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BAKERSFIELD COLLEGE ASSOCIATE DEGREE NURSING PROGRAM NURSING B25: CURICULLIM OBJECTIVES AND ACTIVITIES GUIDE INTRODUCTION update Spring 2012 Course expectations and level objectives are established to help guide the student to successful completion. The student will be building on the content received in their first semester of the nursing program. The focus, as we begin Psychiatric Mental Health Nursing, for level 2 is to develop a theoretical and technical knowledge base to care for individual clients and families in a variety of psychiatric settings across the lifespan. Clinical experiences correlate with theoretical concepts from Nursing B25. OBJECTIVES Upon completion the student will be able to: A. Activity: Theory 1. Review the level objectives introduced in first semester courses. 2. Discuss course objectives and course student learning outcomes for Psychiatric Mental Health Nursing. 3. Define course activities, policies and testing procedures for Nursing B25. 4. Relate grading procedures to successful outcome. 5. Discuss participation in B25 remediation. 6. Recognize student participation and responsibility in learning. 7. Describe the use of the unit objectives as a guide in their study. 8. Evaluate theory course at the end of the semester Print syllabi from instructor web page Review student handbook Obtain required texts Consider recommended text Participate in Community Project 1 Journal weekly Insure access to ATI Attend at least one (1) NAMI Meeting prior to final exam: general meeting Bakersfield Chapter meeting 3rd Monday each month scheduled Feb. 20, March 19 and April 16 OR NAMI Frontline Conference Clinical 9. Examine the specific learning activities as well as the evaluation criteria used to measure the student's competence in performing nursing skills for the Psychiatric Mental Health clients. 10. Maintain the Performance Checklist. 11. Actively journal during clinical rotation 12. Maintain portfolio Activity: Print clinical manual from web page Review student handbook regarding clinical guidelines Participate in orientation Complete communication workshop per schedule for clinical group Attend 12-Step CD meeting time and date of choice during clinical rotation Attend 1 other CD meeting time and date of choice during clinical rotation Facilitate 2 groups with at least 3 clients within scope of nursing practice 2 Complete 1 individual teaching project Complete 1 mini psychosocial assessment on a client daily Complete 1 process on a client intervention pass with at least 80% Complete 1 psychosocial assessment on a client with at least 80% Journal each clinical day with focus on perception, communication and feelings Participate in pre and post clinical conference Make up all missed clinical hours Participate in clinical evaluation 3 Unit I – Professional Issues and Nursing Practice The goal of this unit will be to define, describe and apply the legal, ethical and professional principles by utilization of the nursing process for clients with mental health disorders. The focus of this unit is to prepare students so they will be less fearful and more open to the psychiatric experience. The unit contains multiple patient situations to establish relevance in applying the nursing process to clinical practice. The role of the Psychiatric Mental Health nurse as provider of care, manager of care and member of a profession will be explored. Column I Column II Column III Column IV Theory Objective/ Outcomes Learning Activities Clinical Objectives/ Outcomes Clinical Activities (Expected Competencies/ Skills) Read chapter 27 prior to 1st clinical experience Tour facility Begin to journal/document thoughts and feelings from experience Practice a mental status exam Practice a concept map Participate with patient’s rights advocate Refer to Patient’s Rights Handbook Participate in HIPPA review 1. Define and describe psychiatric mental health nursing including role and practice standards. 2. Introduce and define Advocacy, Caregiver, Delegation, Teacher, and Communicator. 3. Compare mental health to mental illness. Complete chapter reviews Read & begin to learn coping mechanism: study guide from syllabi 4. Describe treatment settings for individuals with mental illness. 5. Describe experiences, feelings, beliefs and attitudes on issues related to mental illness. 1. Demonstrate openness to new experiences through self-evaluation. Read chapters 1,, 2, 5, 25 assessment pg 499 & communication pgs 510 to 512 and 26 2. Begin to utilize self as a therapeutic tool in an interpersonal context through expanding selfawareness. 3. Describe the treatment modalities of each clinical setting. Begin to recall past experiences and how they might effect PMHN learning 4. Identify professional, legal and ethical guidelines in the mental health setting and function within these standards. ATI (RN 7tthedition) unit 1-1; unit 1-2 5. Demonstrate nursing practice that reflects an understanding of and 6. Discuss the legal basis for 4 mental health treatment as it relates to the role of the nurse in mental health. sensitivity to the advocacy role of the Psychiatric Mental Health nurse. 