Skills for mentally disabled clients Assessment techniques Emotional Mental Physical PSYCHIATRIC TECHNICIAN Interviewing techniques Observation Techniques Activities of daily living Recreational activities SCOPE OF Socialization techniques Therapy techniques Group Psycho PRACTICE Milieu Developing care plans Scope of Practice issues in Charting, recording, reporting Crisis intervention techniques the Psychiatric Technicians Law This law starts with Business Suicidal client and Professions Code Section 4500 Behavioral modification techniques Intervention techniques Management of assaultive or combative 4502. As used in this chapter, “psychiatric client: technician” means any person who, for compensation or personal profit, imple- Seclusion and restraint techniques ments procedures and techniques which Anger reduction As the professional association for involve understanding of cause and effect Goal-setting techniques Legal aspects Psychiatric Technicians in California, CAPT and which are used in the care, treatment, is often asked for a list of functions that and rehabilitation of mentally ill, emotionally Client rights Psychiatric Technicians are allowed to disturbed, or mentally retarded persons and Confidentiality perform under their state license. There is who has one or more of the following: Commitment procedures no such list, aside from some basic language in the Psychiatric Technicians (a) Direct responsibility for administering or Medication for MD clients Law as described below. Essentially, the implementing specific therapeutic proce- Treatments scope includes everything that is taught in dures, techniques, treatments, or medica- Admission procedures the Psych Tech education program that tions with the aim of enabling recipients or Escorting clients must be completed before taking the patients to make optimal use of their Discharge procedures licensing examination. therapeutic regime, their social and Safety procedures The state Board of Vocational personal resources, and their residential Nursing and Psychiatric Technicians care. (BVNPT) is often asked whether a certain procedure is included in the scope of (b) Direct responsibility for the application practice. If you have such questions, you of interpersonal and technical skills in the may contact the BVNPT’s Nursing Educa- observation and recognition of symptoms The California Association tion Unit at (916) 263-7843. and reactions of recipients or patients, for of Psychiatric Technicians From time to time, the BVNPT issues the accurate recording of such symptoms 1220 S Street, Ste 100 written decisions on scope of practice and reactions, and for the carrying out of treatments and medications as prescribed Sacramento CA 95811-7138 issues. CAPT publishes them in our Outreach magazine and includes them on by a licensed physician and surgeon or a www.psychtechs.net our website: www.psychtechs.net. psychiatrist. The psychiatric technician in the perfor- hospital or medical group with whom the all Psych Tech programs, but are Skills for developmentally disabed clients mance of such procedures and techniques supervising physician and surgeon is “desirable” for teaching to Psych Tech Self-care techniques is responsible to the director of the service associated. students. The interpretation is that if a in which his duties are performed. The Psych Tech has training in these Motor director may be a licensed physician and (b) In performing activities pursuant to procedures, it is within that Psych Tech’s Eating surgeon, psychiatrist, psychologist, subdivision (a), the psychiatric technician scope of practice: Toileting rehabilitation therapist, social worker, shall satisfactorily demonstrate compe- Dressing / Grooming tence in all of the following: Colostomy dressings registered nurse, or other professional Activities of daily living personnel. Assessment techniques (1) Administering the testing or immuni- Communicable diseases Nothing herein shall authorize a licensed zation agents, including knowledge of all Emotional psychiatric technician to practice medicine indications and contraindications for the Eye and ear irrigations Physical or surgery or to undertake the prevention, administration of the agents. Mental treatment or cure of disease, pain, injury, Gastrostomy feeding Observation techniques deformity, or mental or physical condition (2) Recognizing any emergency reac- Behavior modification in violation of the law. tions to the agent that constitute a Insertion of nasogastric tube danger to the health or life of the patient. Positive reinforcement 4502.1. A psychiatric technician, working in Isolation and reverse isolation (Standard Reward techniques a mental health facility or developmental (3) Treating those emergency reactions Precautions & Universal Precautions) Intervention techniques disability facility, when prescribed by a by using procedures, medication, and Contracting physician and surgeon, may administer equipment within the scope of practice Lavage Establishing baseline data medications by hypodermic injection. of the psychiatric technician. Sequencing techniques Orthopedic tractions Group therapy techniques 4502.2. A psychiatric technician, when Psychiatric Technicians education prescribed by a physician and surgeon, Preparation for diagnostic tests Supportive may withdraw blood from a patient with a The state requires that a graduate from Corrective mental illness or developmental disability if a Psych Tech program must have com- Steam inhalations Confrontation the psychiatric technician has received pleted at least 1,530 hours of instruction Play Therapy techniques certification from the board that the in both classroom and clinical settings. Stoma care Socialization techniques psychiatric technician has completed a Normalization techniques prescribed course of instruction approved