WEST COAST UNIVERSITY DEPARTMENT OF …n204xn214l.pbworks.com/f/NURS+214L+PART+A+B+0110.pdfWCU NURS 214L Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client

WCU NURS 214L Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Practicum

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WEST COAST UNIVERSITY DEPARTMENT OF NURSING

COURSE TITLE: MENTAL HEALTH/PSYCHIATRIC NURSING:

PROMOTING WELLNESS IN THE MENTALLY ILL CLIENT PRACTICUM

COURSE NUMBER: NURS 214 L COURSE PREREQUISITES: NURS 201, NURS 211L COURSE COREQUISITES: NURS 204 INSTRUCTOR NAME: DATE: CREDIT HOURS: 2 units COURSE LENGTH: 9 weeks COURSE SCHEDULE: INSTITUTIONAL MISSION: West Coast University is a private, nonsectarian, coeducational institution. The m ission of the University is to ensure provision of an innovati ve and relevant learning environment and to support the personal and professional development of adult learners in acquiring lifelong critical thinking and analytical skills.


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NURSING PROGRAM MISSION: The Nursing Program’s mission is to assist each st udent in the recognition of his/her individual abilities to progress and build com petence in a chosen nursing educational goal. T he 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: Nursing care for adolescents, adul ts and older adults with psychi atric health problems. Practice in public and private clinical agencies and in community settings. This practicum course in psychiatric nursing focuses on iden tification, examination and appl ication of psychiatric nursing theory, con cepts, asses sment and interven tion with psych iatric c lients. This cou rse is tak en concurrently with NURS 204 and integrates and applies diagnosis, management, and evaluation of clients with psychiatric di sorders. Students apply the sk ills, th erapeutic co mmunication strategies a nd som atic trea tments used in psyc hiatry and collaborate with other health care professionals in a m ultidisciplinary setting. During the practicum , students w ill be on a psychiatric unit applying psychi atric principles and delivering nursing care to individuals and groups of clien ts. They will be in community settings fo cusing on issues related to m ental health. COURSE OBJECTIVES: On conclusion of the course, in order to provid e nursing care related to promoting wellness in culturally diverse populations, the student will be able to:

1. Demonstrate a psychiatric assessm ent incl uding conducting a neurobehavioral m ental status evaluation, and determining risk of suicide and violence.

2. Describe how proper docum entation, and comm unication to staff m embers of pertinent

data about the client' s mental health and behavior including medications, treatments, and diagnostic tests results in error prevention.

3. Initiate, maintain, and term inate a therapeu tic nurse-client relationship with atten tion to

transitions m anagement. De monstrate and evaluate effective verbal and non-verbal therapeutic communication skills.

4. Collaborate with staff members; recognize and follow the clin ical agency's policies and

rules. Par ticipate in a ll appropriate activ ities, conferences and m eetings. Consult with faculty and staff to respond therapeutically to clients who are angry, m anipulative, dependent and who need limits.

5. Apply and integrate developm ental transitions and other psyc hiatric theories to nursing

practice with adolescents, adults, and elderl y clients with m ental health problem s. Describe various models of community mental health nursing.


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6. Analyze in teractions, defense mechanisms, and dem onstrate therapeutic comm unication techniques.

7. Evaluate nursing care in term s of sensitivit y to client’s developm ental state, unique

heritage, belief and value syst em, sexuality and in rela tion to established standards of practice. Evaluate your interventions.

8. Appraise one’s own values in relation to: age, gender, spirituality and c ultural diversity:

then analyze how these values m ay contribute to stereotyping, bias ing & racism while working mental health clients.

9. Utilize the nursing p rocess and G ordon's Functi onal Health Pattern in the care of the

mentally ill client

10. Demonstrate understanding of reliab ility and valid ity in order to utilize current res earch as a foundation for evidence-base d practice in the field of psychiatric m ental health nursing.

11. Discuss the laws pertaining to the care of m ental health clients, include concepts of

informed consent, voluntary Vs involuntary status, rights of hum an subjects in research participation, negligence, abuse reporting, malpractice and risk management.

12. Discuss current political policy/activism pertaining to mental health issues, legislation,

financing, reim bursement and regulatory pr ocesses (include inform ation on the Lanterman-Petris-Short Act and the Short-Doyle Act).

13. Describe how the Nurse Practice Act & ANA Code of Ethics impact care on a psychiatric

mental health unit.

14. Discuss how com plementary & al ternative therapies can b e used to reduc e stress with mentally ill clients.

REQUIRED TEXT: Boyd, D., Hinds, M., Hyland, J., & Saccoman, E. (Eds.). (2008). Evolve reach comprehensive

review for the NCLEX-RN examination (2nd ed.). St. Louis, MO: Mosby Elsevier. Kneisl, C., Wilson, H., & Trigoboff, E. (2009). Contemporary psychiatric-mental health nursing

(3rd 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.


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SUPPLEMENTAL READINGS: Aschen, S. (1997). Assertion training therapy in psychiatric milieus. Archives of Psychiatric Nursing, 11(1), 46. Bechtel, G. A., Davidhizar, R., & Tiller, C. M. (1998). Patterns of mental health care among Mexican Americans. Journal of Psychosocial Nursing, 36(11), 20-27. Bender, A., & Ewashen, C. (2002). Group work is political work: A feminist perspective of

interpersonal group psychotherapy. Issues in Mental Health Nursing, 21, 297 Collins, A. M., & Diego, L. (2002). Mental health promotion and protection. Journal of

Psychosocial Nursing, 38(1), 27-32. Drug Watch (1998). How ethnicity and culture affect anti-psychotic response. Journal of

Nursing, 98(5), 56. Forchuk, C., et al. (2000). The developing nurse-client relationship: Nurses' perspectives.

Journal of Psychiatric Nurses Association, 6(1), 3-10. Glod, C.A., & Cawley, D. (1997). The neurobiology of obsessive-compulsive disorder. Journal

of Psychiatric Nurses Association, 3(4), 120-122. Holzworth, R., & Wills, C. (1999). Nurses' judgments regarding seclusion and restraint of

psychiatric patients: A social judgment analysis: Research Nursing Health, 22, 189-201. Walker, C. (1998). Homeless people and mental health: A nursing concern. American Journal of

Nursing, 98(11), 26-32. Winslow, E. H. (2001). Patient education materials: Can patients read them, or are they ending

up in the trash? American Journal of Nursing, 101(10), 33-38. TEACHING STRATEGIES: Practice will occur in acute inpatient, outpatient and community settings. A focus on community outreach is present. Role-playing, journal, co mmunication exercises, process recording, NCP’s, community reports, and multimedia will be additional teaching strategies. EVALUATION METHODS/GRADING: Grades Letter Grade Percentage of Class Points A 91 - 100% B 84 - 90 % C* 76 - 83 % D 64 - 75 % F 63 or Less


