BAKERSFIELD COLLEGE
Associate Degree Nursing Program
Nursing B25:
PSYCHIATRIC MENTAL HEALTH
Instructional Syllabus
FALL 2010
Ann Marie Michalski, -Professor
Level 2 Syllabus
Revised 8/2010
COURSE DESCRIPTION
NURS B25 Psychiatric/Mental Health Nursing (3.5 units)
This Level 2 course provides an introduction to Psychiatric Mental Health Nursing using the nursing
process as the framework to promote psychosocial integrity within the context of the health illness
continuum across the lifespan. Emphsis is on therapeutic interactions and communication,
biopsychosocial rehabilitation and the therapeutic use of self. Correlated clinical experiences will
provide opportunities for students to participate in therapeutic activities in a variety of mental health
settings. The roles of provider of care, Manager of Care and Member of the Profession are integrated
in both the theory and clinical components. Prerequisite: Appropriate standing in the Associate
Degree Nursing Program or evaluation of skills and knowledge by Program Director.
Recommended: None. Hours: 36 lecture and 81 laboratory by arrangement.
Offered: F, S. CCS: Occupational Education. Transferable: CSU and private colleges.
INSTRUCTOR
Ann Marie Michalski, FNP,MSN, RNBC
MS 155
Monday 8 to 1030; Tuesday 8 to 11:30; Wednesday 3 to 5; and by appointment
As a distance ed instructor, Mrs. Michalski will occasionally travel to PC and CC during office times
661-395-4389 office phone
amichals@bakersfieldcollege.edu
PROGRAM STUDENT LEARNING OUTCOMES
The Bakersfield College Associate Degree Nursing Program is designed to prepare graduates to
competently transition from student to entry level Registered Nurse as defined by these roles: Provider
of Care, Manager of Care, and Member of the Profession. Please refer to Associate Degree Nursing
Student Handbook.
Upon completion of the program, the graduate shall be able to function as a:
A. Provider of Care --- The graduate will provide safe nursing care through therapeutic nursing
interventions to clients with critical and complex disease states. The care is characterized by
consistent critical thinking and problem-solving skills, clinical competence, accountability,
effective communication skills, respect for diverse cultures, with an emphasis on health
education and a commitment to the value of caring.
B. Manager of Care --- The graduate will provide safe nursing care consistently utilizing critical
thinking skills for clients who have critical and complex disease states. The care is
characterized by the ability to assess and establish priority of care for a group of client’s and
delegation of appropriate aspects of nursing care to license and unlicensed personnel and
directs their activities. The manager of care collaborates with other members of the health care
team, including organizational and community resources, using effective oral and written
communication sills. The manager of care recognizes roles and responsibilities within the
levels of the career ladder and is competent in using technology to provide evidence-based
nursing care.
C. Member of the Profession --- The graduate will consistently demonstrate accountability,
advocacy, legal/ethical and caring behavior, and responsibility for one’s own professional
growth, behavior, and formal/informal education. The graduate nurse routinely participates in
Level 2 Syllabus
Revised 8/2010
self-evaluation and makes changes to improve the practice of nursing, with the ultimate goal of
making positive contributions to the nursing profession.
LEVEL 2 STUDENT LEARNING OUTCOMES
LEVEL 2: The focus of level two is to develop a theoretical and technical knowledge base to care for
individual clients and families in a variety of settings across the lifespan.
Upon completion of the course, the student will be able to function as a:
A. Provider of Care --- The student will provide safe nursing care through therapeutic nursing
interventions to clients that have anticipated and unexpected outcomes. The care is
characterized by the ability to cluster nursing activities, recognize abnormal data and report the
findings appropriately, develop and implement nursing care plans, utilize effective
communication skills during unexpected situations, demonstrate respect for diverse cultures, as
well as anticipate and implement the nurse’s role as health educator and client advocate.
1. Developer/coordinator/evaluator of care to individuals, families, groups, communities,
and populations: able to identify the rationale for care and competently deliver this care
to an increasingly complex and diverse population in multiple environments, utilizing the
nursing process.
a. Develops and implements a holistic plan of care for assigned clients with anticipated
and unexpected outcomes
b. Plan and implement care for each client coordinating ADL’s with client’s treatments
and procedures
c. Coordinates care of multiple clients/families during clinical rotations
d. Develop, implement and evaluate interventions for clients with anticipated and
unexpected outcomes to assist clients to goals
e. Discusses the scientific rationale for each of the chosen interventions (either
verbally with questioning or on the nursing process)
f. Evaluates the effectiveness of interventions (either verbally with questioning or on
the nursing process) and verbalize possible modifications
g. Prioritizes medication delivery to assigned clients consistently utilizing the 6 rights
of medication administration. Prepared daily for med pass including, PO, SQ, IM,
IV appropriate for Level 2 students. Begin to correlate supportive data, labs,
diagnostics, age appropriateness when administering medications.
h. Role models professionalism, respect and kindness for the client’s uniqueness,
developmental level, socio-cultural background, spiritual beliefs, perceptions and
values.
i. Performs skills at the expected level with moderate supervision.
j. Proficiently develops a process paper(s) according to specified guidelines with a
passing grade of at least 80%.
k. Maintains asepsis at all times and role models appropriate behaviors.
2. Demonstrate effective communication with clients, families, and other health care team
members in all health care settings.
a. Utilizes effective verbal and nonverbal communication techniques and effective
communication techniques during stressful situations
b. Utilizes communication to develop the therapeutic nurse/ client/family relationships
during stressful situations
c. Communicates confidently with peers, client, family, and other healthcare team
members when providing client care to assigned clients
Level 2 Syllabus
Revised 8/2010
d.
Demonstrates appropriate required documentation in an accurate and timely manner
for clients with anticipated and unexpected outcomes.
3. Advocate for the client, profession and the interdisciplinary health care team in an effort
to ensure that clients, families, and communities are well informed and included in care
