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The Skills to Succeed -The Values that Guide
Nursing Workforce Nursing Workforce Development: Implications Development: Implications
for Children’s Mental Healthfor Children’s Mental Health
Nalini Jairath, PhD, RN, DeanNalini Jairath, PhD, RN, DeanEllen Mahoney, DNSc, CARN, RNCSEllen Mahoney, DNSc, CARN, RNCS , ,
Clinical Assistant ProfessorClinical Assistant ProfessorSylvia Stevens, MS,RN,CS, Clinical Sylvia Stevens, MS,RN,CS, Clinical
Assistant ProfessorAssistant Professor
School of Nursing, The Catholic School of Nursing, The Catholic University of AmericaUniversity of America
The Skills to Succeed -The Values that Guide
Purpose: Describe an educational Purpose: Describe an educational initiative for nursing personnel initiative for nursing personnel caring for adolescents and children caring for adolescents and children in a dedicated psychiatric facilityin a dedicated psychiatric facility
Assumption: The knowledge, skills Assumption: The knowledge, skills and attitudes of care providers can and attitudes of care providers can be changed through targeted, on-be changed through targeted, on-site educationsite education
The Skills to Succeed -The Values that Guide
Mental Illness in Mental Illness in ChildhoodChildhood
Approximately 1 in 5 American children Approximately 1 in 5 American children have diagnosable mental illness in any have diagnosable mental illness in any given year (US Surgeon General)given year (US Surgeon General)
Mental illness significantly affects daily Mental illness significantly affects daily life for approximately 5 million American life for approximately 5 million American children and adolescentschildren and adolescents
The most severely affected children The most severely affected children require some type of acute/longer term require some type of acute/longer term intervention in a dedicated psychiatric intervention in a dedicated psychiatric settingsetting
The Skills to Succeed -The Values that Guide
Mental Illness in Mental Illness in ChildrenChildren
Anxiety DisordersAnxiety Disorders Disruptive behavior disordersDisruptive behavior disorders Developmental disordersDevelopmental disorders Eating & Elimination disordersEating & Elimination disorders Learning & communication disordersLearning & communication disorders Affective/mood disordersAffective/mood disorders SchizophreniaSchizophrenia ““Tic” disordersTic” disorders Dual DiagnosesDual Diagnoses
The Skills to Succeed -The Values that Guide
TreatmentTreatment
MedicationMedication Psychotherapy (directed counseling)Psychotherapy (directed counseling) Expressive therapies (music, play, Expressive therapies (music, play,
art)art) Team approach; all care providers Team approach; all care providers
are involved in therapyare involved in therapy
The Skills to Succeed -The Values that Guide
Nursing RoleNursing Role Therapy involves changes in life Therapy involves changes in life
patterns and responsespatterns and responses Therapy is not confined to Therapy is not confined to
encounters with psychiatrist, but also encounters with psychiatrist, but also occurs in groups and individually occurs in groups and individually
Nursing personnel are present 24 Nursing personnel are present 24 hourshours
The Skills to Succeed -The Values that Guide
The ConcernThe Concern Massive shortage of nursesMassive shortage of nurses Even greater shortage of psychiatric Even greater shortage of psychiatric
nurses because of need for special nurses because of need for special skills, stigma of mental illnessskills, stigma of mental illness
Balance between RN, LPN and Balance between RN, LPN and psychiatric technicians psychiatric technicians
The role of culture and education The role of culture and education upon knowledge, skills and attitudes upon knowledge, skills and attitudes of nursing personnelof nursing personnel
The Skills to Succeed -The Values that Guide
Nursing personnel must be present Nursing personnel must be present in sufficient numbers and must in sufficient numbers and must have the knowledge, attitudes and have the knowledge, attitudes and skills to be therapeutic as opposed skills to be therapeutic as opposed to simply being presentto simply being present
The Skills to Succeed -The Values that Guide
Grant GoalsGrant Goals
Develop career advancement Develop career advancement program for culturally diverse program for culturally diverse nursing personnel nursing personnel
Augment skills in current child and Augment skills in current child and adolescent psychiatric-mental health adolescent psychiatric-mental health care roles across clinical settingscare roles across clinical settings
Promote entry into nursing and Promote entry into nursing and advancement through nursing advancement through nursing degreedegree
The Skills to Succeed -The Values that Guide
PartnersPartners School of Nursing: The Catholic School of Nursing: The Catholic
University of AmericaUniversity of America Adventist Behavioral Health NetworkAdventist Behavioral Health Network (Potomac Ridge)(Potomac Ridge) (Crownsville Hospital)(Crownsville Hospital) (Adventist Healthcare Group Homes)(Adventist Healthcare Group Homes) (Runaway Program)(Runaway Program) Montgomery County Community Mental Montgomery County Community Mental
Health Center/LinkagesHealth Center/Linkages
The Skills to Succeed -The Values that Guide
Potomac Ridge Adventist Potomac Ridge Adventist Behavioral Health Behavioral Health
Acute children’s unitAcute children’s unit Acute adolescent unitAcute adolescent unit Two long term units for girls who Two long term units for girls who