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*Minimum passing grade for all nursing classes is a 76%. CLINICAL EVALUATION Clinical per formance wi ll be ev aluated m id-semester and at the end of the semest er using t he clinical evaluation tool. Please co mplete your s elf-evaluation and consult with instructor at mid-term. CLINICAL PREPARATION Preparation for your clini cal assignment is required for all cli nical days. Because each psychiatric setting has different options for out patient and community experiences, clinical faculty will direct the student’s assignment to community experiences. WRITTEN ASSIGNMENTS Written assignments are due on time. Any assignment turned in late cannot receive a score higher than 76%. ATTENDANCE: The WCU Clinical Rotations and Practicum Policy is in effect for all classes. In addition: Clinical time includes all pre and post conferen ces and any scheduled observations; students are not to leave clinical rotations during these times/experiences. Leaving early or without explicit permission of the clinical instructor will elicit an absence for the clinical day and may be considered abandonment of the patient (a very serious infraction). All a bsences can potentially affect a student' s ability to succ essfully co mplete the course ob jectives an d consequently their ability to pass. In the even t of an absence, a m ake-up day will not be allowed. Attendance at clin ical is required? In extrem e circumstances such as d eath, hospitalization, a physician’s letter or death certificate will be required as proof. To maintain satisfactory attendance in a clinical course, only 20% of the total clinical class hours can be missed. The 20% is calculated based on the number of minutes/hours in the clinical day that were missed for that class and minutes/hours counted for tardiness. If absences due to illness or other m atters are ongoing, and the student is therefore unable to complete th e clin ical o bjectives, th e studen t will b e advis ed to withd raw f rom the course. Withdrawal from the clinical cou rse also re quires withdrawal from the corresponding theory course by BRN regulations. Note: Students are responsible to notify the selected agency and the clinical faculty if unable to attend clinical or arrive on time. Calls must be made at least one hour prior to beginning of designated shift. Calls must be made directly to the clinical unit and the clinical faculty, and the message left with someone in authority at the clinical site as well as with the clinical faculty.


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ACADEMIC INTEGRITY: In its commitm ent to academ ic honesty and accurate assessm ent of student work, W est Coast University uses a plagiarism -detection web-serv ice to help prevent pl agiarism. Consequently, instructors reserve the right to submit student assignments to the website to check for similarities between student subm issions and the internet, va rious res earch datab ases, and the web-site’s database of previous student submissions. Students may be required to electronically subm it their work to the ins tructor or to the website , and by taking WCU c ourses, students agree that all as signments are subject to plagiarism detection processes and Academic Honesty policie s. Assignments submitted to the website b y the student or instructor will becom e part of the service’s database and will be used for plagiarism prevention and detection. Student papers, however, will rem ain the intellectual property of the authors. COURSE COMPLETION: Based on California Board of Registered Nursing requirements each clinical nursing practicum class m ust be taken s imultaneously with each theo ry clas s of that su bject. Clinical practicu m classes are important in order to learn how to apply nur sing theory learned to the actual practice of nursing. The student’s ability to apply that knowledge is ev aluated by using the clinical evaluation tool designed to meet the conceptual needs of the curriculum and the syllabus for that class. The tool is graded by the clinical ins tructor on a day-by-day basis. Faculty will provide feedback, if not daily, than at least three times during the term of the class at about week 5, 7 and 10. In addition, each tim e a nursing skill is learn ed it m ust be perform ed in th e skills lab under supervision first and when perform ed for the fi rst time on a patient it m ust be observed by the instructor who will determ ine if the student has perf ormed it saf ely. If the per formance is satisfactory, the instructor will in itial in the s ection of the skills book let. This booklet is to b e carried by the student each day she/he is at clin ical or in sk ills lab to insure all skills are signed off prior to moving on to another class. Student s should keep a copy of this booklet in a safe place. The information in this booklet is part of the grading for the class and without this booklet, there is no verification that a sk ill has been su ccessfully completed. Therefore, it is crucial th e student keep this booklet safe th roughout the entire nursing program, as it is a record of skills achieved and a required reference by the Board of Registered Nursing that skills were obtained first in the skills lab and later in the clinical practicum. Quizzes: Unsche duled quizze s will be give n pe riodically throughout the te rm. The quiz zes will cover pr evious c ontent a nd/or conte nt covered du ring a part icular class sessi on i n t heory as it applies t o c linical. Students are required to be pres ent when an exam ination is giv en. 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 receiv e a 0%. Lack of preparation at the scheduled exam time is not an acceptable excuse for not taking an examination or quiz.


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The fi nal gr ade is cumula tive a nd i ncludes cl inical per formance, medi cation te sts, pre or post conference presentati ons, concep t mappi ng of nursing care , nursi ng c are plans , and quiz zes. All students must pass with a 76% and evaluated by the clinical instructor to be a safe practitioner, to be eligible to move forward in the nursing curriculum. Case Studies will be assigned throughout the course either from the EVOLVE website or from the instructor. *Participation includes attendance, participation in discussions, and engagem ent in the learning activities during the clinical practicum as well as pre and post conferences. ** The medication math test will be given in each of the clinical classes throughout the nursing program. In each class, it is required that the students pas s the m edication m ath test for that practicum BEFORE they can pass m edications. The passing grade is 85%. If the student does not pass th e test on the f irst a ttempt, they m ay take it ag ain two m ore tim es. The f irst gr ade achieved is the one counted toward the final grade. If the student does not pass this m edication exam ination, they are considered unsafe and therefore fail the clinical class and must drop it and the corresponding theory class. Because the body of nur sing knowledge builds from one class to the next and the practicum is based on knowing the corresponding theory, the student must successfully pass this class before they can move on to the next nursing class. The Board of Registered Nursing requires that the practicum be taken at the sam e time as the corresponding theory class, i.e. during th e same term, as the theory course is given. If the student fails any course, they are given one opportunity to retake it and if they fail the second time, they are dropped from the program. Students must achieve a passing grade of C (76 %) or above, subm it all required exercises and projects, complete all required quizzes and examinations, and meet the standards of safe practice and the school attendance policy. Student Papers: Unless designated as a Group Projec t by the instructor, all student papers and assignments must be com pleted by the individual student and repr esent the student’s own original work. Group projects are designated as such so that all othe r assignments are individual assignm ents and are to be com pleted by th e student and NOT as a group as signment or subm itted as a group assignment. Any subm itted pape rs that a re not th e studen t’s orig inal work will b e conside red plagiarism, in violation of the Academic Honor Code. For clar ification of plagiarism , please refer to the RN Student Handbook, WCU Catalog, Dean or instructor. Each student is responsible for his or her own learning which includes a ll 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 f ax papers to the school. Do not e-mail papers to instructors without written permission from the instructor.