planning.
a. Demonstrate the role of the nurse as an advocate.
b. Suggest to the instructor possible interventions to ensure that the client and family
receive appropriate services
4. Educate clients, families, and health care professionals under their supervision using
appropriate teaching principle, strategies and current information.
a. Anticipate and implement the nurse’s role as health educator, utilizing the principles
of teaching/learning
b. Performs appropriate teaching for clients/families with anticipated and unexpected
outcomes with instructor’s guidance.
5. Anticipates risks to the client and provides appropriate interventions to achieve optimal
client outcomes.
a. Anticipates situations where clients are at risk. Able to develop and implement
appropriate interventions into the care of the client.
B. Manager of Care --- The student will provide safe nursing care utilizing critical thinking skills
for clients who have anticipated and unexpected outcomes. The care is characterized by the
mastery of basic care skills, as well as the ability to modify care when unexpected events occur,
operate area specific equipment, maintain cost effectiveness by utilizing supplies appropriately
and minimizing waste and demonstrate team-leading skills under the guidance of an instructor.
1. Demonstrate critical thinking to problem solve, organize, and prioritize care for
individuals or a group of clients.
a. Demonstrate mastery of prioritization of basic care and is able to modify care when
unexpected events occur
b. Cluster nursing activities and complete the charting for client(s) as appropriate for
clinical situation.
c. Consistently recognize self-limitations, seeking additional resources or support with
the assistance of the instructor.
d. Discuss possible solutions for conflict situations in the healthcare setting (Client
care, nursing, family, or health care team situations)
e. Recognize abnormal data, discuss the findings and implement appropriate
interventions under the guidance of the instructor.
f. Demonstrates the ability to problem-solve in the delivery and management of care
for clients with anticipated and unexpected outcomes.
g. Based on a medical diagnosis anticipates normal or abnormal assessment findings
and begins to implement diagnostic data into the assessment and plans care
accordingly
2. Manage human and fiscal resources in an efficient and cost effective manner.
Level 2 Syllabus
Revised 8/2010
a. Maintain cost effectiveness by utilizing supplies appropriately and minimizing
waste.
3. Integrates current technology to provide competent client care.
a. Retrieve and record pertinent information utilizing current technology.
b. Utilizes more complex equipment: IV pumps, PCA, EFM, etc. Reports and utilizes
the data gained from specialized equipment in delivery of client care.
4.
Serve as a leader and partner in the interdisciplinary health care team.
a. Relate important information to responsible licensed caregiver obtained during time
of client care.
b. Design a plan of care incorporating other health team members.
c. Is able to consistently function within a team. Demonstrates team leading under the
guidance of an instructor.
d. Demonstrates more advanced leadership skills (i.e.: acts as Team leader, delegation
and conflict resolution strategies) with the guidance of the instructor.
C. Member of the Profession --- The student will assume basic responsibility and accountability
in providing quality care within the legal and ethical boundaries of nursing. The student will
develop a beginning recognition of self-limitations, as well as define caring behaviors.
1. Demonstrates accountability for the provision and evaluation of nursing care that
conforms to professional standards and incorporates legal and ethical responsibilities of
the nurse especially the rights of the clients.
a. Conducts Nursing Services in Accordance with college, state, and federal practice
standards as Safety outlined in:
b. California Nursing Practice Act (Sections 2725, 1443.5, and 70215)
c. ANA Nurses Code of Ethics and Standards of Care
d. Associate Degree Nursing Program Student Handbook
e. HIPAA, The Joint Commission (TJC), National Patient Safety Goals, Core Measures,
Facility policies and procedures
f. Consistently arrives punctually to clinical setting, wearing approved uniform, and
fully prepared for clinical experience, including completed care plan(s)/ assignment(s)
and appropriate equipment.
g. Demonstrates clinical reasoning at the expected level. Demonstrates active
participation and contribution in the clinical setting including, but not limited to, shift
report, client care, multidisciplinary and/or physician rounds, and post conferences.
h. Follows appropriate chain of command.
i. Demonstrates capacity to smoothly transition between the roles of followership and
leadership.
j. Demonstrates ability to practice in the spirit of cooperation.
2. Demonstrates accountability and responsibility for clinical decisions and actions, and
conducts practice with commitment and personal integrity.
a. Demonstrates a capacity for self reflection and independently develops strategies to
master areas of deficiency.
b. Demonstrates ability to balance professional responsibilities and personal life.
Level 2 Syllabus
Revised 8/2010
c. Receives constructive feedback, accepts responsibility for individual actions, develops
and implements a plan to change.
d. Follows directed learning activities as assigned and keeps scheduled appointments.
When unable to keep scheduled appointments provides notification of cancellation in
a timely manner.
e. Demonstrates responsibility for their own learning, and helps promote an atmosphere
which facilitates maximum learning for classmates.
f. Consistently displays the nursing values of caring, integrity, altruism, social justice,
and honesty.
g. Demonstrates respect for peers, staff, faculty, and acts in a manner which promotes
dialogue, open communication, and positive interdisciplinary working relationships.
3. Establishes a foundation for the commitment to lifelong acquisition of knowledge and
skills to effect change in health care practice and outcomes.
a. Independently and consistently seeks out instructor to cultivate and validate clinical
judgment and reasoning and critical thinking skills, and demonstrates ability to accept
responsibility for decisions.
b. Maintains professional requirements including, but not limited to, Portfolio, Basic
Life Support Certification, PPD, TB Fit Test, Safety Packet, Skills Checklist.
c. Is a member of a professional nursing organization and / or participates in student
governance committees, Student Advisory Committee, and / or faculty meetings.
d. Performs peer evaluation and communicate evaluative findings in professional
manner.
e. Consistently utilizes reputable resources when transferring classroom knowledge to
