarism 01/2010 Page 8

9 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client prevention and detection. Student papers, however, will remain the intellectual property of the authors. Students who violate university standards of academic integrity are subject to disciplinary sanctions, including failure in the course and suspension from the university. Since dishonesty in any form harms the individual, other students and the university, policies on academic integrity will be strictly enforced. Familiarize yourself with the academic integrity guidelines found in the current WCU catalog and/or Nursing Student Handbook. Examinations There is a school testing policy which includes such things as no phones or other electronic devises with you while taking exams, no food or drink, no baseball or other type of hats can be worn, no papers, backpacks or other type of material can be taken into the exam space. There is no talking or sharing of information regarding the test questions during the test. Please review the policy for the complete list of testing requirements and the Academic Honor Code. Once the exam results are available, the students can only schedule a review of their exam with their instructor. The student will be provided with a test copy (not applicable to HESI exams), answer sheet, and a copy of his or her Scranton, which must all be returned unchanged upon completion of review. No written or oral notes can be taken when a student reviews his or her exam. The school encourages students to review their test results as soon as the exam is completed. HESI (or ATI) exam results are available for review on line through the Elsevier (or ATI) website usually within 24 hours of completing the exam. Students are encouraged to use this information to tailor their remediation in areas of weakness as identified by subjects missed on the HESI or ATI exam. The HESI and ATI testing policy require that you may not share any of the testing information with anyone at any time. Please read it carefully as this is a legal document you are signing and will be legally held accountable to uphold, when taking these examinations. See Testing policy and Academic Honor Code in WCU catalog and/or Nursing Student Handbook. DISRUPTIVE BEHAVIOR: Behavior that persistently or grossly interferes with classroom activities is considered disruptive behavior and may be subject to disciplinary action. Such behavior inhibits other students' ability to learn and instructors' ability to teach. A student responsible for disruptive behavior may be required to leave class pending discussion and resolution of the problem and may be reported to the Office of the Dean/Director or Academic Dean. 01/2010 Page 9

10 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client ACADEMIC ACCOMMODATIONS: Any student requesting academic accommodations based on a verified disability is required to provide documentation to, and to register with, the Director of Student Services at least six weeks prior to his/her first class start, or as soon as is reasonable based on the date of enrollment. This documentation will be reviewed and appropriate reasonable accommodations will be determined. A letter of verification will be provided to the student explaining the reasonable accommodation granted. Please be sure the letter is delivered to your instructors at the beginning of each class so that they may appropriately assist you. Syllabus is subject to change throughout the course. 01/2010 Page 10

11 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client AACN Essentials for Baccalaureate Education for Professional Nursing Practice The purpose of this section of the syllabus is to guide the student in understanding how the ACCN 9 Essentials are incorporated into their education and to provide guidance to them in developing their individual portfolios. The Essentials that are met in NURS 204 Promoting Wellness in the Mentally Ill Client include the following: Essential I, Liberal Education for Baccalaureate Generalist Nursing Practice Outcome 1 Integrate theories and concepts from liberal education into nursing practice. o Students will give a presentation on defense mechanisms Essential III, Scholarship for Evidence-based Practice Outcome 2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice. o Utilize evidence-based practice in the care of the mentally ill client. Essential V, Healthcare Policy, Finance, and Regulatory Environments Outcome 12 Advocate for consumers and the nursing profession. o Analyze the politics of mental health care in the current legal and healthcare environment, and discuss the role of the nurse as a client advocate in this environment. 01/2010 Page 11