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Grading Scale as Follows:

Grade Points Nursing Numerical Score

A 4 91-100 B 3 84-90

C 2 76-83 (minimum passin g grade)

D 1 64-75 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: Students are required to m ake up all assignm ents and work missed as a result of absences. The instructor m ay assign additional outside m ake-up work to be completed for each absence. Arrangements to take tests and /or quizzes missed because of an absen ce or tardy can only b e made with the instructo r’s app roval. Hours of make-up work cannot b e accep ted as hours of class attendance. CLASSROOM / CLINICAL POLICIES: To m aintain satisf actory attendan ce, students should not be absent for more than two clinical days and more than that may lead to dismissal from the class, and the student may be required to repeat the class. Students who are requir ed to pa rticipate in m ilitary duties a nd are abse nt f rom their schedu led classes will not be penalized. Students m ust provide the Dean of Nursing with writte n documentation verifying the required military leave and length of time requested. Students are expected to wear a clean pressed school uniform, clean white shoes, a watch with a second hand, their school ID badge and whatever other identification th e hospital require. In community experience they m ay wear the full unifo rm or wear appropriat e business attire or smart casual attire. A student w ho acts in an unethi cal or unprofessional m anner on an assignment will receive a grade of “0%” for that assignm ent. A second incident of unethi cal or unprofessional behavior


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may result in administrative termination from the college. Unsafe nursing care or falsification of medical records may lead to immediate disciplinary action or dismissal from the program. Uses of cell phones in the clinical settings are NOT allowed. Phones may be confiscated if found on and/or in use while in the hospital settings as this is against hospital policies and may interfere with medical equipment. ACADEMIC DISHONESTY: Written assignments and all other documentation: The Univer sity co nsiders plag iarism and f alsification of docum ents, including docum ents submitted to the Univers ity for other than acade mic work, a serious m atter 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. A ll students are required to follow the Am erican Psychological Assoc iation (APA) writing guid elines. All sources use d as ref erences m ust be identified Plagiarism-detection website: In its comm itment to academic honesty and accurate assessment of student work, W est 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 ele ctronically submit their wo rk to the instructor or to th e website, and by taking WCU courses, st udents ag ree th at all assignm ents ar e subject to p lagiarism detection processes and Academic Honesty policies. Assignments submitted to the website by the student or ins tructor will beco me part of the se rvice’s database and will be used for plagiarism prevention and detection. Student papers, however , will remain the intellectual property of the authors. Students who violate univers ity s tandards of acad emic integrity are subject to discip linary sanctions, including failure in the course and suspension from the university. Since dishonesty in any form harms the individual, other students and the university, po licies on academic integ rity will be stric tly 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 exam s, no food or dri nk, no baseball or other type of hats can be worn, no papers, backpacks or other type of m aterial can be taken into th e exam space. There is no talking or sharing of inform ation 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 availab le, the students can only schedule a review of their exam with their instructor. The student will be provided w ith a test co py (not app licable to H ESI exams), answer sheet, and a copy of his or her Scranton, which m ust all be returned unchanged upon completion of review. No written or oral no tes can be tak en when a student revie ws his or he r


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exam. The school encourages students to review their test results as soon as the exam is completed. HESI (or ATI) exam results are availa ble for review on line through the Elsevier (or ATI) website usually within 24 hours of com pleting the exam. Students are encouraged to use this information to tailor their remediation in areas of weakness as identified by subjects m issed on the HESI or ATI exam. The HESI and ATI te sting policy require that you may not share any of the testing inform ation with anyone at any tim e. Please read it carefully as this is a legal document you are signing and will be legally held accoun table to uph old, 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 gr ossly interferes with classroom activities is cons idered disruptive behavior and may be subject to disciplinary action. Such behavior inhibits other students' ability to learn and instructors' ability to teach. A st udent responsible for disruptive behavior m ay be required to leave class pending discussion and reso lution of the problem and may be reported to the Office of the Dean/Director or Academic Dean. 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.


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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 AACN 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 214 L Promoting Wellness in the Mentally Ill Client Clinical Practicum include the following: Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice

Basic Psych and Humanities Course meets this essential through the application of psychiatric theory based in the

sciences and humanities to direct client care on a psychiatric unit.

Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety Leadership Role – Psych team is system and interdisciplinary Course meets this essential through the provision of a leadership experience for the

student during one day of their clinical rotation. Essential III: Scholarship for Evidence-Based Practice

Specific Course meets this essential by requiring the student to provide research regarding the client’s psychiatric diagnosis and to support each intervention listed in the care plan with researched based data.

Essential IV: Information Management and Application of Patient Care Technology

Electronic charting – access and provide patient information to charge nurse for charting purposes

Course meets this essential by requiring the student to be familiar with the technology used to record client data in the psychiatric hospital and use a computer based nursing care plan.

Essential V: Healthcare Policy, Finance, and Regulatory Environments

Insurance as partial driving force for early discharge and length of stay issues Lanterman Petris Short Act Short Doyle Act All seclusion, restraints and other regulations Course meets this essential through a discussion of psychiatric legal issues and the impact

of a client’s source of reimbursement and length of stay. The student is also required to consider how medical necessity impacts insurance reimbursement.

Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes

Psych mental health interdisciplinary team Attend reports – Pre and Post Conference


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Group therapy sessions with patients and staff Present case in post conference Course meets this essential by through discussions held in pre and post conferences, the

attendance of all group therapies on the unit and the presentation of a client case. Essential VII: Clinical Prevention and Population Health

Community clinical assignments Written applications applicable for theory course AA – MENTALLY ILL HOMELESS – Mental Health Court 95 – Patient family

education – counseling and teaching signs and symptoms of clients illness for family members

Course meets this essential through the provision of safe client care in a psychiatric setting, with special consideration to issues regarding suicide and homicide.

Essential VIII: Professionalism and Professional Values

Professional role modeling behavior by faculty – ethical discussions – cultural discussions – BRN regulatory issues

Course meets this essential through clinical discussions regarding the stigma and stereotyping that can occur in regard to a psychiatric client. Issues related to client’s rights, ethical behavior and moral responsibility are emphasized during pre and post conference.

Essential IX: Baccalaureate Generalist Nursing Practice Course meets this essential by encouraging the student to view the psychiatric client from

a holistic perspective and use a variety of psychiatric theories in the planning of care.