7. Describe different members of multidisciplinary mental health team. 6. Maintain client confidentiality at all times. 8. Discuss the purpose and use of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision. 9. Describe the multiaxial classification system. 10. Discuss cultural and spiritual considerations 11. Discuss leadership & management applications 5 Unit 2A – Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 A: Unit 2 A reviews the Central Nervous System, brain imaging techniques and introduces psychiatric medications prescribed for mental health disorders. Psychiatric medications are categorized by type, disorders treated by each type, and the action, use and adverse effects of these medications. Nursing responsibilities and teaching opportunities are identified when administering psychiatric medications. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes Column II Learning Activities Read chapter 4 pages 45 to antipsychotics page 57 1. Review and discuss structures, process and functions of the CNS. 2. Identify pertinent teaching for clients and families about brain imaging techniques. 3. Describe how psychotropic medications are used in the collaborative management of mental illness. 4. Explain the common psychiatric medications including: action, use, and adverse reactions. 5. Explain the nursing responsibility related to Column III Clinical Objectives/ Outcomes 1. Recognize commonly prescribed psychotropic medications Begin chapter review ` CM Medications Issues in Mental Health 636 series o Pre tests o View videos o Complete post test with 80% competency Complete “brain” drawing assignment per instructor guidelines Recall legal and ethical information from chapter 26 Complete 3 medication case profiles from packet as assigned in group Serotonin syndrome Hypertensive crisis Neuroleptic Malignant syndrome 6 2. Observe reactions and evaluate response of selected clients to prescribed medications 3. Observe and discuss side effects of psychotropic medications 4. Observe and discuss difference between behavioral symptoms of mental and side effects of psychotropic medications 5. Participate in patient teaching about prescribed psychotropic medications 6. Discuss under what circumstances clients may or may not refuse prescribed Column IV Clinical Activities (Expected Competencies/ Skills) Recall CM Movement Disorders Observe and/or perform AIMS test on peer or faculty Review conservator ship and voluntary and involuntary admissions as related to medication administration Pass medication test 100% prior to giving medication in clinical Observe and discuss psychopharmacologic treatment modalities. medication 7. Master leveled medication exam 6. Discuss cultural and identified movement do of clients with pees and instructor Participate in safety lecture and demonstration of IM & Z track procedure for the psych client spiritual considerations. 7. Evaluate own experiences, feelings, attitudes and beliefs. 8. Acknowledge evidence Demonstrate recall of these IM proceduress & state rationale for procedure based information as presented. 9. Discuss leadership & management applications 7 Unit 2B - Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 B: Unit 2 B provides an overview of therapeutic communications, the use of the mental status exam as a tool for assessing mentally disordered clients and utilization of the nursing process in the mental health setting. This unit also introduces the nursing student to various theories and treatment modalities including group and milieu therapy and the value of the therapeutic relationship. Column I Theory Objective/ Outcomes 1. Demonstrate components of the therapeutic communication process. 2. Contrast effective and ineffective communication techniques. 3. Discuss the use of the nursing process in the psychiatric setting including assessment, outcome identification, nursing diagnoses, intervention and evaluation. 4. Describe and discuss therapeutic non pharmocological treatment in the mental health setting. Column II Learning Activities Column III Clinical Objectives/ Outcomes 1. Demonstrate increasing Read chapters 3, 6, 7, 25 pgs 499-501 effectiveness in the use of therapeutic communication techniques. Complete chapter reviews 2. Demonstrate healthy personal and professional boundaries as a student nurse in the psychiatric health care setting. Recall concepts of CM Communication Techniques from clinical workshop 3. Obtain and organize psychosocial assessment data to use as a basis for planning nursing care and document findings. Review cultural assessment In back of text Review spiritual assessment 4. Perform a mental status ATI 1-3; 1-4; 1-6; 1-7; 1-8 assessment on selected clients. 5. Identify the psychosocial 5. Apply the nursing process to theory on which treatment strategy is based. 6. Discuss key ingredients of a therapeutic relationship. the care of selected clients in the psychiatric/mental health setting. 