clinical setting for the provision of evidence based nursing practice.
f. Participates in community projects.
COURSE ACTIVITIES
Various instructional methods may include, but are not limited to, lectures/discussions,
demonstrations, audiovisual aides, required reading, computerized assisted instruction, simulated
learning experiences, independent study, problem solving exercises, and quizzes/exams. Additional
learning activities may also include nursing process assignments, calculation of age appropriate drug
dosages, and leadership/ teaching assignments.
COURSE ASSIGNMENTS
Students are required to complete a variety of assignments which may include simulated learning
experiences, computer assisted instruction, weekly reading, homework assignments, nursing process,
presentations, and community projects in order to successfully meet the objectives for B25. Detailed
instructions for each assignment are located in the Assignment section of the Theory syllabus and / or
the Clinical Manual.
COURSE POLICIES
General:
Students are expected to attend each class, be punctual, and assume
responsibility for assigned activities, be active participants in the learning
process, and meet all established level objectives.
Cell phones and electronic devices must be turned off or placed in silent or
vibrate mode.
Children are not allowed in classroom or clinical setting.
Level 2 Syllabus
Revised 8/2010
Supportive
Services:
Students at Bakersfield College with disabilities who believe they may
need accommodations in this class are encouraged to contact Disabled
Student Programs & Services (661-395-4334), FACE 16, as soon as possible,
or at your specific School site, to better ensure such accommodations are
implemented in a timely fashion.
Students at Porterville College: Contact the Disability Resource Center in AC
115 or call (559)791-2215.
Students at Cerro Coso College: contact the Learning Assistance Center at
(760) 384-6161.
Live Captioning: Students with disabilities who are in need of live captioning in
this Interactive Video Class are encouraged to contact Distance Learning
(661)395-4694 as soon as possible to better ensure such accommodation is
implemented in at timely fashion. Please contact Disable Student Programs &
Services for all other accommodation requests at (661) 395- 4334 (FACE 16)
Please note: The Student Handbook also outlines a variety of services available
to help meet your academic needs.
Attendance:
The attendance policies as outlined in the Bakersfield College Catalog and
Associate Degree Nursing Student Handbook will be strictly enforced.
For the lecture component the maximum number of allowable absences is 2
theory classes or 4 hours. For the clinical component the maximum number of
allowable absences is 1 day per handbook, however this instructor requires
all absences to be made up.
Lateness is not acceptable! Students who are late to locked facilities and
instructors have already started pre conference are in danger of being sent
home. Any student arriving more than 30 minutes late must contact instructor
by cell and Mrs. Michalski and be prepared to make up clinical time missed. All
send homes is at the discretion of the clinical instructor.
Exams/Quizzes:
Students are responsible for material presented during their absence.
The opportunity to make up one missed exam will only be allowed if the
student informs the instructor prior to the scheduled exam. Pop quizzes
may not be made up.
Students will not be allowed to retake any exam or quiz on which an
unsatisfactory grade was earned.
Students may make arrangements with the instructor to review an individual
exam up to 2 weeks after the exam has been returned. The final exam will not
be reviewed.
All cell phones, pagers, and / or any electronic device must be turned off during
exams / quizzes unless prior arrangements are made with instructor.
Level 2 Syllabus
Revised 8/2010
Electronic devices other than a calculator may not be used for in-class
calculations work (ie. Cell phones, PDA’s, etc).
Academic
Honesty:
There will be zero tolerance for academic dishonesty, including
plagiarism. Plagiarism is the intentional use of another person’s idea, data,
information, or work without giving credit.
If the student is caught cheating, the test will be collected, a failing grade (0)
will be recorded, and the student will be directed to leave the classroom. The
student is required to meet with the Director of Nursing to discuss his / her
standing in the program.
Please refer to statements on academic honesty located in your Bakersfield
College Catalog and Associate Degree Nursing Student Handbook.
Course
Evaluations:
As mandated by the Board of Nursing, all student experiences in the program must
be evaluated. All students will evaluate the theory course and theory instructor at the
completion of the course; the clinical instructor, and all clinical
rotations/experiences are evaluated upon completion of the rotation. The student
evaluation is done electronically using Class Climate. You can expect to receive at
least four (4) surveys for the clinical portion of this course. In the event of
technological difficulties, the instructor will provide the student with the Survey and
the Scantron Form 20S. Failure to comply may result in delay of your grade
STUDENT EVALUATION
Evaluation is an ongoing, essential process in education, by which the student is apprised of his/her
progress in meeting the level outcomes and unit objectives. Theory and clinical grades are calculated
separately. In order to pass the course, the student must achieve at least 75% in the theory and 80% in
clinical components. If the student achieves either less than 75% in the theory component, OR clinical
component, the student will not pass the course. The student must achieve cumulative score of 75% or greater
in order to successfully complete the course. Extra credit points cannot be used to attain a course grade of 75%.
Grading scale
A = 90 – 100 %
B = 80 – 89 %
C = 75 – 79%
D = 70 – 74%
F = 69 or less
Level 2 Syllabus
Revised 8/2010
Weighted grades in %
Exams -------------------------------------------------20%
Midterm -----------------------------------------------20%
Final Cumulative Exam------------------------------30%
Other: Group Research Project -------------- 15%
Movie cases and internet search---------8%
ATI proctored exam ------------------ 7%
REQUIRED TEXTS AND MATERIALS
Varcarolis, Elizabeth M. (2009). Essentials of Psychiatric Mental Health Nursing: A
Communication Approach to Evidence-Based Care 1st ed., St. Louis, Missouri: Saunders
Elsevier
ISBN 978-1-4160-0051-8
Richardson, Betty K. (2007). Clinical Decision Making: Case Studies in Psychiatric Nursing.
Clifton Park, NY: Thomson Delmar
ISBN
Scantrons: Five 100 question (Form No.882-e) and one survey answer form (Form 20-s).
RECOMMENDED TEXTS
Varcarolis, Elizabeth M. (2006). Manual of Psychiatric Nursing Care Plans:Diagnoses, Clinical Tools