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Community Experience Report Due on Week # 4

Orientation & Acute care clinical experience: 80 hours Community clinical experience: 10 hours Total 90 hours Because community experiences are often not available du ring course hours, students are asked to be flexible. Open communication is im portant, and it is best to handle problems or questions as they arise. Comm unity service forms must be completed for AA and Court 95, students m ay attend AA or Court 95 more than once to accru e the needed 10 hrs of comm unity experience or attended NAMI, NA (narcotics anonymous) or CA (cocaine anonym ous) for additional community hours. Paper is to be typewritten, double spaced, and written using American Psychological Association (APA) manual guidelines. (1) Spelling and grammar (2) Content must include the following:

Name of the organization (1) Purpose of the organization (1) Population served (type of patient and disease(s) served) (1) Geographical/environmental is sues (describe the facility, physical layout, access ibility, transportation issues if any) (1) Professional services available in this setting (1) Social issues in the lives of the population (1) How does the organization communicate internally and with the larger community (1)


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Community Experience Documentation Form Name of student _____________________________________________ Name of facility _______________________________________________________________ Address ______________________________________________________________________ Phone number (_____)_______________________________________ # of hours performed ________________________________________ Contact person (print name) _________________________________ Title______________________________________________________ Contact phone number (if different from facility number) (______)____________________ I verify that the above nam ed student has perform ed _______ hours of comm unity experience observation at this facility. Contact person’s signature _______________________________________


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Community Experience Must include attendance and wri tten papers (turned in to theo ry in structor) for Alcoholic s Anonymous and Court 95. Other acceptab le experiences to complete the 10-hour requirem ent are Alliance for the Mentally Ill and Narcotic s Anonym ous. See attached inform ation and directions for all comm unity experiences. Comm unity hours must be signed by group leader or court officers and the 10 hours will be due the 8 th week of class to you r theory instructor. You will not pass this class without the required 10 hours of community experience. Community Experience No. 1 Self Help Group: Alcoholics Anonymous: The student is to attend a m eeting of AA and observe the group interaction. You can find the time and location of meetings by calling Alcoho lics Anonymous, and a sking for the place and time of an AA m eeting near your hom e. For safety reasons, it is best that you go w ith someone else—either another student, or a friend. Please do not go in groups of m ore than two as this tends to lim it your interaction with program participants. Com plete comm unity assignm ent paper worth 2% of your theory grade within one week following your visit. Turn paper into your theory instructor. Community Experience No. 2 Judicial Review Hearings by Writ of Habeas Corpus at: Department 95 of the Superior Court of Los Angeles County 1150 North San Fernando Road Los Angeles, California 90065 (323) 226-2908 Students will be scheduled to attend writ hearings from 9:00 a.m. to 2:00 p.m. on days court is in session. You are expected to dress professionally (no gym shoes, jeans, or sweatshirts), and to observe cou rtroom protocol. There m ay be l ong periods of waiting so you m ay want to tak e study materials with you. Other than vending m achines, there is no food available, so consider taking a lun ch. Occasio nally you m ay find there are no hearings scheduled for the day yo u attend. DO NOT LEAVE IN THE MIDDLE OF A COURT HEARING OR CALL THE COURT. Superior Court: Directions and Schedule On San Fernando Road BETWEEN ALICE and ROSEVIEW. From downtown L.A., take the 110 f reeway north to Pasadena. Just past the 5 F reeway, exit on Figueroa (the exit will be on your left). Turn right on Figueroa to A venue 26A (there is a McDonald’s at your right just after you exit the freeway). At Avenue 26A turn left, and go a short distance to San Fe rnando Road. Turn right a short distance to 1150 N. San Fernando Rd.


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The court building is in a residential nei ghborhood. PARK ON THE STREET, not the parking lot. Please arrive at 8:30 a.m. for the 9:00 a.m . hearing. If you are late, you m ay not be allowed in. Ask where the “writ” h earings are held. This is a jud icial hear ing by writ of habeas corpus (Latin for “present in the body”) which must be granted to anyone on a 14-day hold who requests this. A “probable cause” hearing is first held on the hospital unit with a court appointed referee before a court hearing is granted. Occasionally hearings will be canc elled. Brin g plenty of reading m aterial as you may have to wait for a couple hours. If ther e are no writ hearings schedule d, you may observe Certification Review Hearings. P lease pick up a brochure in the rack as you enter which will explain these procedures. Remember, when the co urt is in sess ion, you may not talk or whisper to each oth er, or you may be asked by the judge to leave. O ccasionally at an attorney ’s request, you m ay not be allowed in certain hearings. Also, be aware that patients and family members will be waiting in the lobby areas outside the courtroom. Plan to stay until 2:00 p.m. or until you hear a couple of good cases. There is no break for lunch, so take a snack with you. (There are vending m achines available a nd som etimes a catering truck). Assignment for Superior Court Students are to subm it a written report of thei r court exp erience the following week after th e experience. This will count for 2% of your co mmunity grade. Includ e the date and tim e of attendance as well as the num ber and type of ca ses observed. Give the na me of the presiding judge or judges and the rooms in which you observed. Selecting one case, address the following course objective: Analyze the moral, legal, and psychiatric implications of involuntary commitment. In your discussion, include the reason the client is being held involuntarily, psychiatric diagnosis, and medications prescribed. Include a personal reflection on this experience. Paper should be in APA format, 1-2 pages in length, due in theory class – date listed on course outline. Community Experience No. 3 Self Help or Support Group/Brothers Helpers With faculty assistance, the student will identify a self help or support group to attend. This can be a group s uch as a fam ily support group spo nsored by th e National Alliance for the Men tally Ill (NAMI), Alanon, a Parkinson’s disease support group, persons with AIDS support group, or a bereavement support group or Brothers Helpers (s ee 204 syllabus). Local m edical centers usually have listings of these m eetings. Other resources for locating these groups are the front pages of the telephone directory an d the USC guide to student servic es. This is experience is required to supplement your community hours, no paper is required.


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Community Assignment Paper Guidelines: For Community Experience Assignments 1 and 2

Students will subm it two community experience pape rs, which will be due in the theory class. Include the following areas: Date, time and place of meeting and population served. Issues of concern for participants (group themes). Philosophical or theoretical approach forming the basis for the intervention. What communication techniques were used? Identify a group process that occurred. Your experience attending these groups. Conclude with your own evaluation of the effectiveness of the group meetings. These are in addition to the brochures published or provided by the support group. Papers are to be written using APA guidelines and are 2 pages in length.

Clinical Written Assignments Guidelines for Process Recording Select a client to participate with you. Please do not create a script to use for this interview. The purpose of this interview is to give you an opportunity to practice specific com munication strategies and to correctly use and identify these strategies. The recorded interaction should last 5 pages in length with 2 interaction s per page. You should successfully use 3 differ ent strategies from the following list: Communication Strategies Clarifying Giving feedback Rephrasing or restating or paraphrasing Summarizing Structuring

Focusing/pinpointing Using empathy Using immediacy Using silence

Please see attached process r ecording form . When com pleting this assignm ent, you m ay use additional pages. If you prefer to use a word processor, you may modify the column format, but you must clearly show the sequence of your interaction. Be sure to conclude with a summary. A process recording is a written account and analysis of an interaction between two people, i.e., nurse-client interaction. Do not take notes during the interaction, but do this immediately following. The interpretation can be done later, however, it is im portant that the nonverbal aspects of the conversation be recorded immediately while it is fresh in your memory.