12 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Guidelines for all Mental Health Papers 1. Alcoholics Anonymous Yahoo the Alcoholics Anonymous meetings in your local area. Pick a meeting, which meets your schedule, and arrive early. Introduce yourself as a nursing student who would like to learn more about resources to assist your future clients. Do not state you are an alcoholic. Sit in front of the meeting. Do not wear name badges or take notes. Do not put money in the basket as it goes around. Feel free to have refreshments and talk with members. Keep in mind you are representing the nursing program and dress appropriately and casually. Paper: Must be 2 typed pages, APA style. The first sentence must give the date you attended and place of the meeting. Describe the things that happened during the meeting, what was of interest to your, your thoughts about the meeting, what members spoke at the meeting, the members you spoke with after the meeting, how you felt about the meeting and what you learned. 2. Brothers Helpers The purpose of this program is to feed the homeless on Skid Row, many of which are mentally ill or substance abusers. The two evenings are Mondays and Wednesdays at St. Bede Church located at 215 Foothill Blvd, in La Canada, ( ) A second location which meets on Tuesday is St. James Church at 4625 Dunsmore Ave., La Crescenta, A third location which meets on Thursday evenings is Holy Redeemer Church at 2411Montrose Ave, Montrose Arrive at 4 pm to assist the staff with preparing meals, packing the meals and clean-up. You must go with staff to the Skid Row area or to the woman s homeless shelter and distribute the food. Stay with the staff at all times while in Skid Row. Do not give money to the homeless. Paper: Must be 2 typed pages, APA style. The first sentence must give the date you attended Brothers Helpers. Describe your experiences, the characteristics of the population you served and your feelings toward these people. Discuss the ethical, psychological, spiritual, cultural legal & economic principles related to the homeless population living in Los Angeles. Describe some of the environmental health risks associated with living on the streets. Discuss the staff at Brothers Helpers. How did you feel about the experience and what did you learn which you could apply to your future. A sign-up sheet will be provided by your instructor, not more than 4 students can attend on a given night. Your behavior is being monitored by the staff and you must be respectful at all times or a report will be made to WCU. 3. Internet Paper The purpose of this assignment is to use information technology in an online-search for current research as it applies to psychiatric practice. Students are to research a psychiatric disorder of interest to them coded in the DSM-IV-TR. The article must be a research article, not just informational. Remember research generally includes a control group and experimental group. The article must be less than five years old. Please review the article and then summarize it in your own words. The body of the paper is to be approximately two typed pages, double-spaced with 12-point font. Please attach the entire article to your finished paper at the back. On the cover sheet, include the title of your paper, your name, the search engine(s) you used and the process you went through in finding your information. Grades will be determined by your ability to describe your topic, to accurately summarize.the article, as well as your use of grammar and spelling. The paper s due date will be given the first 01/2010 Page 12

13 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client day of class. Late papers will be marked down 5% for each day late. No excuses will be accepted for late papers. Please do not fax or papers to the instructor. The final computerized examination is required to be taken to pass the course. It will include cumulative questions on key concepts from course content throughout the semester including all readings and computer assisted materials. Students must receive at least a raw score of 825 on the final computerized examination in order to pass NURS 204. Students are given two (2) attempts to pass the final computerized examination to achieve the above mentioned passing raw score. This raw score will be converted to a conversion score (aka % percent score) by HESI. This percent will be used in calculating your final grade. If a second test is required the maximum percent score one can achieve is 76%. Students must achieve the 825 raw score before the course grade is calculated for all the additional course work as described above. Also, to pass the course the students must maintain at least a 76% average overall on didactic examinations and non-didactic material (papers, presentations, etc.) according to the Evaluation Method. 01/2010 Page 13