6. Identify components of 8 Column IV Clinical Activities (Expected Competencies/ Skills) Review scope and standards of care Begin using communication strategies to complete a mental status exam CM Communication series o Take pre tests o View videos o Complete communication workshop w/faculty o participate in debriefing o Post test with 80% competency Role play with peers/faculty Participate by discussion of observations of milieu in Post Clinical Conference therapeutic milieu. 7. Describe phases of therapeutic relationship. 7. Identify the use of therapeutic modalities in treatment while attending various clinical settings. 8. Identify cultural and spiritual considerations as it relates to care. 8. Describe the effect the 9. Evaluate own experiences, environment has on people including self. feelings, attitudes and beliefs 9. Identify role/ responsibilities 10. Discuss leadership & of inter multidisciplinary team (IDT) and paraprofessional personnel. management applications 10. Evaluate the milieu of various clinical sites. Identify safety and boundary issues and be prepared to discuss in clinical conference. 11. Interact and communicate effectively as an extension of the Inter Disciplinary Treatment Team. 9 Role play group process with faculty & peers Recall chapter 3 group reading & demonstrate ability to facilitate clinical group with clients Participate in discussion after viewing Mary Moller video on communicating with Clients suffering with hallucinations Unit 2C – Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 C: Unit 2 C will provide direction to assist the student in identification of sources and stages of conflict, conflicts unique to healthcare and resolution and problem solving related to this conflict in a healthy constructive way. As member of the profession the student will be directly involved with leadership activities that conflict resolution is needed. Column I Theory Objective/ Outcomes Column II Learning Activities Column III Clinical Objectives/ Outcomes 1. Review positive and negative aspects of conflict and four levels of conflict. 2. Discuss seven common sources of conflict. 5. Identify and observe 1. Read chapter 21 in Marquis & Huston 2. Participate in learning exercises in group as assigned 3. Recall anger & aggression techniques from Unit 2E and dynamics of each stage. 5. Demonstrate strategies for 4. review study guide from instructor’s web page conflict resolution. 6. Resolve conflict, applying problem solving technique. 7. Discuss leadership & management applications 10 7. Practice and role play scenarios. 4. List five stages of conflict 6. Identify and discuss impact conflict may have on clients. 3. Discuss four sources of conflict unique to health care. conflict in clinical settings and discuss this conflict in clinical conference. Column IV Clinical Activities (Expected Competencies/ Skills) Review reading prior to clinical 8. Function as team leader Complete Journal thoughts and feelings related to conflict with family, peers, instructors and co workers Debrif with instructor in post conference Recall anger & aggression techniques from Unit 2E. Unit 2D – Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 D: Unit 2 D introduces student to definitions of anxiety, levels of anxiety, and identifies the differences in stress, fear and anxiety, as well as adaptive and maladaptive coping. Column I Theory Objective/ Outcomes 1. Define anxiety and Column II Learning Activities differentiate among stress, fear and anxiety. 2. Discuss anxiety levels and physiological response. 3. Discuss adaptive/ maladaptive behavioral responses to stress, fear and anxiety. 4. Discuss adaptive coping strategies in the management of stress. Column III Clinical Objectives/ Outcomes 1. Recognize Read chapter 8 to anxiety do page 135 - 6 adaptive/maladaptive behavioral responses to stress, fear and anxiety. Use defense mechanism handouts in syllabi as study guide for exam 2. Interact with a client exhibiting signs of anxiety and identify the level of anxiety observed. Role play with peers and faculty how to work & communicate with an anxious client 3. Identify any coping ATI 1-5; 2-11; 4-32 feelings, attitudes and beliefs. Identify and document defense mechanisms used by client in psychosocial assessment. mechanism the client might be using to decrease anxiety. Discuss your own defense mechanisms used with day’s clinical experience 4. Identify own behaviors that Recall role play activity from theory in relationship to anxious clients might increase the client’s anxiety. 5. Evaluate own experiences, Column IV Clinical Activities (Expected Competencies/ Skills) Compare stress and anxiety of peers, staff faculty with clients and discuss defense mechanisms used by each in post clinical conference . 6. Discuss cultural and spiritual considerations. 7. Discuss leadership & management applications 11 Unit 2E – Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 E: Unit 2 E will introduce the student to anger, aggression, violence and assaultive behavior, therapeutic methods to manage this behavior and safety issues relevant to nursing practice when caring for the client who is exhibiting anger, aggression and violence. The student will be introduced to altered family patterns and effects on individuals in these families and factors that are thought to contribute to sexual assault, rape and abuse. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Identify psychiatric disorders that may be associated with increased risk of hostility and physical aggression. 2. Describe cycle of violence 3. Describe issues for nurses when working with angry, hostile or aggressive clients. 4. Discuss characteristics, risk factors and family dynamics of abusive and violent behavior. Column II Learning Activities Column III Clinical Objectives/ Outcomes Read chapters 18, 19 and 21 with children & 24 pgs 482-5 (impulse) 1. Apply the nursing process to Complete chapter reviews 2. Identify and promote survivors of abuse, violence and sexual assault. education for prevention and intervention of abuse, violence and sexual assault. Classroom case Participate in internet search of domestic violence statistics and local services Participate in classroom research on Bullying Column IV Clinical Activities (Expected Competencies/ Skills) Participate in role play about angy, manipulative and aggressive clients Read chapter 21 prior to attending clinical orientation and be prepared to role play with faculty & peers Observe in clinical anger and/or aggression of peers, clients or staff & note impact on milieu Observe & identify in clinical any factors of manipulation and discuss with faculty 3. Participate in IDT meeting or legal proceedings related to domestic violence or sexual assault. ATI 4-32; 4-33; 4-34 5. Examine incidence and trends in domestic violence, elder and child abuse. 6. Compare characteristics of 12 the batterer and the battered. 7. Define rape trauma syndrome. 8. Recall reporting requirements. 9. Discuss cultural and spiritual considerations. 10. Evaluate own experiences, feelings, attitudes and beliefs. 11. Acknowledge evidence base information as presented. 12. Discuss leadership & management applications 13 Unit 2F – Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 F: Unit 2 F introduces the student to clients in crisis and clients at risk for suicide and/or self harm and the interventions implemented to protect these clients. The student will be involved with a team charged with the care of clients in crisis, the nurse delegating roles. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Recognize clients at risk for suicide and/or self harm and implement interventions to protect these clients. 2. Recognize clients experiencing crisis and interventions needed Column II Learning Activities Column III Clinical Objectives/ Outcomes Read chapters 17, 20 and 25 pages 504 to 506 1. Perform lethality assessment on an assigned client. 2. Apply the nursing process to Role play with faculty & peers on how to work & communicate with suicidal client. the care of individuals and families affected by suicide. 3. Apply the nursing process to the care of individuals and families affected by crisis. 3. Discuss types and phases of crisis 4. Define and discuss lethality ATI 4-30; 4-31 Participate in classroom case on crisis in packet handout 5. Recall ethical and legal responsibilities of the nurse in caring for a suicidal individual. 6. Recognize cultural and spiritual considerations. 7. Evaluate own experiences, feelings, attitudes and beliefs. 14 Column IV Clinical Activities (Expected Competencies/ Skills) Review lethality from reading Complete a concept map in post conference on client interviewed admitting to SI or in crisis. 8. Acknowledge evidence base information as presented 9. Discuss leadership & management applications 15 Unit 2G – Biopsychosocial Concepts Related to Health Care INTRODUCTION: Unit 2 G: Unit 2 G focuses on the needs of individuals and families who are homeless or have HIV and the relationship these issues have to mental illness. The student will describe de institutionalization, problems of homelessness of the mentally ill, and through use of the nursing process will be able to utilize community resources for treatment of the mentally ill living in the community. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Describe the concept of Column II Learning Activities deinstitutionalization. 2. Describe factors that contribute to homelessness and/or HIV. 3. Recognize cultural and spiritual considerations. 4. Evaluate own experiences, feelings, attitudes and beliefs. 6. Discuss leadership & management applications the psychiatric care when encountering a homeless or HIV inflicted individual or family. Participate in internet search project individually or in a group looking for data on individuals suffering with mental illness that also have HIV Classroom case Participate in internet search of homelessness and the relationship to mental illness Participate in internet search of individuals with HIV and the relationship to mental illness information as presented. 