and Psychopharmacology 3rd ed., St. Louis, Missouri: Saunders Elsevier
ISBN 13 978-1-4160-2916-8
Townsend, Mary C. (2008). Nursing Diagnoses in Psychiatric Nursing 7th ed., Philadelphia:
Davis
ISBN 10-0-8036-1834-4
Schultz, Judith M. & Videbeck, Shiela L. (2009). Lippincott’s Manual of Psychiatric Nursing
Care Plans 8th ed, Philedelphia: Lippincott, Williams & Wilkens
ISBN 13 978-0-7817-6868-9
Level 2 Syllabus
Revised 8/2010
COURSE CONTENT
OUTCOMES AND OUTLINE
COURSE INTRODUCTION
I. Review Program and Course Learning Outcomes.
II. Review Syllabus.
III. Discuss Policies, Expectations and Requirements.
PROFESSIONAL ISSUES AND NURSING PRACTICE
I. Role of the Psychiatric Mental Health Nurse (PMHN)
A. Advocacy
B. Caregiver
C. Delegation
D. Teacher
E. Communicator
II. ROLE OF THE STUDENT NURSE
A. PERCEPTIONS AND STIGMAS
B. EXPECTATIONS
C. FEARS
III. Mental Health Versus Mental Illness
A. Discuss the Continuum.
B. Discuss the Prevalence
IV. Delivery Systems for Psychiatric Mental Health Clients
A. Crisis
B. Acute
C. Rehabilitation
D. Forensics
E. Chemical Dependency
F. Pediatric
G. Geriatric
H. Community-Based
V. Critical Thinking
A. Nursing Process In Psychiatric Mental Health Nursing
VI. Self- Awareness
VII. Legal and Ethical Concepts
A. Mental Health Laws
B. Patient’s Rights
C. Bioethics
D. Self-Awareness and Boundaries
VIII. Leadership
A. Management
B. Goal Setting, Priorities, Decision Making, Delegation
C. Teaching / Learning
D. Stress and Time Management
E. Team and Group Processes
F. Organizational Culture and Climate/ Trends In Nursing
G. Professional / Employment Issues
H. Documentation
I. Nurse Practice Act
BIOPSYCHOSOCIAL CONCEPTS RELATED TO HEALTH CARE
Neurobiology
A. Review the Anatomy and Physiology of the Brain
B. Neurotransmitters
C. Brain Imaging
II. Pharmacotherapy
A. Cultural and Spiritual Considerations
B. Self-Awareness Regarding Pharmacotherapy
I.
Level 2 Syllabus
Revised 8/2010
III. Neurobiological / Psychosocial Theories and Therapies
A. Psychosocial
B. Sociocultural
IV. Communication Skills / Conflict Resolution
A. Therapeutic Relationship and Communication
1.
Techniques
2.
Self-Disclosure
3.
Cultural Variations
4.
Caring
B. Review and Reinforce Overview of Conflict
1.
Various Views People Hold About Conflict
2.
Positive and Negative Aspects of Conflict
3.
Four Levels of Conflict
C. Sources of Conflict.
1.
In the General Work Environment
2.
In Healthcare Environment
D. Stages of Conflict.
1.
Five Stages of Conflict
E. Strategies for Conflict Resolution
1.
Accommodation
2.
Avoidance
3.
Collaboration
4.
Competition
5.
Compromise
6.
Introduce/Discuss Resolving Conflict Using Problem Solving
V. Social and Emotional Concerns
A. Stress and Anxiety
1.
Adaptation
B. Anger and Aggression
C. Altered Family Patterns
D. Sexual Assault
E. Suicide
F. Special Populations
G. Theories
H. Nursing Process
I. Self Awareness
J. Cultural and Spiritual Considerations
NURSING PRACTICE FOR PSYCHIATRIC DISORDERS
I. Anxiety Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
II. Mood Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
Level 2 Syllabus
Revised 8/2010
III. Thought Disorders / Schizophrenia
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
IV. Chemically Impaired
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
V. Personality Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
VI. Eating Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
VII. Somatoform Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
VIII. Sexual Dysfunction and Gender Identity Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
Level 2 Syllabus
Revised 8/2010
H. Treatment
I. Outcomes
J. Self-Awareness
IX. Cognitive Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
X. Pediatric and Adolescent Disorders
A. Etiology
B. Theories
C. DSM IV Criteria
D. Age Appropriate Care
E. Cultural Considerations
F. Nursing Process
G. Diagnostic Studies
H. Treatment
I. Outcomes
J. Self-Awareness
Level 2 Syllabus
Revised 8/2010
CLASS SCHEDULE
CALENDAR
FALL 2010
Instructor expectation is that the student will have read and/or reviewed chapter
assignments from text, case profile and case study for the week PRIOR to class so
discussion and group work will be most productive. This instructor reserves the right to
change an assignment if necessary. Unit objectives and activities are listed following
this semester calendar.
WEEK 1
Aug.23 & 24*
WEEK 2
Aug 30 & 31
WEEK 3
Sept 6 & 7
9-6 Holiday
For MC
Introduction to B25
Unit 1 psych nursing, mental health vs mental illness
Unit 2B introduce therapeutic communication & relationships
Continue Unit 2B nursing process and theories and therapies
as treatment
Unit 2A psychopharmacotherapy as treatment
Classroom cases in packet
Unit 2D stress & adaptation - defense mechanisms
Anxiety levels
Unit 2F Crisis & suicide
Classroom case 3-1 John- Role play scenarios
Ticket to class project of the “brain” MC due 9-14 DE due 9-8
WEEK 4
Sept 13 & 14*
Continue week 3
For MC Unit 2C Conflict
Resolution independently or in groups in computer lab
For DE class observation 9-15
WEEK 5
Sept 20 & 21*
UNIT EXAM 1: ______
all previous theory class material
Unit 3C Schizophrenias
Classroom case study 1-1 Sarah
WEEK 6
Sept 27 & 28
Unit 3B Mood disorders
Classroom case 3-2 Maria
Classroom case 3-4 Elke
Research Project 1: ECT
Level 2 Syllabus
Revised 8/2010
WEEK 7
Oct 4 & 5*
Unit 3A Anxiety disorders
Review stress and defenses
Classroom case 2-3 Caroline
Classroom case 2-2 Betty
Research Project 2: Trichotillomania
WEEK 8**
Oct 11 & 12
EXAM 2: Midterm__________
all previous theory class material
Research Project 3: Research Project Grief & loss
WEEK 9
Oct 18 & 19
Unit 3D Substance disorders/addictions
Research Project 4: Chemically Impaired Nurse
Classroom case 4-1 Ron
Classroom case (see additional packet)
WEEK 10
Oct 25 & 26 *
Unit 3E Personality disorders
Research Project 5: Self Injurious Behaviors
Classroom case study 5-4 Brad
WEEK 11
Nov 1 & 2
Unit 3G Somatoform disorders
Research Project 6: Dissociative DO
Classroom case study 6-2 Melba
Classroom case 6-4 Linda
WEEK 12
Nov 8 & 9*
UNIT EXAM 3________all theory material from week 9
through week 11including legal & ethical issues in MH &
clinical sites
Research Report 7: Sleep & Sleep DO as R/T Mental Heal;th
ASSIGNMENT ALERT: Between week 13 and week 16 watch an assigned
movie and answer questions assigned to this movie for full credit
WEEK 13
Nov 15 & 16
Unit 3J Children
Classroom case 8-9 Martin
Research Project 8: Bullying
Unit 2E objectives 2 & 4-12 domestic violence &
sexual assault
Classroom case 9-3 Chuy
WEEK 14
Nov.22 & 23*
ATI predictor exam date & location TBA
Unit 3F eating disorders
Case 7-1 Sabrine
Research project 9: Pyromania/firestarters
Unit 2G homelessness & mental illness
Level 2 Syllabus
Revised 8/2010
Additional criteria HIV-see handout
Case 1-2 Dean
WEEK 15
Nov.29 & 30
Unit 3H sexual disorders
Unit 3I cognitive disorders
Case study 8-7 Hannah