14 WCU NURS 204 Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client NURS 204 Registered Nursing Syllabus Receipt Form This form is designed to ensure elements of the syllabus are discussed and presented to the student. Initial each item after you read and understand it. Ask questions if you need clarification. 1. I have been informed about the syllabus in its entirety. I understand, accept and abide by all of its provisions. 2. I understand the coursework requires consistent classroom attendance and active participation. 3. I understand the course workload will be very high and I have factored this into my schedule. 4. I will make note of any important dates on the Readings and Assignments Outline. 5. I am aware of the policy concerning make-up examinations. 6. I understand I am responsible for my own learning. 7. I will stay current with the material, including completion of reading assignments. 8. I understand cell phone use or texting, food in class, and liquids in non-screw top containers is forbidden in classrooms. If these are found, they may be confiscated by the instructor and reported to the Dean for disciplinary action. 9. I understand in order to pass this class: a) I must maintain at least a 76% average overall on didactic examinations and nondidactic material (papers, presentations, etc.) according to the Evaluation Method. b) Successful completion of this course related HESI (or ATI) computerized examination with a minimum score outlined in this course syllabus is required in order to pass this course, independent of other course grades. c) The final HESI (ATI) exam is given before the last week of the term and I will have two (2) attempts ONLY to achieve the minimum score required for this course. d) If a second attempt on the HESI (ATI) is required, the maximum percent score allowed for calculation of the final course grade is 76% e) NURS 220 has a different scoring system and has three (3) attempts to achieve the minimum raw score of 850 for the Exit Examination needed for graduation. 10. I understand the remediation and final examination time schedules are subject to change. 11. I understand I have received many resources for mastering the course related objectives, such as books, course readers, HESI and ATI review books, CD s, DVD s, on line study material, sample tests and case studies, etc. These resources are a means to assist me with meeting the course objectives and prepare for the evaluation of my learning through the examination and/or clinical evaluation, HESI (ATI) Exams and the NCLEX. 12. I understand that there are no make up assignments and late assignments must be requested in writing prior to the date due. If there was not a written request and/or it was not approved by the instructor, in writing, this may result in a grade of 0 for that assignment. 13. I understand all written assignments are due on the assigned due date and delivered to the classroom. No other location or delivery method is accepted such as or fax unless otherwise directed, in writing, and approved, in writing, by the instructor. My signature verifies that I have received information about and understand the contents of the syllabus and this verification Printed Last Name: Signature: Printed First Name: Date: 01/2010 Page 14

15 COURSE OUTLINE NURS 204: Promoting Wellness in the Mentally Ill Client Week Date Objectives Outline Assignments, Papers Due, Test Schedule Week 1 Psychiatric-Mental Health Nurse s Personal Integration & Professional Role 1. Relate the concept of personal integration to self and self-knowing to psychiatric mental health nursing. 2. Describe the qualities that enable psychiatric mental health nurses to practice the use of self artfully in therapeutic relationships. 3. Discuss the importance of empathy in psychiatric mental health nursing. 4. Identify the standards that guide the delivery of contemporary psychiatric mental health nursing. 5. Compare & contrast the roles of the psychiatric mental health nurse with other members of the mental health care team. 6. Describe factors that influence the success or failure of collaboration among the health care team, clients, and significant others. 7. Describe how accountability for communication & collaboration contributes to effective psychiatric mental health nursing in professional practice. 8. Incorporate principles of teaching and learning in psychiatric client education. 9. Demonstrate understanding of lifestyle choices with psychiatric clients. 10. Describe the role of the psychiatric mental Activity-Mental Health Nursing- A. Introduction B. Factors affecting mental health services (legal) C. Conceptual Framework for psychiatric nursing D. Human needs assessment within the nursing process E. Therapeutic Communication & the nurseclient relationship I Text readings: Kneisl Chps. 1, 2, 4, 5 6, 7, 8, 9, 11, 32 1/2010 Page 1

16 health nurse in regard to spiritual influences on health. 11. Describe the role of the psychiatric nurse in making community referrals. 12. Describe the use of electronic data to the application of the care of the client with a mental health diagnosis. 13. Discuss how the use of client monitoring devices can be useful to the psychiatric nurse. 14. Describe how a caring approach on the part of the psychiatric mental health nurse can reduce risk and liability on a mental health unit. 15. Explain why care for the caregiver is an important concept for the psychiatric mental health nurse. 16. Discuss the responsibility psychiatric mental health nurses have in relation to participation in professional nursing organizations. Cultural Competence & Psychiatric Epidemiology 1. Define cultural competence. 2. Explain general strategies used to develop cultural competence when working with specific cultural groups. 3. Discuss psychiatric epidemiology in a culturally diverse society. 4. Identify risk factors associated with mental disorders that affect the experience expression, reporting, and evaluation of mental disorders among culturally diverse groups. 5. Explain the natural history of disorder, including stages. 1/2010 Page 2