1. Apply the nursing process to Read chapter 24 to page 482, 25 pg 509 & 27 5. Acknowledge evidence base Column III Clinical Objectives/ Outcomes 2. Assess the needs of a homeless mentally ill person in the community and formulate an appropriate referral list of support services. 16 Column IV Clinical Activities (Expected Competencies/ Skills) Based on knowledge from study, comprise a concept map as a group in post clinical conference ( if a client on unit has housing in axis IV use them as model) In post conference discuss appropriate referrals for homeless and/or HIV effected individuals 17 Unit 3A – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 A: Unit 3 A introduces the prevalence, co morbidity, diagnostic criteria, theories and treatment of the anxiety disorders. The nursing process is applied. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes Column II Learning Activities Column III Clinical Objectives/ Outcomes 1. Identify the major anxiety Read chapter 8 starting page 135 anxiety do, chapter 4 page 63; chapter 23 page 465 1. Apply the nursing process Complete chapter review 2. Form a therapeutic disorders across the life span and recognize the common symptoms associated with each. 2. Evaluate treatment for the client with an anxiety disorder. to a client experiencing an anxiety disorder. relationship with a client diagnosed with an anxiety disorder. View CM videos on anxiety disorders Complete classroom 3. Prepare and administer 3. Discuss three classes of medication appropriate for anxiety disorders. medication to an individual diagnosed with an anxiety disorder and document appropriately. Continue to recall levels of anxiety and defense/coping mechanisms 4. Evaluate own experiences, feelings, attitudes and beliefs. 5. Identify cultural and Participate in research project Trichotillomania ATI 2-11; 3-13; 4-19 spiritual considerations. 6. Acknowledge evidencebased practice material as presented. 18 Column IV Clinical Activities (Expected Competencies/ Skills) Review reading Review coping mechanisms learned earlier and identify with assigned patients Review treatment options including medication management Recall communication techniques when working with anxious clients Complete concept map on a client diagnosed with an anxiety do 7. Discuss leadership & management applications 19 Unit 3B – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 B: Unit 3 B introduces the prevalence, co morbidity, diagnostic criteria, theories and treatment of the mood disorders. The nursing process is applied. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Identify the mood disorders across the life span and recognize the common symptoms associated with each. 2. Evaluate treatment for the client with a mood disorders. 3. Evaluate own experiences, feelings, attitudes and beliefs. 4. Identify cultural and spiritual considerations. Column II Learning Activities Chapter 12 & 13; chapter 23 page466-7; chapter 25 page 502-4; 4 pages 60 to 63 1. Apply the nursing process to a client experiencing a mood disorder. Complete chapter review 2. Prepare a teaching plan for a client taking a MAOI including foods and drugs that are contraindicated. View CM videos Mood disorders Complete case Recall lecture on suicide from Unit 2F Participate in research project ECT 5. Acknowledge evidencebased information as presented. Column III Clinical Objectives/ Outcomes ATI 2-12;3-14; 3-15; 4-24; 4-25;4-36;4-37 3.Establish a therapeutic relationship with a client diagnosed with a mood disorder. 4.Prepare and administer medication to an individual diagnosed with a mood disorder and document appropriately. Column IV Clinical Activities (Expected Competencies/ Skills) Review medications from reading and video Complete appropriate documentation in a clinical setting of a client suffering from a mood disorder Complete concept map on client diagnosed with a mood disorder Present MAOI teaching plan in pre or post conference 5. Review other treatment options for clients suffering from a mood disorder 6. Discuss leadership & management applications 7. 20 21 Unit 3C – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 C: Unit 3 C introduces the prevalence, co morbidity, diagnostic criteria, theories and treatment of the Schizophrenias. Adverse effects of the antipsychotic agents are discussed. The nursing process is applied. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Define schizophrenia and differentiate distinguishing characteristics. 2. Describe the symptoms and the chronic course of this illness. 3. Differentiate between Column II Learning Activities Column III Clinical Objectives/ Outcomes 1. Assess the client diagnosed Read chapter 14; chapter 4 page 57 to 60 Complete chapter review View CM videos on schizophrenia Complete classroom Role play with faculty and peers on working & communicating with a hallucinating, confused and/or psychotic client with schizophrenia for therapeutic effects, side effects & adverse effects of antipsychotic medications. 2. Using therapeutic communication, interact with a client who is experiencing hallucinations, delusions or other psychotic behavior. negative and positive symptoms. 4. Evaluate treatment for the schizophrenias. 