Research Project 10: Gender Identity DO
WEEK 16
Dec 7**
Dec 8
FINAL EXAM inclusive all B25 material
DE Tuesday 12:30 to 1:50
MC Wednesday 10:30 to 11:50
A 50 question scantron will be needed for unit exams
A 100 question scantron will be needed for final
Instructor has provided a place on this calendar to record exam grade/points so please
do so for your future reference and so the student will know where they stand point wise
through the whole semester. For individual attention please contact instructor (see
below). Please know that instructor is available and encourages appropriate student
interaction and communication. Please ask instructor for remediation and 201B
information.
updated 8-20-10
Level 2 Syllabus
Revised 8/2010
ASSIGNMENTS
See instructor web page
for
NURSING B25: CURICULLIM OBJECTIVES AND ACTIVITIES GUIDE
ansd GROUP PROJECT
Level 2 Syllabus
Revised 8/2010
CLINICAL MANUAL
B25: CLINICAL GUIDELINES
REMINDER: Clinical progress will be an accumulation of skills, attendance and assignments
evaluated by Clinical Teaching Assistants (CTAs)/Faculty and lead faculty during the clinical portion
of the class. Faculty will complete a Level II Clinical Evaluation Form and meet with student to
discuss outcomes based on performance in clinical settings. Two Psychosocial Assessment grades are
not used as part of final grade score; however student must earn at least a 75% on each to pass course
and student may have one revision attempt if score falls below 80%. As well as attendance of required
clinical hours and 2 psychosocial assessments, other clinical assignments include two (2) CD meetings,
facilitate a client group, individual teaching project. As part of the psychiatric clinical experience,
students are required to journal about the clinical experience after each shift with focus on feelings
about experience more than a on tasks performed. Journals are to be sent to Ann Marie by e mail by
Sunday morning following the clinical shift. Failure to complete these journals may result in failure of
clinical course. Clinical assignments are not to be attended or completed until clinical rotation
orientation and will not be accepted if completed prior to clinical rotation. All clinical assignments
except daily assessment must be typed.
ATTENDENCE: Attendance policies as outlined in Bakersfield College Catalog and Associate
Degree Nursing Student Handbook (will be refer to in this document as Student Handbook) will be
strictly enforced If, due to excessive absence either theory or clinical, the instructor believes the
student cannot meet course objectives, the student may dropped from the course. It is the student’s
responsibility to drop with discussion with instructor and Cindy Collier, Dean of Allied Health,
immediately. All clinical hours missed must be made up at the discretion of the Ann Marie, Lead
Faculty, and must be arranged before a student can make up hours. Tardiness to clinical may result in
being sent home from clinical, and if student is tardy they must be prepared to make up time lost.
COURSE EVALUATIONS: Nursing 25 evaluation is a requirement of this course. Student
evaluations are generally done at the last clinical meeting by current CTA, however if student is in
an outpatient site a MEETING TIME with AM must be made). If all assignments are not complete
(due to drastic circumstances only) PLEASE DISCUSS WITH Ann Marie so a grace period can be
worked out. However, this is not recommended, because you will move right into another clinical or
the end of semester. WE WANT YOUR SUCCESS as much as you so talk to me if you are having
problems.
At the time of your final clinical evaluation you are expected to have completed CTA and site
evaluations with class climate. Please evaluate 2 CTAs and 2 clinical sites on appropriate forms
found on BC web site and e mail to Ann Marie within the week of the last B25 clinical rotation.
If student has had outpatient experience, please document that evaluation of site and
preceptor/contact where documentation/comment section of one of the forms.
Level 2 Syllabus
Revised 8/2010
B25 CLINICAL DRESS CODE
Professional casual dress/clothing which includes
Toes and heels covered
No high heels
No cleavage
No big heavy jewelry
No scarves or bandanas
No T shirts with writing or codes that may resemble or imitate
gang affiliation
No blue jeans
No Capri length pants
No sleeveless or tank tops both male and female students
Skirts and dresses below knees
Name tag at all times
B25: TEAM LEADING
Team leading is a leadership component of this clinical course. The expectation is that
each student will have an opportunity to function as a team leader or professional leader.
Each clinical site with CTA is unique and has a specific service provided within the
community. Each clinical instructor uses the team leader in a unique way. The student
team leader is expected to follow instructions so experience will be unique and most of
all be flexible. Expect the unexpected. You are a professional leader so cherish the
role.
Team leading with a CTA may not be possible for all students due to clinical
assignment. However, some students will be autonomous in the community with a
preceptor. This can serve as a leadership assignment because the student is independent
of an instructor. The student will be professional, punctual and appropriately dressed
and flexible with whatever the preceptor’s schedule may be for that day. Each preceptor
functions within the Kern County Mental Health system of care as a case manager or
client advocate. Assignments may be giving injections to moving a client to another
board and care to assessing and inmate for suicidal ideation to running an anger
management group at a local school. Each location has a specific function within the
system of care and is equally important. The student shall function with the preceptor
within this parameter.
Level 2 Syllabus
Revised 8/2010
CLINICAL SITES:
Just as team leading is unique to the clinical sites, each clinical site is unique. The
psych faculty/team works very hard to provide each student with a rewarding unique
clinical experience. Sometimes the most gratification comes from the least likely place
and least likely individual. Please take a few minutes and become somewhat familiar
with your assigned sites so you won’t be overwhelmed when it comes to parking, eating
and expectations. Please talk to the clinical instructor and let post conference be your
place to ask, vent appropriately and defuse before going home. Remember: stress free
environment!
Chateau information:
Chateau is an adult health day care located downtown at 824 – 18th Street.
Criteria for participant (client) attendance is not because of the diagnosis but
if the individual would decompensate or symptoms would exacerbate if they
were not in attendance. 90% of the participants at Chateau have an Axis I
diagnosis. In addition to regular scheduled clients, Chateau has a contract