17 6. Describe how psychiatric mental health nurses incorporate the three levels of prevention into their practice. 7. Discuss how to apply epidemiological principles in professional practice. 8. Describe how to incorporate cultural competency & sensitivity in professional practice. Client s Rights, Ethics & Advocacy, Legal issues 1. Relate bioethics principles to the practice of psychiatric mental health nursing. 2. Describe ethical guidelines that should be applied in reconciling psychiatric ethical dilemmas. 3. Explain why psychiatric mental health nurses need to be knowledgeable about the mental health statutes & regulations in the state in which the practice. 4. Identify the responsibilities psychiatric mental health nurses have in protecting the rights of mental health clients. 5. Describe possible acts that could make psychiatric mental health nurses legally liable. 6. Describe circumstances when psychiatric mental health nurses should act as advocates for mental health consumers..7. List the legal reasons for the application of restraints. 8. Describe how to maintain the safety of a client in restraints. 9. Determine how to incorporate legal & ethical guidelines in professional practice. 1/2010 Page 3

18 10. Describe the role of the nurse in protecting client s confidentiality in regard to electronic records. 11. Define the Short-Doyle Act in relation to state funding for mental health. 12.Describe the 5150 process for involuntary clients in the state of California according to the Lanterman-Petris-Short Act Creating a Therapeutic Environment 1. Identify hospital-based & community-based settings where psychiatric mental health nurses practice. 2. Describe specific challenges psychiatric home health & case manager s face. 3. Describe how managed mental health care influences psychiatric care. 4. Differentiate case management from other types of nursing care. 5. Describe how psychiatric mental health nurses create & manage therapeutic environments. 6. Describe the role of the psychiatric nurse in relation to a client with impaired activities of daily living. 7. Identify severely & persistently mentally ill clients and what adaptations are required for their care, including self care principles. 8. Discuss challenges associated with caring for the high-risk severely & persistently mentally ill. 9. Differentiate the roles of the various health care providers on a mental health unit and describe how these providers contribute to the maintenance of a therapeutic environment. 1/2010 Page 4

19 10. Discuss how stereotyping, gender, racism, age & bias impact the therapeutic milieu. Philosophy & Theories for Interdisciplinary Psychiatric Care 1. Describe the basic premises of interactionism. 2. Identify the major principles of humanism. 3. Describe the impact of the knowledge explosion in psychobiology. 4. Discuss the concepts of human interactionsim & psychobiology as they relate to psychiatric mental health nursing. 5. Analyze the assumptions & key ideas among the medical psychobiologic, psychoanalytic, behaviorist, social interpersonal and nursing theories. 6. Discuss implications each theory has for psychiatric mental health nursing. 7. Describe the application of these interdisciplinary principles to professional practice. Psychobiology 1.Describe how neuroanatomic structures affect thought, behavior, memory understanding of consequences, and emotions. 2. Identify neurotransmitter alterations that occur in major psychiatric disorders. 3. Describe the contributions genetics have made to the understanding of mental disorders. 4. Describe how endocrine & immune systems affect mood & behavior. 5. Discuss possible implications the 1/2010 Page 5

20 psychobiologic theories may have on psychiatric mental health nursing. 6. Discuss the importance of teaching clients/families about the biological aspects of psychiatric disorders. 7. Describe how to apply psychobiology principles in professional practice. 8. Explain the reasons informed consent is important prior to the administration of psychiatric medications. Cognitive & Behavioral Interventions 1. Compare & contrast cognitive therapy to behavioral therapy. 2. List examples of humans expressing themselves in cognitive & behavioral ways. 3. Relate conditioning & association to human learning. 4. Describe therapeutic interventions a psychiatric mental health nurse would use in a cognitive behavioral framework. 5. Identify which diagnostic group would benefit from cognitive behavioral-based case management. 6. Design a behavioral contract using the nursing process to promote a change in health-related behaviors. 7. Describe how to incorporate cognitive & behavioral interventions in professional practice. Stress, Anxiety, and Coping 1. Describe the effects of stress & anxiety on an individual. 1/2010 Page 6