5. Evaluate own experiences, feelings, attitudes and beliefs. 3. Perform a mental status exam on an individual diagnosed with schizophrenia or schizoaffective disorder. 4. Analyze and interpret ATI 3-16; 4-26 assessment data and infer the appropriate nursing diagnoses. 6. Identify cultural and spiritual considerations. 7. Acknowledge evidence- Participate in internet search of nicotine r/t mental illness 5. Apply the nursing process to the care of a client diagnosed with schizophrenia or based information as presented. 22 Column IV Clinical Activities (Expected Competencies/ Skills) Recall Mary Moller video on Communicating with Hallucinating Individuals from clinical orientation Role play with faculty and peers Review medication management from reading & videos viewed Recall information seen on CM video of Managing Movement Disorders from clinical orientation Complete concept map on individual with schizophrenia schizoaffective disorder. 8. Discuss leadership & management applications 6. Establish a therapeutic relationship with a client diagnosed with schizophrenia or schizoaffective disorder. 9. Compare schizoaffective disorder to schizophrenia 23 Unit 3D – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 D: Unit 3 D introduces the nursing student to individuals across the life span who has issues related to substance use and abuse. Addictions are also introduced. DSM IV-TR criteria for substance abuse and substance dependence and treatment modalities is presented. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Differentiate between substance abuse and substance dependence, using criteria identified in the DSM-IV-TR. 2. Discuss the nurse’s responsibility related to an impaired colleague. Column II Learning Activities Column III Clinical Objectives/ Outcomes Read chapters 16; 25 pages 506 to 509 1. Apply the nursing process to clients across the life span with substance-related disorders. Complete chapter review View Hazelton video Medical Aspects of Addiction in class substance abuse and mentally illness 4. Compare and contrast the nursing care given to individuals who have overdosed, are withdrawing from or have major health problems related to substance abuse. Complete a group concept map of a sub stance abusing client in post clinical conference Attend 2 chemical dependency meetings At least 1-12 step 2. Read 12-Step Program & principles & rationale behind process Complete classroom case 3. Discuss the co-morbidity of Column IV Clinical Activities (Expected Competencies/ Skills) Review detox information from chapter reading 3. Assess an individual’s use, Participate in research project Fetal Alcohol Syndrome &/or Chemically Impaired nurse abuse or dependence on substances. Include data from health history, demographics, physical exam, screening instruments, and laboratory tests. ATI 4-29 4. Assess the effects of alcohol or other drugs on the biological, psycho-social, cultural, cognitive & spiritual dimensions of clients. 5. Review and discuss case studies of impaired nurses. 5. Acknowledge appropriate 24 community resources for individuals with substancerelated disorders. 6. Discuss common nurse reactions (attitudes and resulting behaviors) to caring for clients with substance abuse. 6. Care for a client with a substance-related disorder in one of the treatment/clinical settings. 7. Evaluate own experiences, 7. Prepare and administer feelings, attitudes and beliefs. medication to a client in a treatment setting and document appropriately. 8. Identify cultural and spiritual considerations. 9. Acknowledge evidence-based information as presented. 10. Discuss leadership and management issues 25 Week 10: Oct 25 & 26 Unit 3E – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 E: Unit 3 E introduces the nursing student to personality disorders. Treatment modalities and nursing interventions are identified for patients with personality disorders. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Compare the personality Column II Learning Activities 1. Assess and care for a client Read chapter 10 disorders using DSM IV – TR diagnostic criteria. Complete chapter review 2. Discuss co morbid conditions View CM video diagnosed with personality disorders. Column III Clinical Objectives/ Outcomes Complete classroom case Recall Unit 3D Roll play with faculty & peers on how to work with & communicate with the manipulative client with a personality disorder in a clinical setting. 2. Analyze your own reactions to caring for clients with personality disorders and the influence of these reactions on client care. 3. Describe the current treatment modalities in managing the care of clients with personality disorders. 3. Analyze & interpret assessment data & infer the appropriate nursing diagnoses. 4. Discuss common nurse reactions (attitudes and resulting behaviors) to caring for clients with personality disorders. Participate with Self Mutilation/SIB research project 4. Apply the nursing process to the care of a client diagnosed with a personality disorder, focusing primarily on nursing diagnoses of ineffective coping, chronic low self- ATI 4-22 5. Evaluate own experiences, feelings, attitudes and beliefs. 