with Kern Regional Center. Kern Regional provides services and case
management for disabled individuals in this community. Clients that attend
Chateau from Kern Regional are physically and mentally challenged.
Chateau has 1 RN and 3 LVNs on staff as well as social services, nutritionist,
family nurse practitioner, occupational and physical therapists that are
contracted to complete assessments on each participant. Students will have
an array of experiences from group teaching with low functioning and
Down’s Syndrome adults to nursing duties to individual interactions.
You are give 45 minutes for lunch. There is Goose Loonies next door,
Mexicalli and Too Fats within 2 blocks East and Rice Bowl 2 blocks West.
Numerous restaurants and fast foods are close.
Parking is at a premium and parking on the street is 2 hours. DO NO park in
Goose Loonies lot, the doctor’s office on the north-east corner lot or Jasmine
Tyree Center lot. Dirt lot across the street is also not available. Most of us
park on the street but it is a 2 hour limit. So far no one has gotten a ticket but
I am making no guarantees. Friday is community day so some students will
go to the community with clients for various activities. There is usually
room in the van so students go with staff and participants.
Level 2 Syllabus
Revised 8/2010
Students also participate in a small aftercare program that is fun and
rewarding. Post conference is flexible and students are given a schedule at
pre conference each clinical day. Daily assessments are due by post
conference.
Good Samaritan information:
Good Samaritan is located in the south west part of town off White Lane and Grissom
Streets. It is an acute care facility that treats adult, children and adolescents that are
acutely mentally ill, suicidal, homicidal, gravely disabled or emotionally disturbed.
There is also a chemical dependency unit and adult outpatient unit. Students always
participate in the outpatient program and often have an opportunity to treat clients that
are hospitalized for substance detox. All clients must be medically cleared prior to
admission. Good Sam has 2 floors, the children and adolescents are housed on the 2nd
floor. There is an elevator in the main hall. This is a locked facility and there is no
receptionist in the lobby at 7. DO NOT PICK UP PHONE to be let in facility UNLESS
YOU ARE LATE because the clinical instructors meet students in the front of the
hospital at 7 AM sharp so be a few minutes early. Post conference is at 2:15 daily and
daily assessments are due at this time.
Students will see a multidisciplinary team approach to treatment with psychiatrists,
nurse practitioners, therapists or social workers, nurses (RNs and LVNs) , mental health
workers and psych techs. You will also encounter Chemical Dependency counselors as
well as intake staff and security. Observe and be aware of the disciplines and scope of
practice of each, as each has a certain therapeutic role in the treatment the client.
Individuals from the community may also be coming and going such as case managers,
patient rights advocate and conservators that participate in plan of care meetings
required for re-embursement.
There is ample parking in the lot so that is never an issue. The cafeteria serves decent
food for $3 and students are welcome to eat on site. Students must purchase a ticket at
the reception desk after 8 AM. There are numerous fast food places to eat outside the
hospital on White Lane. You are given 45 minutes for lunch so plan your time carefully
so you can be back as assigned.
3B Information:
3B is a locked unit within the Kern County System at Kern Medical Center,
Flower and Mt. Vernon Streets. This unit has acutely mentally ill, suicidal,
homicidal or gravely disabled clients that may be compromised medically.
Students will see a multidisciplinary team approach to treatment with
psychiatrists (residents and interns from UCLA), nurse practitioners,
Level 2 Syllabus
Revised 8/2010
therapists or social workers, nurses (RNs and LVNs) and mental health
workers. You will may also encounter chemical dependency counselors as
well as intake staff and security. Observe and be aware of the disciplines and
scope of practice of each, as each has a certain therapeutic role in the
treatment the client.
Individuals from the community may also be coming and going such as case
managers, patient rights advocate and conservators that participate in plan of
care meetings required for re-embursement.
Clinical instructor will meet students in the East Lobby (by gift shop) no
later than 6:45 because you must be on the 3rd floor unit by 7 for report. Post
conference is at 2 and daily assessments are due at this time.
Parking is in the east section of the hospital parking lot-first come first serve.
The cafeteria is very good with a variety of food choices and cheap prices ( I
think students with name badge still get employee discount). Students
should not plan to leave hospital for lunch unless walking across the street
due to parking crunch on returning from lunch and with only 30 minute
break.
Crestwood Rehab Facility Information:
Crestwood is located in the East part of town at 6700 Eucalyptus Dr. and can be
accessed from Hwy 58 or 178 East off of Fairfax. This facility is for rehab and
transition back to community. Treatment is for adult mentally ill. Most clients’
symptoms are chronic and persistent. Many clients are incompetent to stand trial for
offenses committed in a community and Crestwood has a MIST Program to assist
clients with this process. Many clients are from other counties and have been sent to
Crestwood for a specific service.
Like the acute facilities the student will see a multidisciplinary team approach to
treatment with psychiatrists, nurse practitioners, therapists or social workers, nurses
(RNs and LVNs) , mental health workers and psych techs. You will also encounter
Chemical Dependency counselors, recreation staff as well as kitchen staff and
housekeeping that assist with client redirection. Observe and be aware of the disciplines
and scope of practice of each, as each has a certain therapeutic role in the treatment the
client.
Level 2 Syllabus
Revised 8/2010
Individuals from the community may also be coming and going such as case managers,
patient rights advocate and conservators that participate in plan of care meetings
required for re-embursement. Crestwood offers a pre-voc program so clients that are
stable enough and qualify may be working in laundry, housekeeping or kitchen.
Crestwood offers a canteen and out of facility functions clients can participate in if
stable and qualify.
Crestwood also has an acute 15 bed unit and a Bridge Program on site. Students may
spend time at the Bridge with clients as arranged by instructor.
Although there is a parking lot students can also park in the dirt area east of facility