01/2010 Page 18

Specific goals are selected by the student prior to the interaction, and are related to particular behaviors. The goals must be realistic and m easurable. Broa d goals refers to the ultim ate expected go al. Therapeutic Communication: p lease also dem onstrate the use of broad open-ended questions, clarification, confronting, refl ecting, empathy, immediacy, focusing. Your goal is to use therapeutic communication and identif y what you used and w hy and its effect. Your goal is not to solve the client’s problem but to explore and use therapeutic communication. In the description of the client, the client shou ld be described in such a way that anyone can identify him or her. Include grooming, affect, posture and environment or setting. Also describe yourself and your feelings prior to the interaction. Never use patient’s nam e in your papers. Use first and last initials instead. Verbal communication is concerned with the s poken word, including inflection and tone of voice. It may also refer to the written word. Note : If the responses are relevant to the goal, did the client initiate the conversation? Did you change the subject being discussed? Non-verbal communication is c oncerned with gestures, body m ovements, posture and other unspoken forms of relaying ideas and feelings. Focus is on what is happening to you and the client that has communication value. Assessment. Is there congruency of verbal and nonverbal comm unication? W hat communication techniques are you using and why? Try to make some interpretation of behavior. Identify your own feelings. When possible, document reasoning behind assessment. Identify the themes discussed, the strategies you used, and your evaluation of these. Interpretation relates to the observer’s perception of the meaning behind the communication. Summary includes an evaluation as related to the goal. W as the goal m et? W hat did the communication mean? If you were to redo this interaction, what would you change? Please type your interaction or print legibly, using the headings of the above columns as a guide. Don’t forget your summary and evaluation. Read your guidelines for this assignm ent as well as your chapter on therapeutic comm unication. Please avoid trying to “solve” the client’s problem . Use 3 or more different communication strategies including the following: Use the worksheet to assess the interaction, identify the strategies you used and your rationale and evaluate their effectiveness. Students fi nd this a difficult but rewarding learning strategy, and some repeat the exercise to improve their skills and understanding. Nursing Care Plans: Students will use the nursing care plan form at on the West Coast University computer. Focus of the nursing care plan should be psychiatric issues with a priority on safety of clients and staff. Case Presentations:


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Students will present one client case using the attached for m to th eir clinical group and instructor. Student will be able to use eviden ce-based practice Vs clinical opinion in supporting their inte rventions. Stu dents are e ncouraged to use on-line lite rature searches, a nd curren t publications in their presentation. Clinical Performance: Criteria for clin ical performance includes: safety , written and oral communication skills, patient teaching, therapeutic skills and professional behavior.

West Coast University –Nursing Program NURS 214L: Promoting Wellness in the Mentally Ill Client Practicum

Clinical Evaluation Tool Based on Gordon’s Functional Health Plan Model

1

STUDENT: FINAL GRADE:

ID#:

CLINICAL SITE:

COMMUNITY DATES: NO. OF HOURS:

EVALUATION CRITERIA Score Obtained

Percentage of Grade

Points Obtained

CLINICAL EVALUATION TOOL X .75

MED MATH EXAM P/F

COMMUNITY EXPERIENCE REPORT X .05

PREP GUIDES/CARE PLANS X. 10

SUPERIOR COURT EXPERIENCE X. 05

SELF HELP OR SUPPORT GROUP X. 05

TOTAL 100

5

th Week Evaluation Completed By:

Student’s Signature: Comments:

7th

Week Evaluation Completed By: Student’s Signature: Comments:

Final Evaluation Done By: Student’s Signature: Comments:



2

BEHAVIORAL OBJECTIVES 5th

Week 7th

Week

STRENGTHS AREAS FOR IMPROVEMENT

FINAL GRADE RATING SCALE (CIRCLE ONE)

1. Nursing process of assessment, diagnosis, plan, intervention and evaluation of nursing care

A Demonstrate skill in using the nursing process according to Gordon’s 11 patterns of human functioning for the patient/client, family and community. Uses these 11 patterns in the assessment, diagnosis, plan, implementation and evaluation of care.

1. Health perception and health management patterns

1 2 3 4 5

2. Nutritional and Metabolism patterns

1 2 3 4 5

3. Elimination patterns 1 2 3 4 5

4. Activity and exercise pattern 1 2 3 4 5

5. Cognitive and perception patterns 1 2 3 4 5

6. Sleep and rest patterns 1 2 3 4 5

7. Self perception and self concept 1 2 3 4 5

8. Roles and relationship patterns 1 2 3 4 5

9. Sexuality and reproduction patterns 1 2 3 4 5

10. Coping and stress tolerance patterns 1 2 3 4 5

11. Values and beliefs patterns 1 2 3 4 5

Total possible points 55

B. Demonstrates skills in using the nursing process as a framework for development of a nursing plan of care

1. Uses Correct assessment skills 1 2 3 4 5

2. Develops a plan of care based on assessment data

1 2 3 4 5

3. Implements plans as appropriate to client situation

1 2 3 4 5

4. Evaluates goal achievement and nursing interventions

1 2 3 4 5

5. Based on evaluation of plans, alters them as needed to address client needs

1 2 3 4 5


2. Uses research methods to obtain data for determining the best nursing care available

A. Uses various sources to obtain nursing clinical data

1 2 3 4 5

B. Incorporates evidenced based information in the plan of nursing care

1 2 3 4 5

C. Presents data that can be utilized in designing nursing care plans

1 2 3 4 5

D. Uses APA format in presenting written sources of clinical data

1 2 3 4 5




3

BEHAVIORAL OBJECTIVES 5th

Week 7th

Week

STRENGTHS AREAS FOR

IMPROVEMENT

FINAL GRADE RATING SCALE (CIRCLE ONE)

3. Provides therapeutic nursing care in a variety of settings

A. Provides nursing care to individuals 1 2 3 4 5

B. Provides nursing care to families 1 2 3 4 5

C. Provides nursing care to aggregates or communities

1 2 3 4 5

D. Provides care but also evaluates and revises plan of care for a more therapeutic environment

1 2 3 4 5


4. Identifies areas of instruction needed by the client that will aid in development of health promotion and health maintenance of self-care activities

A. Is able to assess and provide for the educational needs of the client

1 2 3 4 5

B. Collaborates with the family to design, provide and evaluate an educational plan for the client and family

1 2 3 4 5

C. Designs educational sessions appropriate to the learning abilities of the client and family

1 2 3 4 5

D. Demonstrates the effectiveness of knowledge acquisition of the client, family or community

1 2 3 4 5


5. Uses effective written, verbal and nonverbal therapeutic communication skills.

A. Verbal- is able to use proper therapeutic communication skills with individual, family, aggregates and community

1 2 3 4 5

B. Nonverbal- is able to use proper therapeutic non verbal communication skills when caring for patients and their families

1 2 3 4 5

C. Written- is able to use proper written communication skills in English in nursing notes, reports, patient instructions and presentations

1 2 3 4 5

D. Speaks and writes in a professional manner

1 2 3 4 5


6. Role Development as leaders, manager and patient advocate

A. Demonstrates an accountability to agency and college protocols

1 2 3 4 5

B. Demonstrates an accountability for client/ family well being

1 2 3 4 5

C. Demonstrates and understanding of being accountable for ones own professional and self development

1 2 3 4 5

D. Shows proper leadership styles depending on the nursing care or professional situation

1 2 3 4 5

Others behaviors and comments

TOTAL RATING SCALE:



4

FINAL GRADE CALCULATIONS: Second Year Level I Third Year Level II

Fourth Year Level III

1-Rating for objective: 1A (11-55) _____ + B (5-25) _____ = X 0.45 X 0. 30 X 0. 15

2-Rating for objective: 2 (4-20) = X 0.11 X 0. 20 X 0..20

3-Rating for objective: 3 (4-20) = X 0.11 X 0. 15 X 0. 15



6- Rating for objective: 6 (4-20) = X 0.11 X 0. 10 X 0. 20

20-180 TOTAL 100% 100% 100%

Note: Any rating below "3" in the final evaluation constitutes a failure in this course.