21 2. Discuss the sources of stress & anxiety. 3. Describe everyday methods to cope with stress & anxiety. 4. Describe common defense mechanisms people use to cope with stress & anxiety. 5. Identify common medical conditions that have an onset or a course influenced by psychological & behavioral factors. 6. Assess levels of anxiety in clients. 7. Describe how to incorporate nursing strategies in professional practice that help stressed & anxious clients cope. The Nursing Process with Psychiatric-Mental Health Clients 1. Relate the American Nurses Association Standards of Psychiatric Mental Health Nursing Care to the nursing process. 2. Use the American Nurse Association standardized language of NANDA to provide & document care for clients with psychiatric diagnoses. 3. Identify measurement criteria used to determine that the care provided to psychiatric clients meets each of the Standards. 4. Discuss the importance of a common vocabulary that describes psychiatric mental health nursing care. 5. Describe how to use psychiatric mental health nursing standards and the nursing process in professional practice. 1/2010 Page 7

22 Assessment 1. Identify when assessment takes place. 2. Describe the steps a psychiatric mental health nurse would take to conduct a psychiatric history, a mental status exam & physical assessment. 3. Define terms used in a psychiatric history & a mental status exam. 4. Differentiate among a physiologic assessment, neurological assessment, psychological testing and psychosocial assessment. 5. Describe the DSM-IV-TR multiaxial system. 6. Determine how to apply assessment principles in professional practice. 7. Identify the different circumstances in which a psychiatric mental health nurse would use the mental status exam and the mini-mental status exam. 8. Formulate a quality assurance program for a set of psychiatric nursing interventions. Complementary & Alternative Healing Practices 1. Describe the therapeutic uses for each of the complementary & alternative medicine (CAM) techniques. 2. Describe characteristics & functions of the various CAM techniques. 3. Apply CAM strategies for care of clients in any health care or community setting. 4. Explain CAM techniques to clients & their families for integration into a plan of care to promote, maintain, and restore emotional well-being. 1/2010 Page 8

23 5. Identify cautions a psychiatric mental health nurse would give to clients & their families about CAM approaches. 6. Use CAM strategies to enhance personal functioning & professional practice. Therapeutic Communication 1. Describe the process of human communication. 2. Identify factors that influence the process of human communication. 3. Compare & contrast nonverbal & verbal communication. 4. Discuss theories of human communication as they relate to humanistic, psychiatric mental health nursing. 5. Describe concepts of facilitative communication that are essential ingredients of a therapeutic interpersonal relationship. 6. Explain culturally competent communication strategies. 7. Describe effective communication skills & how they can be used throughout the nursing process. 8. Demonstrate facilitative verbal & nonverbal communication techniques in professional practice. 9. Discuss how change theory can be used to improve client outcomes on a psychiatric unit. 10. Discuss the use of the problem solving techniques and how these techniques are creatively modified when working with a variety of psychiatric diagnoses. 1/2010 Page 9

24 Week Describe the use of conflict resolution when dealing with aggressive clients. Schizophrenia and other psychotic disorders 1. Identify the positive and negative symptoms of schizophrenia. 2. Describe the psychological and social pressures that influence the course of schizophrenia. 3. Discuss the various theories for the causes of schizophrenia. 4. Explain the major nursing implications in caring for clients with a difficult & chronic illness such as schizophrenia. 5. Describe methods to prevent or minimize relapses in schizophrenia. 6. Apply the nursing process to clients with schizophrenia. 7. Describe case management, community-based care, and home care for the client with schizophrenia. 8. Identify personal challenges that may be encountered in professional practice when caring for clients with schizophrenia. 9. List 5 interventions with the client who is experiencing sensory/perceptual alterations. O. Schizophrenia (Disturbance of Thought) Therapeutic Communication & the nurseclient relationship II F. Therapeutic Modalities Text readings: Kneisl Chps. 16, 14 & 28 Text readings: Kneisl Chps.10, 30 & 29 Counseling the Individual 1. Explain the common shared characteristics and phenomena of one-to-one relationships. 2. Identify client abilities & behaviors that are most often associated with growth-producing outcomes. 3. Analyze the following special concerns as they 1/2010 Page 10