between rehab and Bridge.. Students have access to employee lounge and may purchase
a meal ticket for $3, get tray from cafeteria and eat in lounge or leave for lunch. Lunch
break is 45 minutes. This unit is locked and students are to meet instructor by 7AM in
facility lobby. All students must sign in and out of facility log on the reception
counter. Post conference is at 2:15 and daily assessments are due at this time.
COMMUNITY OUTPATIENT:
All students will have an outpatient experience. Some at Good Sam outpatient, some at Chateau and
some students will be assigned a rotation in the community autonomous with a preceptor.
Each of these sites that a student will be with a preceptor is within the Kern County System of Care
and treats clients diagnosed with a mental illness. Each site is unique and provides a service within the
Mental Health System of Care. Each preceptor will give the student information about the site and
their specific role at the site and within the System.
Please refer to SITE SPREADSHEET for specific address and number of site assigned.
Level 2 Syllabus
Revised 8/2010
B25 MEDICATION EDUCATION FOR CLINICAL ROTATION
( OK to use TACTIS)
Medication pass is an essential part of nursing. However with access to pyxis issues,
this learning experience has been compromised. In brief, we can teach a monkey to
hand a pill/pills to a patient/client, but we cannot teach the monkey the rationale for
giving the medication. That is the most important issue with medication education. The
why and what if questions that nurses must know. Essentially, the critical thinking
behind the task. Take every opportunity to pass medications when you can. Give as
many IMs as they will let you, but remember the important aspect of the learning
experience is the rational.
What is the patient/client on?
List all meds
What of these medications has to do with DSM IV-TR diagnosis?
Why is your client/patient on these medications?
(list relevant symptoms)
What are the side effects?
Any nursing considerations?
While in outpatient, please pick a client you have seen and ask/find out what meds they
are on and work medications up on TACTI at home after the rotation and hand in to
next CTA with daily psychosocial assessment
Level 2 Syllabus
Revised 8/2010
Student Name:____________________________________________________
Clinical Dates
N25: CLINICAL CHECK LIST
Psychosocial Assessment #1: faculty received on date______ initials_______
Psychosocial Assessment #2: faculty received on date______initials_______
Group Teaching: faculty received on date______ initials_______
Individual Teaching: faculty received on date______ initials_______
CD(12 step): faculty received on date______ initials_______
CD #2: faculty received on date______ initials_______
Concept map and/or Mini Psychosocial Assessment daily per clinical objectives: Faculty Initial
#1_______
#2_______
#3_______
#4_______
#5_______
#6________
#7_________ #8_______
Journals: Please focus on feelings associated with experiences and impact it may have had on
learning and/or life
Date sent to AM starting with day 2:
day 1_____ day 2_____ day 3_____ day 4_____ day 5_____
day 6_____ day 7_____ day 8_____
GET A FOLDER or manila envelope and place all completed assignments in it WITH THIS
CHECK OFF SHEET and return to faculty at the time of your final evaluation. (Evaluations are
generally done at the last clinical meeting by current CTA, however if student is in an outpatient site
a MEETING TIME with AM must be made). If all assignments are not complete (due to drastic
circumstances only) PLEASE DISCUSS WITH Ann Marie so a grace period can be worked out.
However, this is not recommended, because you will move right into another clinical or the end of
semester. WE WANT YOUR SUCCESS as much as you so talk to me if you are having problems.
Reminder: All CTAs (NOT PRECEPTORS) as well as Ann Marie correct and sign off the
assignments. Please utilize the expertise of your CTA and get appropriate feedback as needed.
Reminder 2:
At the time of your final clinical evaluation you are expected to have completed CTA and site
evaluations through Class Climate. Please evaluate 2 CTAs and 2 clinical sites on appropriate forms
found on BC web site and e mail to Ann Marie within the week. If student has had outpatient
experience, please document that evaluation of site and preceptor/contact where
documentation/comment section of one of the forms.
Level 2 Syllabus
Revised 8/2010
B25: Individual Teaching Plan
Student Name:_______________________________________
1. State what you are going to teach this client.
2. Give the evidence which led you to decide that the above is a learning need for this
client.
3. Objective/Outcome goal for your Teaching Plan. Upon the completion of the plan
client will..............
the
4. What do you know about this client that you will have to take into account in teaching? (Attention
span, educational level, memory deficit, etc.)
5. Method to be used:
6. Where and when teaching will be done:
7. Teaching Aids that will be used: (Must bring with you and be appropriate for the
client.)
8. Outline of content of Teaching Plan: (List specific steps beginning with a motivation statement
based on what you know about this client.)
9. Evaluation of the PROCESS: were teaching goals met and self evaluation
Level 2 Syllabus
Revised 8/2010
B25: GROUP TEACHING
Student Name:___________________________________
GROUP Plan: Use your assessment and STAFF & faculty input to formulate plan. (The topic may
be assigned by facility staff or student group may pick a topic) This project may be done with 2 or
three students but must have at least three (3) clients to constitute a group.
1. State what you are going to teach these clients.
2. Give the evidence which led you to decide that the above is a learning need for this
of clients.
group
3. Objective/Outcome goal for your Teaching Plan. Upon the completion of the plan
clients will..............
the
4. What do you know about this client population that you will have to take into consideration
when teaching this group? (Attention span, educational level, memory deficit, etc.)
5. Method to be used:
6. Where and when teaching will be done:
7. Teaching Aids which will be used: (Must bring with you and be appropriate for the
client.)
8. Outline of content of Teaching Plan: (List specific steps beginning with a motivation statement
based on what you know about this client.)
9. Evaluation of the PROCESS and yourself: were teaching goals met and what made group
successful and what could have been improved?
Update 8-19-09
Level 2 Syllabus
Revised 8/2010
DAILY MINI PSYCOSOCIAL ASSESSMENT
Student Name: __________________________________
Date of care:_______
Age:______ Gender_______ Allergies________________
Admissions Status:____________________________
Diagnoses:
Axis I:
Axis II:
Axis III:
Axis IV:
Axis V: admission_______ current from your assessment ______
Reason for admission, primary problem