Grades Letter Grade Percentage of Class Points A 91 - 100% B 84 - 90 % C* 76 - 83 % D 68 - 75 % F 67 or Less *Minimum passing grade for all nursing classes is a 76%.



5

INSTRUCTIONS FOR USE

EVALUATION METHOD: 1. Use the key to rate each of the behavioral objectives on the tool. 2. Enter the numerical rating that most accurately describes your perception of the

student's performance. 3. Clarify your ratings, both positive and negative, with examples of student performance

in the comments section. 4. Share your ratings in an evaluation conference with the student at the end of the clinical

rotation.

RATING SCALE KEY Rating Behavior

5 Consistently demonstrates knowledge and behaviors in a manner which reflects a superior level of competence. Performance is independent, accurate and complete. (Creativity, initiative, systematic, resourceful, knowledge in depth)

4 Consistently demonstrates knowledge and behaviors in a manner which reflects an above average level of competence. Performance requires minimal assistance from instructor. (Efficient, organized, goal director)

3 Consistently demonstrates knowledge and behaviors in a manner which reflects an average level of competence. Performance requires moderate assistance from instructor; it is acceptable but needs strengthening. (Basic knowledge, but without breadth and depth beyond assigned content)

2 Inconsistently demonstrates knowledge which reflects below average level of competence. Performance requires step by step assistance from instructor or staff nurse. (Inaccurate, incomplete, unable to reflect basic knowledge)

1 Consistently demonstrates knowledge of behavior which reflects dangerous level of incompetence. Tasks are not completed and performance is unsafe. Cannot identify areas of need and does not benefit from special guidance. (Does not have basic knowledge, below level of safety, unaware).

Definition of terms in scale:

Knowledge/ Behaviors:

Course objectives which define course content.

Competence: Judgment, safety, prediction, anticipation

Consistency: Regular, routine pattern of behavior observable over a period of time.

Inconsistency: Erratic unpredictable patterns of behavior.



6

1. USES EFFECTIVE THERAPEUTIC COMMUNICATION SKILLS Strength Improve

1A. DEMONSTRATES WRITTEN COMMUNICATION SKILLS

Examples of the behavior include, but are not limited to: Week Week

5 7 10 5 7 10

1. Records pertinent subjective and objective information accurately, promptly, legibly, and concisely in a format that is grammatically correct and conforms to agency policy.

2. Uses correct medical terminology.

3. Demonstrates application of the nursing process in written charting.

1B. DEMONSTRATES VERBAL THERAPEUTIC COMMUNICATION

Examples of the behavior include, but are not limited to:

1. Develops an effective relationship with individual clients or groups as evidenced by:

a. Communicates facts, ideas, and feelings clearly.

b. Focuses on clients and family’s feelings, thoughts, and behavior during interactions.

c. Interacts with client to focus client on psycho dynamics and issues.

d. Conveys an attitude of acceptance and empathy.

e. Displays a non-judgmental attitude during the nurse client interaction.

f. Uses appropriate non-verbal communication techniques (paraphrasing, reflecting).

g. Uses appropriate non-verbal communication techniques (gestures, facial expressions).

h. Listens receptively.

i. Communicates to client on the level of the learner using appropriate terminology.

j. Examine and monitor the effect of their own attitudes, values, and behavior on the client/group.

k. Gives appropriate explanation when needed.

l. Develops skill in diagnosing and responding therapeutically to alter communication common among clients

m. Conducts mental status evaluation.

n. Uses self as a therapeutic tool.

2. Participates in pre and post clinical conferences, multi-disciplinary staff meetings.

3. Reports on and off to staff in an organized, concise, and accurate manner.



7

4. Reports to appropriate person when a change in the client’s condition

is noted.

5. Other:

Comments:

2. DEMONSTRATES SKILL IN UTILIZATION OF THE NURSING PROCESS AS A FRAMEWORK FOR DEVELOPMENT OF A NURSING PLAN OF CARE.

Strength Improve

2A. DEMONSTRATES CORRECT ASSESSMENT SKILLS:


5 7 10 5 7 10

1. Uses appropriate interviewing techniques for obtaining historical information from client.

2. Uses a systematic approach to collect biological, psychosocial, cultural, spiritual, and developmental data to use as a basis for assessment including mental status, assessment of ADL’s and DADL’s.

3. Uses content from the conceptual models of psychiatric care to perform a neurobehavioral assessment.

4. Uses, when appropriate, physical assessment techniques to assess physiological systems, integumentary, musculoskeletal, neurological, cardiovascular, respiratory, GI, rental, and HEENT systems.

5. Distinguishes between normal and abnormal findings in both subjective and objective database as appropriate for developmental age.

6. Analyzes subjective and objective data to determine a prioritized list of DSM IV and nursing diagnosis.

7. Distinguishes normal physiological and psychosocial changes associated with psychiatric population.

8. Assess the ability of both client and family to engage in self-care.

9. Performs appropriate daily assessments individualized to the client’s psych diagnosis, changing conditions, and nursing care needs.

10. Assess laboratory data for relevance to client’s medical diagnosis, current status, and nursing care needs.

11. Assess client’s nutritional needs.

12. Recognized hazards to client’s and family’s safety.

13. Assess the family’s strengths and weaknesses in coping with the health care needs of client.

14. Completes weekly journal assignments that contains daily goals and objectives, and excerpts from client interactions that reflect therapeutic communication.

15. Other:

Comments:



8

2B. DEVELOPS A PLAN OF CARE BASED ON ASSESSMENT DATA: Strength Improve


5 7 10 5 7 10

1. Develops a client care plan utilizing prioritized nursing diagnosis adapted to individual client needs.

2. Identifies realistic client focuses, and measurable goals.

3. Involves both client and family in development of short and long term goals.

4. Other:

Comments:

2C. IMPLEMENTS PLANS AS APPROPRIATE TO CLIENT SITUATION:

Examples of behavior include, but are not limited to:

1. Demonstrates competence in selected psychomotor skills learned in fundamental skills course as:

A. Administers medications safely by:

a. Stating classification, action, reason for use, and adverse effects for each medication before administering.

b. Calculate drug dosages accurately.

c. Charting client response to medications.

d. Accurately checking client identification

e. Identifying factors related to client age, diagnosis, and current status that may change response to administered medication.

f. Identify and implement assessment parameters to monitor client response to medications.

g. Completes medication quizzes.