25 relate to psychiatric-mental health nurses: critical distance, self-disclosure, gift giving, the use of touch, and values. 4. Explain the three phases of the therapeutic nurse-client relationship and the main objectives and tasks of each phase. 5. Describe actions psychiatric mental health nurses would take in establishing & maintaining one-to-one relationships within the context of the client s cultural background. 6. Apply the nursing process to the three phases of the nurse-client relationship. 7. Describe case management, community-based care, and home care for a therapeutic nurseclient relationship. 8. Describe how to incorporate therapeutic nurseclient relationship principles in profession practice. Family & Group Interventions 1. Describe group development & group therapy. 2. Describe creating & maintaining a therapeutic group. 3. Explain the purpose therapeutic groups fulfill. 4. Identify the steps psychiatric mental health nurses would take to apply the process of hereand-now activation to a therapeutic group. 5. Compare & contrast the different types of therapeutic groups. 6. Describe families in terms of their relationships, associations, and connections. 7. Identify strategies psychiatric mental health 1/2010 Page 11

26 nurses use to assess & intervene with families. 8. Analyze group & family processes in personal life & professional practice that will promote & maintain an individual s mental health. Week 3 Psychopharmacology 1. Define psychopharmacology. 2. Describe the positive & negative impacts of psychiatric medications on behavior. 3. Discuss factors that affect the extent to which clients will comply with prescribed medication treatment regimens. 4. Describe major side effects associated with broad categories of psychotropic medications, and formulate nursing interventions to address them. 5. Identify personal feelings and attitudes that may exist is these medications must be taken for an indefinite period of time. 6. Describe how to incorporate psychopharmacology principles in professional practice when administering psychotropic medications. Week 4 Substance-Related Disorders 1. Describe the major theories for substancerelated disorders. 2. Identify client groups at risk for substancerelated disorders. 3. Describe the physical, psychological, and withdrawal effects of major categories of abused substances. 4. Identify treatment approaches for the major categories of abused substances. 5. Apply the nursing process to clients with Therapeutic Modalities II (cont) Review of psychotropic medications G. Components of self concept H. Substance-related disorders I. Eating disorders Text readings: Kneisl Chps. 32 Text readings: Kneisl Chps. 15, 21 Medication quiz AA paper due 1/2010 Page 12

27 substance related-disorders. 6. Identify assessment tools used for clients with substance-related disorders. 7. Identify short-term and long-term nursing strategies for clients with substance-related disorders. 8. Describe case management, community-based care, and home care for clients with substancerelated disorders. 9. Identify personal outcome criteria for clients who have substance-related disorders. 10 Discuss personal feelings & attitudes about clients with substance-related disorders that may affect professional practice. Eating Disorders 1. Identify the various types of eating disorders. 2. Discuss biopsychosocial theories that aid in the understanding of eating disorders. 3. Identify steps for assessing individual & family problems of clients with eating disorders. 4. Apply the nursing process for clients with eating disorders. 5. Describe the psychiatric mental health nurse s role & appropriate nursing interventions for clients with eating disorders and their families. 6. Describe case management, community based care, and home care for clients with eating disorders. 7. Discuss possible feelings of frustration while caring for clients with eating disorders. 8. Examine personal feelings & attitudes that may affect professional practice when caring for clients 1/2010 Page 13

28 with eating disorders. Coexisting Psychiatric & Substance Use Disorders 1. Discuss the fact that people with mental illnesses have a high rate of substance use disorders. 2. Identify how alcohol or drug use can complicate the course of psychiatric disorders. 3. Describe the components of an effective substance use assessment for a mentally ill client. 4. Discuss ways that the mental health & substance abuse treatment systems may fail to meet the needs of clients with coexisting psychiatric and substance use disorders. 5. Identify interventions that are most likely to be effective in working with clients who have coexisting psychiatric and substance use disorders. 6. Apply the nursing process to care for clients with coexisting psychiatric and substance use disorders in an emergency setting or an inpatient setting. 7. Discuss case management, community-based care, and home care for clients with coexisting psychiatric & substance use disorders. 8. Identify what can be done in professional practice to maintain a positive & hopeful attitude when caring for clients with coexisting psychiatric & substance use disorders. Week 5 J Personality Disorders 1. Differentiate personality traits from personality disorders. 2. Compare & contrast the biopsychosocial J J..Axis II Personality disorders K. Somatoform disorders L. Anxiety disorders M...Dissociative disorders Text readings: Kneisl Chps. 22, 18, 19 (pp ) 1/2010 Page 14