Santa Monica College

SANTA MONICA COLLEGE Health Sciences

NAME OF COURSE: Nursing 25 L - Psychiatric Mental Health Nursing Laboratory

COURSE UNITS: 1.5 units, CSU transferable

PREREQUISITES: Nursing 20, 20L or acceptance into advanced placement and completion of Nursing 19 with a “C” grade or better.

COREQUISITES: Nursing 25, Nursing 28

ADVISORY: Speech 5, Psychology 19

COURSE DESCRIPTION The focus of this nursing laboratory course is to provide the student with the opportunity to apply theoretical knowledge to patient care in the clinical setting. Students will utilize critical thinking strategies, therapeutic communication skills, and Orem’s self-care model when providing nursing care to patients manifesting behaviors of psychiatric disorders. The clinical setting will include acute psychiatric facilities and non-acute community mental health programs. This course must be taken concurrently with the theoretical companion course, Nursing 25.

REQUIRED TEXTS:

1. Fortinash, Katherine M. and Holoday-Worret, Patricia A., Psychiatric Mental Health Nursing. 4th Ed. Mosby, Inc., St. Louis, 2008. 2. Doenges, Marilyn, Nurse’s Pocket Guide: Nursing Diagnoses with Interventions. 10th Ed. F.A. Davis Co., Philadephia, 2004. or the nursing diagnoses book used in previous courses.

RECOMMENDED TEXTS:

1. Isaacs, Ann. Mental Health and Psychiatric Nursing. 2nd Ed. Lippincott-Raven, Philadelphia, 2001. 2. Pedersen, Darlene D. Psych Notes: Clinical Pocket Guide, Philadelphia: F.A. Davis Company, 2005

COURSE OBJECTIVES Upon completion of the course, the N25 L student will: 1. Demonstrate use of critical thinking strategies and appropriate communication skills in response to common patient behaviors associated with emotional distress and psychiatric disorders. 2. Demonstrate competency in establishing and maintaining a therapeutic nurse- patient relationship with a patient experiencing psychiatric symptoms. 3. Utilize the nursing process and Orem’s self-care model as an organizational framework to promote self-care for patients with health care deviations related to psychiatric disorders. 4. Implement and evaluate nursing care for patients with health care deviations related to psychiatric disorders. 5. Demonstrate skill in psychosocial assessment including interview techniques, observation skills, and use of selected validated tools.

CLINICAL OBJECTIVES Upon completion of Nursing 25 L, the student will demonstrate skill in the performance of the following objectives:

1. Identify the independent and collaborative roles of the psychiatric nurse in the assigned clinical setting. 2. Recognize symptoms of schizophrenia, bipolar disorder, major depression, anxiety disorders and personality disorders. 3. Demonstrate use of critical thinking strategies and appropriate communication skills in response to patient behaviors related to anxiety, depression, cognitive and perceptual distortions, aggression and manipulation of others. 4. Utilize therapeutic communication skills to establish a therapeutic relationship with assigned patients. 5. Identify the phases of the nurse-patient therapeutic relationship as the student initiates interaction with the patient, enters the working phases, and plans for termination. 6. Assess assigned patient’s cultural beliefs about the healthcare system and attitudes about seeking appropriate mental health care. 7. Assess patient’s psychosocial and physical state through use of interview techniques, observation skills and chart review. 8. Perform a complete mental status exam 9. Assess a patient’s theoretical and behavioral stage of psychosocial development. 10. Evaluate patient’s response to psychotropic medications; including effectiveness, side effects and compliance. 11. Develop and implement a teaching plan to promote mental health and to instruct patient in the safe use of psychiatric medications. 12. Develop a plan of care for assigned patients by assessing symptoms, identifying priority nursing diagnoses, developing and implementing a nursing care plan for assigned patients. 13. Analyze one’s own interactions with patients, use of effective communication techniques, and impact of one’s own communication on the patient. 14. Promote health/health maintenance to a group of patients experiencing psychiatric symptoms by identifying learning needs and providing effective instruction. 15. Apply principles of therapeutic-use-of-self to engage in psychosocial therapeutic activities with patients.

TEACHING METHODOLOGIES Teaching methodologies include: clinical experiences, documentation exercises, self- assessment, role play, audio-visual material, case study simulations and discussion.

METHODS OF EVALUATION 1. Methods of evaluation include: observation, pre and post conference participation, attendance, and compliance with college, program, and health care facility policies. 2. Students must pass BOTH Nursing 25 (theory) and Nursing 25 L (clinical) in order to successfully pass Nursing 25 L. Students must earn a grade of C or better in the theory course. Below 75% is considered failing in the SMC ADN Program. 3. The student must successfully demonstrate and pass the assigned skills under instructor supervision by the stated deadlines. 4. Compliance with attendance requirements, confidentiality standards, and the uniform policy is required for successful completion of Nursing 25 L.

CLINICAL GRADING SCALE

This clinical course is graded pass or fail according to the criteria documented on the Nursing 25 L Clinical Evaluation Tool. Satisfactory clinical performance and completion of course assignments are necessary to pass the course. Failure in this clinical course constitutes an “F” grade in N 25 regardless of the grade achieved.

COURSE CONTENT 1. Legal issues, safety concerns, confidentiality, milieu assessment, and therapeutic communication 2. Observation skills, interview techniques, chart review: obtaining assessment data, DSM medical diagnoses, nursing documentation 3. Therapeutic use of self and therapeutic relationship development, self- assessment of communication skills and assessment of patient-nurse interactions, psychiatric nursing history and assessment, mental status examination, other validated assessment tools. 4. Psychotropic medication assessment: target symptoms, effectiveness, side effects and compliance issues. 5. Assessment and intervention in behaviors associated with schizophrenia Assessment and intervention in behaviors associated with depression and bipolar disorder 6. Assessment and intervention in behaviors associated with anxiety disorders Assessment and intervention in behaviors associated with personality disorders 7. Nursing care plan development, implementation and evaluation. Assessing learning needs and abilities of assigned patient and providing effective instruction. 8. Designing and implementing a teaching plan to promote health or health maintenance for a group of patients. Grand Rounds: case presentation

EXIT SKILLS

1. Demonstrate use of critical thinking strategies and appropriate communication skills in response to common patient behaviors associated with emotional distress and psychiatric disorders. 2. Implement and evaluate nursing care for patients with health care deviations related to psychiatric disorders. 3. Demonstrate skill in psychosocial assessment including interview techniques, observation skills, and use of selected validated tools. 4. Recognize symptoms of schizophrenia, bipolar disorder, major depression, anxiety disorders and personality disorders. 5. Demonstrate use of critical thinking strategies and appropriate communication skills in response to patient behaviors related to anxiety, depression, cognitive and perceptual distortions, aggression and manipulation of others. 6. Utilize therapeutic communication skills to establish a therapeutic relationship with assigned patients. 7. Identify the phases of the nurse-patient therapeutic relationship as the student initiates interaction with the patient, enters the working phases, and plans for termination. 8. Assess patient’s psychosocial and physical state through use of interview techniques, observation skills and chart review. 9. Develop and implement a teaching plan to promote mental health and to instruct patient in the safe use of psychiatric medications. 10. Apply principles of therapeutic-use-of-self to engage in psychosocial therapeutic activities with patients.