B. When institutional policy does not allow the administration at medications by nursing students, students will demonstrate knowledge of the above.

2. Demonstrates knowledge of specific psychiatric treatment modalities such as psychotherapy, cognitive therapy, electro-convulsive therapy, and group process.

3. Demonstrates understanding of the common defense mechanisms used by psychiatric clients.



9

4. States scientific rationale for all nursing interventions.

5. Prepares client for all nursing interventions required for selected diagnostic and therapeutic procedures.

6. Identifies and implements nursing interventions required for selected diagnostic and therapeutic procedures.

7. Collaborates with client and family to identify self-care learning needs.

8. Develops a teaching plan that is appropriate to client’s age, educational level, and cultural background.

9. Uses independent nursing judgments appropriate to level.

10. Seeks guidance from instructor appropriately.

11. Uses research findings to provide a basis for development of nursing interventions.

12. Uses appropriate therapeutic interventions for psychiatric diagnosis.

13. Other:

Comments:

2D. EVALUATES GOAL ACHIEVEMENT AND NURSING INTERVENTIONS

Strength Improve

Examples of behavior include, but are not limited to: Week Week

5 7 10 5 7 10

1. Evaluates client response to nursing interventions and environment.

2. Evaluates client goal achievement in an ongoing manner as a basis for adapting nursing care.

3. Adapts nursing care to meet client goals effectively.

4. Evaluates client and family learning to provide education.

5. Updates client care plan based on evaluation as appropriate to clinical setting

6. Other:

Comments:



10

3. IDENTIFIES AREAS OF INSTRUCITON NEEDED BY THE CLIENT THAT WILL AIDE IN THE DEVELOPMENT OF SELF-CARE ACTIVITIES AND PROMOTION OF HEALTH

Strength Improve


5 7 10 5 7 10

1. Collaborates with staff to identify self-care learning needs of the client during hospitalization and for discharge.

2. Applies appropriate principles of learning and teaching in client care.

3. Teaches correct principles, procedures and techniques of health care status when appropriate.

4. Informs client about his/her health care status when appropriate

5. Teaches client and family stress reduction techniques.

6. Develops and implements a teaching plan that is realistic to the client’s situation related to his value system and psycho-socio-cultural and educational background.

7. Collaborates with the client and staff in setting short and long term teaching goals.

8. Uses resources appropriately during the planning and implementation of the teaching plan.

Comments:



11

4. DEMONSTRATES BEGINNING MANAGEMENT AND LEADERSHIP

SKILLS: Strength Improve


1. Notifies instructor or appropriate staff member of changes in the client condition.

2. Admits, discharges and transfers clients according to hospital policy/procedure.

3. Organizes the administration of medications according to established priority of needs for 1-2 clients

4. Identifies the roles of health care team or staff members who support the organization of clinical activities.

5. Identifies appropriate health or social resources in the community and in the hospital.

6. Maintains flexibility and changes organizational strategies in response to changing client needs.

7. Organizes work priorities to conserve energies of client(s) and self and completes assignment efficiently and in a timely manner.

8. Works effectively in peer group work by contributing ideas, knowledge and assistance.

9. Verbally contributes to clinical conferences and / or group discussions though sharing of appropriate experiences and ideas.

10. Assista group to evaluate work accomplished and plan continued work.

11. With guidance uses the decision making process correctly in caring for the client.

12. Seeks instructor/staff assistance appropriately in providing care to clients.

13. Evaluates interaction of multidisciplinary team.

14. Participates proactively according to agency protocols in client care conference and treatment/planning sessions.

15. Collaborates with other members of the interdisciplinary team such as the psychiatrist, psychologist, psychiatric social worker, occupational therapist, and physical therapist.

16. Notifies clinical instructor and facility, or department if late or ill. If unable to notify clinical instructor you must notify the school.

17. Communicates with clinical instructor and facility staff of whereabouts at all times.

18. Other:

Comments:



12

5. DEMONSTRATES PROFESSIONAL RESPONSIBILITY AND ACCOUNTABILITY IN CARING FOR CLIENT IN VARIOUS HEALTH SETTINGS.

Strength Improve

5A. THE STUDENT WILL BE ACCOUNTABLE TO AGENCY AND COLLEGE PROTOCOL:


1. Demonstrates professional dress at all times according to school policies as written in student handbook.

2. Arrives to clinical unit and clinical conference on time or contacts clinical instructor, facility personnel, or school of nursing before scheduled time when unable to meet time commitments.

3. Attendance in clinical is in compliance with school policies as written in the student handbook.

4. Follows hospital policies and procedures and accepted standards of care.

5. Hands in clinical assignments on time in compliance with school policies as written in student handbook and provided in course syllabus.

6. Is prepared for clinical as evidences by preparation of all clinical forms, knowledge of medications, and prioritizing of nursing care needs.

7. Other:

5B. THE STUDENT WIL BE ACCOUNTABLE FOR SELF-DEVELOPMENT:

1. Uses clinical time to enhance own learning.

2. Demonstrates self-initiative by identifying daily goals and objectives or learning needs to clinical instructor.

3. Elicits feedback from instructor to enhance own learning.

4. Participates in constructive evaluation of self, faculty , and clinical site.

5. Recognizes how own values and values of others influence care of the client.

6. Accepts values of others that differ from student’s own value system.

7. Accepts responsibility for own nursing actions.

8. Provides for privacy for client and family.

9. Identifies advocacy roles.

10. Uses awareness of self as a basis for understanding basic communication.

11. Other:

Comments:



13

5C. THE STUDENT WILL BE ACCOUNTABLE FOR ENSURING CLIENT / FAMILY WELL BEING (SAFETY, ETHICO-LEGAL STANDARDS OF CARE):

Strength Improve


5 7 10 5 7 10

1. Recognizes hazards to client safety and takes appropriate action to maintain a safe environment.

2. Puts side rails up and bed down and call bell within reach when client is in bed, has been medication or has receive an anesthetic.

3. Restrains client safely when indicated.

4. Checks client identification before administering medications or performing medical/nursing procedures.

5. Administers medical/nursing treatments safely and accurately.

6. Administers medications within prevailing ethico-legal standards of care.

7. Performs technical skills correctly and safely on a consistent basis.

8. Alerts client to hazards in the immediate environment.

9. Investigates unfamiliar medications, therapies, equipment used in the treatment of the client.

10. Maintains confidentiality of client information.

11. Shares client information only with appropriate health team members, instructor, and in group clinical post conferences.

12. Uses only client initials on any papers/discussions containing client information.

13. Adheres to HIPAA guidelines.

14. Fulfills commitments made to clients, families, peers and faculty.

15. Notifies faculty, peers, clients, staff and/or families when unforeseen events inhibit or preclude completion of responsibilities.