Minimum number of hours Tidal drainage Sensory motor training techniques by the board or has demonstrated compe- for Psychiatric Technician education Speech development techniques tence to the satisfaction of the board. (Business & Professions Code Section 2586) T-tube care Charting, recording, reporting Developing care plans 4502.3. Subject Classroom Supervised Total Taking and recording verbal orders Area Theory Clinical Hours Legal aspects (a) A psychiatric technician, when pre- Client rights scribed by a physician and surgeon, may Pharmacology 54 0 54 Tracheostomy care Commitment procedures perform the following activities on a patient Nursing Science 126 270 396 Confidentiality with a mental illness or developmental Removal of fecal impactions disability: Mental Disorders 108 270 378 Management of assaultive Developmental 108 270 378 Vaginal irrigations and combative behavior (MAB) Disabilities (1) Tuberculin, coccidioidin, and histoplas- Seclusion and restraint techniques min skin tests, providing the administration Additional Courses 180 144 324 Behavioral science skills to be taught Sheltered workshops is within the course of a tuberculosis Communications skills Medications for DD clients control program. To expand on those general require- common to all areas Treatments ments, the BVNPT has adopted regula- Verbal Admission procedures (2) Immunization techniques, providing the tions further defining the Psych Tech Non-verbal Discharge procedures administration is upon the standing orders curriculum. These are in Section 2587, Role-playing Safety procedures of a supervising physician and surgeon or Title 16, California Code of Regulations. pursuant to written guidelines adopted by a Problem-solving Speech therapy - language development - 2 - - 7 - Charting Observation of significant changes This regulation specifies that the in the Psych Tech program, it also in body systems curriculum “shall develop the knowl- includes any procedure that’s related to Colostomy irrigation edge, skills and abilities necessary to basic functions, such as a new procedure Oral medication care for patients of all ages in current or use of new equipment. This is within Crutch walking health care settings.” It requires the the scope if the person has appropriate Oxygen administration content of the curriculum to include the in-service training. Decubitus care following: Pain assessment The BVNPT once developed a “skills list” Dosage computation, including pediatric 1. Pharmacology, including knowledge that specified all the skills that Psych Tech Parenteral medication of commonly used drugs and their students should be taught. But in the early Ear, eye and nose drops action, computation of dosages, 1990s, the BVNPT dropped the use of Positioning and draping preparation of medications and prin- that list for its evaluation of a program’s Emergency first aid ciples of administration. curriculum content. However, CAPT Positive pressure equipment believes that the skills list can still be of Enemas 2. Nursing science, which shall include use as a general reference point, since Post-operative care nursing fundamentals and basic most of the skills are still taught in the Finger sticks for blood glucose monitoring medical/surgical nursing. Psych Tech programs. For that reason, we Pre-operative care offer the following list. Please note that, Gavage 3. Classifications, treatment programs since the list was developed, the educa- Providing comfort, safety, privacy and interventions for developmental tion curriculum and scope of practice has Gloving disabilities. been modified in some areas: Range of motion Hair care 4. Classifications, treatment programs Nursing science skills to be taught Restraints and interventions for mental disorders. Hand washing Admission and discharge of patient Shaving male patient 5. Anatomy and physiology. Intake and output Ambulation Sitz bath 6. Nutrition. Irrigation of indwelling catheter Application of heat and cold Skin care 7. Normal growth and development. Measures to stimulate voiding Assisting with medical examination Skin testing and immunization 8. Psychology. Meeting elimination needs Bathing Specimen collection: feces, sputum, 9. The nursing process. Meeting spiritual needs urine, urine for diabetic testing Bladder instillation 10. Communication. Mouth care, including dentures Suppositories Bladder irrigation 11. Gerontological nursing. Nail care Telephone manners Body alignment 12. Patient education Nasogastric tube feeding Topical application of medication Body mechanics 13. Leadership. Neurological check Turn, cough, deep breathe Cardiopulmonary resuscitation 14. Supervision. Non-verbal and verbal communications Vital signs Care planning 15. Treatment programs for addictive Nutritional needs Wound dressings behaviors and eating disorders. Cast care
Observation of response to treatment Following are procedures that the Although the scope of practice is Catheterization and medications BVNPT said “may not be available” in whatever a Psych Tech has been taught continued on page 6 - 6 - - 3 - PSYCH TECHS IN ACTION
To uphold the integrity and human dignity of those entrusted in my care, Psychiatric Technicians in the and protect them against humiliation, Department of Developmental Services insult or injury without regard to race, Department of Mental Health color or creed; Department of Corrections and Rehabilitation To inspire hope and confidence and give assistance, with understanding and friendliness, in finding realistic and meaningful living; To continue my development of professional competence by comple- menting scientific study, improving therapeutic techniques, and maintain- ing high standards of leadership in the field of Psychiatric Technology.
-- The Psychiatric Technician Pledge
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