have been sexually abusedhave been sexually abused Sexual offender unit for boysSexual offender unit for boys
The Skills to Succeed -The Values that Guide
Nursing PersonnelNursing Personnel
Roughly 30% registered nurses, 20% Roughly 30% registered nurses, 20% licensed practical nurses & 50% licensed practical nurses & 50% psychiatric technicianspsychiatric technicians
Many of the nurses have been Many of the nurses have been educated outside of the United States, educated outside of the United States, most notably in the Caribbean & most notably in the Caribbean & African nationsAfrican nations
Multicultural staff Multicultural staff
The Skills to Succeed -The Values that Guide
Orientation
Unit-based training of nursing staff
Intro to Psych. Nursing
Certificate Offerings Nursing Degree
Programs
Pre-nursing transition
REMEDIATION
Proposed Developmental Pathways Through Career
Advancement
The Skills to Succeed -The Values that Guide
StrategyStrategy
Non-degree certificate programNon-degree certificate program Articulation into nursing degree Articulation into nursing degree
programprogram Pre-nursing transition programPre-nursing transition program Computer Labs & Web-Enhanced Computer Labs & Web-Enhanced
LearningLearning
The Skills to Succeed -The Values that Guide
Certificate ProgramsCertificate Programs
Caring & The Healing Arts of Caring & The Healing Arts of Psychiatric-Mental Health NursingPsychiatric-Mental Health Nursing
Human Growth & Development in Human Growth & Development in the Early Yearsthe Early Years
Social Justice & Mental Health Care Social Justice & Mental Health Care Ethics for Children & AdolescentsEthics for Children & Adolescents
Clinical Observations & Assessment Clinical Observations & Assessment of Children & Adolescentsof Children & Adolescents
The Skills to Succeed -The Values that Guide
Certificate Programs Certificate Programs (cont)(cont)
Clinical Interventions for Children & Clinical Interventions for Children & Adolescents 1Adolescents 1
Clinical Interventions for Children & Clinical Interventions for Children & Adolescents 2Adolescents 2
Evidence-Based Clinical PracticumEvidence-Based Clinical Practicum Each module is about 20 hoursEach module is about 20 hours
The Skills to Succeed -The Values that Guide
OutcomesOutcomes
Computer labs/learning centers Computer labs/learning centers established at two sitesestablished at two sites
Long distance Long distance teleconferencing/telelearning teleconferencing/telelearning packages in placepackages in place
Courseware for online learning Courseware for online learning functionalfunctional
Certificate modules available via face Certificate modules available via face to face and onlineto face and online
The Skills to Succeed -The Values that Guide
OutcomesOutcomes
27 nursing staff employees of the 27 nursing staff employees of the Adventist Behavioral System have Adventist Behavioral System have taken classes in certificate program taken classes in certificate program (19 nurses and 8 technicians)(19 nurses and 8 technicians)
Approximately 1 on 5 nursing staff Approximately 1 on 5 nursing staff employees have taken certificate employees have taken certificate programsprograms
27% decrease in turnover rates for 27% decrease in turnover rates for the combined group the combined group
The Skills to Succeed -The Values that Guide
Outcomes (cont)Outcomes (cont)
Pilot of streamlined admission process to Pilot of streamlined admission process to MSN program at CUA through MSN program at CUA through elimination of GRE requirementelimination of GRE requirement
Research project entitled “Hospitalized Research project entitled “Hospitalized Psychiatric Patients’ Perceptions of Psychiatric Patients’ Perceptions of Nurse Caring Behaviors” is under Nurse Caring Behaviors” is under developmentdevelopment
Poster presentation at American Poster presentation at American Psychiatric Nurses Association 2005 Psychiatric Nurses Association 2005 conferenceconference
The Skills to Succeed -The Values that Guide
IssuesIssues
Computer competence of nursing personnel;Computer competence of nursing personnel;in-service education requiredin-service education required
Poor staffing and inclement weather affect Poor staffing and inclement weather affect ability to attend face to face classesability to attend face to face classes
Different learning needs of ABH nursing Different learning needs of ABH nursing personnel and Linkages to Learning personnel and Linkages to Learning personnelpersonnel
Challenges involving nursing staff in Challenges involving nursing staff in research & evidence-based practice research & evidence-based practice opportunitiesopportunities
The Skills to Succeed -The Values that Guide
ConclusionConclusion
Personnel costs of grant offset by Personnel costs of grant offset by retention benefitsretention benefits
Nursing workplace program is cost-Nursing workplace program is cost-effective and should ultimately effective and should ultimately improve patient careimprove patient care
The Skills to Succeed -The Values that Guide
AcknowledgementAcknowledgement
The project described in this The project described in this presentation was supported by a presentation was supported by a grant (D65HP03108) from the grant (D65HP03108) from the Bureau of Health Professions. Their Bureau of Health Professions. Their support and assistance is gratefully support and assistance is gratefully acknowledged.acknowledged.
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