16. Provides accepted standard of care regardless of differences of client’s/family’s when ethno-cultural background, health maintenance practices, beliefs of social status.

17. Stays with assigned clients or knows where and how they are:

18. Visits all assigned clients to ascertain their condition before beginning tasks of the day.

19. Knows where clients are, reasons for their being off the ward or away from the bedside, and when they are expected to return.

20. Knows current condition, as well as changes in past 24 hours, of all assigned clients, and can report plans for care of each.

21. Recognizes the position of clinical agencies regarding informed consent.

22. Identifies situations that require ethical decision making.

Comments:


01/2010 Page 19

NURS 214L 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 non-didactic 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 e-mail 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: Printed First Name: Signature: Date:


1/2010 Page 1

PART B: COURSE OUTLINE: NUR 214L Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client Practicum

WEEK DATE

WEEKLY OBJECTIVES WEEKLY CONTENT ASSIGNMENTS,

PAPERS DUE, TEST SCHEDULE

1/2 1. Discuss the importance of using physical assessment/sensory alterations to determine the overall health care status of the mentally ill client.

2. Differentiate between mental health and mental illness.

3. Assure safety of client/self through adherence to organizational safety processes.

4. Demonstrate knowledge of legal issues/policies in mental health regarding involuntary seclusion, safe application of restraints and medication administration.

5. Examine personal assumptions and concepts about mental health and illness.

6. Increase awareness of personal feelings, values, beliefs, and fears about mental health and illness, and working in a psychiatric setting.

7. Participate in appropriate unit activities. 8. Apply the nursing process and group

dynamics to individuals and groups of clients.

Identify legal status of at least 2 clients; discuss the basis upon which the status rests 1:1 with at least 2 clients utilizing Therapeutic Communication techniques Identify the Therapeutic Modalities utilized in the nurse-client relationship

Text readings: Kneisl Chps. 1, 6, 11, 2, 3, 5, 7, 9, 32, 8, 10, 30, & 29 ATI Review book and DVD’s


1/2010 Page 2

3/4 1. Identify composition and scope of practice of the multidisciplinary team involved in psychiatric care.

2. 10. 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.

3. Define the following terms: Incompetence, confidentiality, privileged communication, and malpractice.

4. State the nature and goal of therapeutic communication in the therapeutic nurse-client relationship.

5. Discuss personal qualities one needs to be an effective helper. Do these differ from leader qualities?

6. Demonstrate therapeutic strategies; include coping mechanisms & identify defense mechanisms.

7. 15. Relate the premises of humanistic interaction and other theories to psychiatric nursing.

Describe the components of Self Concept and identify your perception of the self concept held by at least 2 of your clients List the medications that 2 of your clients are taking Identify at least one client with a substance related diagnosis Identify at least one client with an Eating Disorder or with who has the potential for developing this type of disorder

Text readings: Kneisl Chps. 32 ATI review book and DVD PHARMACOLOGY Chps. 15, 21

5/6 1. Describe the components of psychiatric evaluation and describe dynamics that may motivate a client’s behavior.

2. Examine how self-care requirements are influenced by psychiatric illness.

3. Discuss common transitions for mental health clients specifying challenges and

Discuss: Personality Disorders, Somatoform Disorders, Anxiety Disorders, and Disassociative Disorders Identify clients with these diagnoses and discuss at least one presenting behavior that is consistent with the diagnosis

Text readings: Kneisl Chps. 22, 18, 19, (pp. 478-491) ATI reviewbooks, DVD and practice tests Text readings: Kneisl


1/2010 Page 3

opportunities for change utilizing change theory/problem solving with appropriate nursing actions.

4. Discuss the philosophy and approaches to care used in the hospital or community setting where the student is practicing.

5. Show beginning skill in assessing the mental status and overall health status of selected clients.

6. Describe situational role changes/body image changes as associated with the developmental process.

7. 22. Demonstrate leadership abilities by acting in a leadership role for one clinical day of the rotation with either the charge nurse or the nursing instructor’s supervision.

Discuss: Disturbance of Mood Grief/Loss, Depression & Suicide, Bipolar Disorder

Chps. 17 & 23

7/8 1. Describe the various types of coping. 2. Relate the phases of the nurse-client

relationship to the nursing process. 3. Identify qualities of effective psychiatric

nurse; observe and analyze therapeutic communication strategies.

4. Demonstrate skill in assessing the mental health and overall health status of an assigned client and prioritize nursing diagnoses.

5. In simulated patient situations, identify a therapeutic response by the nurse.

6. Demonstrate the application of the nursing process to psychiatric clients.

7. Demonstrate increase

Discuss: Schizophrenia (Disturbance of Thought) and Dementia Vs Delirium (Disturbance of Cognition)

Text readings: Kneisl Chps.


1/2010 Page 4

autonomy/accountability in the initiation of a therapeutic 1:1 interaction with client.

8. Describe confusion and disorientation; define and employ psychiatric terms.

9. Identify and discuss general treatment modalities for mental illness.

10. Discuss nurse leader roles and impact on care.

11. Identify DSM IV and nursing diagnoses. 12. Identify developmental states and tasks

of individual and family life cycles. 13. Describe cultural relativism and

ethnocentrism and the implications of each for psychiatric nursing care.

14. 14. Observe the influence of culture, age, sexual orientation, spirituality and family on a client’s psychiatric care.

9 1. Recognize the psychiatric nurse’s role in data collection, diagnosis, planning, implementation, evaluation and accountability.

2. Define an ethical dilemma and discuss one that arises in psychiatric nursing practice.

3. Discuss the characteristics of an effective nurse manager in a mental health setting, include decision making, problem solving, delegation and supervision strategies.

4. Identify ways nurses can serve as leaders in community and hospital mental health settings.


1/2010 Page 5

5. Describe various models of community mental health nursing and the process of referrals.

6. Identify the means by which collaboration and conflict resolution occurs and observe roles of multidisciplinary team in psychiatric settings.

7. Identify the trends and challenges facing mental health care today.

8. 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.

9. Identify the common civil and personal rights retained by psychiatric clients.

10. Analyze the moral, legal, and psychiatric implications of involuntary commitment, including the issues of assessing a client’s dangerousness and freedom of choice.

11. Utilize information technology in the provision of safe client care data and maintain confidentiality of this data.

12. Utilize the TV monitors on the unit to observe and maintain client safety.

13. Discuss how a “caring” approach by staff can reduce an organization’s liability.

14. Describe the responsibility of the psychiatric mental health nurse in regard to incident reporting.

Documents

WEST COAST UNIVERSITY DEPARTMENT OF …n204xn214l.pbworks.com/f/NURS+214L+PART+A+B+0110.pdfWCU NURS 214L Mental Health/Psychiatric Nursing: Promoting Wellness in the Mentally Ill Client