26 Column IV Clinical Activities (Expected Competencies/ Skills) Review principles of manipulation and splitting Complete concept map of an individual diagnosed with a personality do in a group at post clinical conference Role play manipulation & splitting with faculty and peers esteem, impaired social interactions, & risk for selfdirected or other directed violence. Include rationales for nursing actions. 6. Identify cultural and spiritual considerations. 7. Acknowledge evidencebased information as presented. 8. Discuss leadership & management applications 5. Implement nursing interventions for ineffective coping, chronic low selfesteem, impaired social interactions, and risk for selfdirected and other directed violence; and evaluate whether the identified outcomes have been met. 6. Refer clients with personality disorder to appropriate community resources. 27 Unit 3F – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 F: Unit 3 F introduces the student to eating disorders and the major health problems related to eating disorders. Current treatment modalities and nursing interventions by use of the nursing process are introduced. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Compare the clinical symptoms of eating disorders using DSM IV-TR criteria. 2. Describe the current treatment modalities in managing the care of individuals with eating disorders. 3. Recall own experiences, feelings, attitudes and beliefs. 4. Identify cultural and spiritual considerations. Column II Learning Activities Column III Clinical Objectives/ Outcomes Read chapter 11 1. Assess a person diagnosed with an eating disorder for clinical symptoms. Complete chapter review View DVD ABCs of Eating Disorders in class 2. Analyze & interpret assessment data and infer the appropriate nursing diagnoses. Complete classroom case Recall SIB information from research project; suicide and defense mechanisms from previous units 3. Apply the nursing process to the care of a client diagnosed with an eating disorder, focusing primarily on the nursing diagnoses: Imbalanced nutrition < body requirements, disturbed body image, ineffective coping. Include rationales for nursing actions. ATI 4-23 5. Acknowledge evidencebased information as presented. 6. Discuss leadership & management applications 28 Column IV Clinical Activities (Expected Competencies/ Skills) As a group project in post clinical conference construct a concept map of an individual diagnosed with an eating disorder Unit 3G – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 G: Unit 3 G introduces student to somatoform disorders with an overview of onset, prevalence and etiology. . The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes Column II Learning Activities Read chapter 9 Complete chapter review 2. Discuss characteristics and Complete case dynamics of specific somatoform disorders. ATI 4-20; 4-21 1. Compare somatoform disorders using DSM IV-TR criteria and identify three central features. Column III Clinical Objectives/ Outcomes 1. Recognize individuals exhibiting somatoform symptoms. 2. Apply the nursing process to the care of clients with somatoform disorders. 3. Define malingering and factitious disorder. 4. Evaluate own experiences, feelings, attitudes and beliefs. 5. Identify cultural and spiritual considerations. 6. Acknowledge evidencebased information as presented. 29 Column IV Clinical Activities (Expected Competencies/ Skills) Review chapter material including potential medication management Assess pain of a client suffering from a somatic disorder Complete concept map on client diagnosed with a somatoform do 7. Discuss leadership & management applications Unit 3H – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 H: Unit 3 H introduces the student to alterations in sexuality. Possible etiologies, clinical manifestations, medical and nursing management of these disorders are presented. Nursing process is applied to assist individuals and families affected by alterations in sexuality. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes Column II Learning Activities Column III Clinical Objectives/ Outcomes 1. Review the developmental Read chapter 24 pages 485-8 1. Apply the nursing process stages of human sexuality through the life cycle. to the care of individuals or couples manifesting sexual needs. View videos on sexuality & discuss in class 2. Discuss the normal human sexual response. 3. Differentiate between 2. Demonstrate ability to Participate in research project Gender Identity DO conduct a sexual assessment and form a nursing diagnosis & interventions for the client. sexuality, sensuality, sex role, sex identity and gender identity. 3. Be aware of appropriate community resources available to individuals or families manifesting sexual needs. 4. Describe common sexual problems and intervention methods for men and women who seek therapy for sexual concerns. 5. Describe impact of medical surgical procedures which alter perception of sexuality and discuss anticipatory 30 Column IV Clinical Activities (Expected Competencies/ Skills) Review sexual assessment guidelines and questions recall feelings and biases in regards to sexuality, sex and relationships manage a client that is sexually inappropriate & discuss feelings in post conference guidance of individuals and family teaching. 6. Recall own experiences, feelings, attitudes and beliefs. 7. Identify cultural and spiritual considerations. 8. Acknowledge evidencebased information as presented. 9. Discuss leadership & management applications 31 Unit 3I – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 I: Unit 3 I describe the aging population in the United States and introduce the student to psycho-geriatrics. Alzheimer’s disease is discussed. Use of the mental status assessment is introduced as part of the nursing process when assessing and planning nursing care for the psycho-geriatric client. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes Column II Learning Activities 1.Discuss demographics of US Read chapter 15 & 25 pgs 497 - 501 aging population and the impact on mental health care. 2.Compare and contrast developmental tasks of aging with tasks of younger cohorts. 3.Differentiate between dementia, delusion and delirium Column III Clinical Objectives/ Outcomes 1. Perform a mental status assessment on healthy and cognitively impaired elders. Complete chapter review 2. Apply the nursing process to Recall clinical experiences in 1st semester in Geri in relationship to behaviors of clients dx with Alzheimer’s Dementia (LVN to RN-recall any previous experiences in relationship to Alzheimer’s Dementia) the individual diagnosed with Alzheimer’s Disease. 3. Attend a family/caregiver support group or prepare a teaching plan for a family caring for a psycho-geriatric client. 4.Discuss various theories of the nature and development of Alzheimer’s disease and the most currently accepted theories. 4. Prepare and administer ATI 3-17; 4-27; 4-37 medication to a psychogeriatric client and document appropriately. 5.Compare the signs and symptoms occurring in the four stages of Alzheimer’s 32 Column IV Clinical Activities (Expected Competencies/ Skills) Review medication management of medication prescribed to client taking in to consideration status and age Complete a concept map on a psychogeriatric individual and present in post conference Disease 6.Recall own experiences, feelings, attitudes and beliefs. 7.Identify cultural and spiritual considerations. 8.Acknowledge evidence-based information as presented. 9.Discuss leadership & management applications 33 Unit 3J – Nursing Practice for Psychiatric Disorders INTRODUCTION: Unit 3 J: Unit 3 J introduces the nursing student to mental health disorders seen in children and adolescents and the legal aspects of treating a minor with a psychiatric diagnosis. Treatment modalities and nursing interventions by utilizing the nursing process is covered. The roles of the provider of care, manager of care, and member of the profession are integrated to promote success in transitioning student from level 1 to level 2 meeting outcome criteria. Column I Theory Objective/ Outcomes 1. Identify DSM-IV psychiatric disorders in childhood and their characteristics. 2. Identify DSM-IV psychiatric disorders in adolescence and their characteristics. Column II Learning Activities Column III Clinical Objectives/ Outcomes Read chapters 23; 24 pages490-2, 27 pg 542 1. Apply the nursing process to the child and/or adolescent and their family with psychiatric disorders. Complete chapter study guide View CM videos ADHD , MR & Autism 2. Prepare and administer medication to a child or adolescent in a treatment setting. Review & discuss process for completing a genogram 3. Identify treatment modalities for the child or adolescent and their family with psychiatric disorders. 4. Discuss variations in the assessment process when working with this population. 5. Evaluate own experiences, 3. Attend, participate or facilitate a group for children or adolescents and/or their families in a treatment setting. Complete case Participate in research project autism 4. Assess interactions between patient and family members and evaluate whether these interactions are adaptive or maladaptive. ATI 3-18; 4-28; 4-36 Review all previous material 34 Column IV Clinical Activities (Expected Competencies/ Skills) Review previous learning on childhood depression, anxiety disorders and suicide. Review your personal family genogram and discuss post clinical conference when completing children’s clinical rotation. Complete a simple genogram with a client during assessment. Recall information from CM videos viewed feelings, attitudes and beliefs. learned on child & adolescent disorders 5. Plan interventions to increase family function based on assessment findings. 6. Identify cultural and spiritual considerations. 7. Acknowledge evidencebased information as presented. 8. Discuss leadership & management applications ***Prior to ATI Proctored exam Instructor recommends covering ATI 4-35, recalling research group project Grief and Loss. 35 36