Client’s perception (ie, what the client states as reason for admission):

Perception of others (ie, information from concerned others, health care providers, chart etc., about
reason for client’s admission):
Treatment history (inpatient and/or outpatient treatment):
Current medications (include dosage, frequency and why your client is taking these medications):
Are labs relevant for this client at this time? Why or why not?

Appearance

Motor behavior
Speech
Level 2 Syllabus
Revised 8/2010
Mental status

Mood and affect

Thought process, cognition

Thought content

Sensorium and intellectual processes):

Suicidal or homicidal ideation

Judgment and insight—limited, poor, good, fair
Client Self-concept
Client problems from your assessment (name up to 6 practice using concept mapping sheet):
Prioritize 3 nursing diagnosis with interventions
Level 2 Syllabus
Revised 8/2010
Name:_______________________________
Nursing B25
DEPENDENCY/ADDICTION "Twelve-Step" Assignment
Attend a "Twelve-Step" Type / Anonymous meeting related to Dependency and or Addiction.
Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, Adult Children of Alcoholics,
Alanon.)
Attend an open meeting. (Anyone can come, not just chemically dependent people) Be prepared to
introduce yourself using your first name and stating that you are a student nurse and want to learn
about the organization and experience what it is like so that you will be able to refer people helpfully.
Do not contribute financially because each group is self-supporting by the members. Remember that
what you hear and who you see at a meeting is confidential. It is best to go to a meeting by yourself
(not with other students) because several extra people at smaller meetings will seriously disturb the
group process.
After attending the meeting, please answer the following:
1.
Type of meeting you attended and the date, time, and place of the meeting.
2.
How did you find out about this meeting?
3.
Describe the process (what happened) at the meeting.
4.
Describe your personal reaction to the meeting.
Level 2 Syllabus
Revised 8/2010
Name:_______________________________
Nursing B25
DEPENDENCY/ADDICTION Assignment #2
Attend a meeting related to Dependency and/or addiction. (Alcoholics Anonymous, Narcotics
Anonymous, Cocaine Anonymous, Adult Children of Alcoholics, Ala Non, Overeaters.) This meeting
does not have to be 12-Step but can be.
Attend an open meeting. (Anyone can come, not just chemically dependent people) Be prepared to
introduce yourself using your first name and stating that you are a student nurse and want to learn
about the organization and experience what it is like so that you will be able to refer people helpfully.
Do not contribute financially because each group is self-supporting by the members. Remember that
what you hear and who you see at a meeting is confidential. It is best to go to a meeting by yourself
(not with other students) because several extra people at smaller meetings will seriously disturb the
group process.
After attending the meeting, please answer the following:
1.
Type of meeting you attended and the date, time, and place of the meeting.
2.
How did you find out about this meeting?
3.
Describe the process (what happened) at the meeting.
4.
Describe your personal reaction to the meeting.
Level 2 Syllabus
Revised 8/2010
PSYCHOSOCIAL ASSESSMENT: COVER PAGE
( to be attached to Assessment when handed in to Clinical Instructor)
Student Name:________________________________________
Date of Care:_____________
Circle Facility Site: Crestwood
Good Sam
Good Sam Children
Chateau
3B
Lerdo
Other:_____________________
Original Score:_________%
2nd Score (Re do if needed)__________%
All items must be included/addressed for a score. Student must get 80% or better to pass this
assignment.
Student Scorer:_______________________________ Date:______________
Faculty Signature:_____________________________ Date:_____________
Updated 8-16-2010
Level 2 Syllabus
Revised 8/2010
PSYCHOSOCIAL ASSESSMENT
Date of care:
Client initials:
Admission date:
Admission status:
Age:
Gender:
Advance Directive signed? Y/N
Allergies:
Primary language (written, spoken):
Ethnicity/culture
Cultural, spiritual beliefs and practices (not just church they use
to go to):
Health beliefs and practices:
Diagnoses:
Axis I:
Define and reference Axis I & II
Axis II:
Axis III:
Axis IV:
Axis V: admission ________ current from your assessment __________
Reason for admission, primary problem
A. What does psychiatric admission assessment say?
B. Client’s perception of admission (ie, what the client states as reason for admission?):
Precipitating factors (eg, recent stressors, medication noncompliance, life events):
Predisposing (risk) factors, family history:
Treatment history (inpatient and/or outpatient treatment):
Psychiatrist & medical PCP orders:
Current medications (include dosage, frequency-list ALL meds but elaborate with TACTIS on
psychopharmocology only):

Prescription medications (include compliance, eg, “When home or in B & C do you take your
medication as prescribed?” “Do you ever skip doses or take additional doses?” “Do you ever take
another person’s medications?”):

Does client take over-the-counter (OTC) medications inc. vitamins, herbals or other
supplements?
Lab values related to medications and/or out of NL results
Substance use, dependence (include type, quantity, frequency, eg, “How often do you drink alcohol?”
“On average, how many drinks do you have?” “How often do you drink to the point of intoxication?”
“Do you drink alone or with others?”): should this be listed under Axis I or Axis IV?
Physiologic and self-care concerns
A. Medical problems (does this match with Axis III?):
B. Physical impairments, disabilities, prostheses (does this match with Axis III?):
Level 2 Syllabus
Revised 8/2010
C. Self-care abilities, deficits, personal hygiene: (does this match axis III or IV?)

Review of systems – (include weight gain or loss, note if intentional or unintentional, vital signsassess like any other patient): include Sleep (include pattern, amount, quality): Nutrition (include
appetite, food intake, food preferences or dietary requirements):
Mental status
Appearance (dress, facial expression, posture, eye contact; dressed appropriately for weather
& occasion?):
Motor behavior (eg, agitated, fidgety, unable to sit, pacing, no movement):
Speech (include quantity—eg, poverty of speech or minimal verbalization, one word answers,
hyperverbal, incessant talking; quality, eg, poverty of content, latent responses, circumstantial,
tangential, nonsensical, clanging or rhyming, perseveration, echolalia):

Mood and affect (mood—eg, labile or stable, depressed, anxious, serious, paranoid, giddy, scared,
angry; affect, eg, broad range or restricted, flat, blunted, silly, inappropriate):

Thought process, cognition (ie, how the client thinks; eg, logical, organized, rational or
fragmented, loose associations, flight of ideas, thought blocking):

Thought content (ie, what the client thinks about; eg, suicidal or homicidal thoughts, delusions—
paranoid, somatic, religious, grandiose, ideas of reference):

Sensorium and intellectual processes (include orientation to person, place, time; confusion;
recent and remote memory; concentration and attention spans; auditory, visual, olfactory,
gustatory, tactile, or command hallucinations; fund of general knowledge; concrete or abstract
thinking abilities, eg, interpretation of proverb):

Suicidal or homicidal ideation (include suicidal ideas, active, ie, thinking of ways to kill self; or
passive, wishing to be dead or never wake up; plan for suicide; whom the client wishes to harm and
why):

Judgment and insight—limited, poor, good, fair (eg, ability to solve problems or make sound
decisions; can the client see the relationship between own behavior and situation?):
Self-concept (how client perceives self; “How would you describe yourself as a person?”)
Additional items to complete the assessment :
3 Client strengths (as identified by nurse during assessment or observation):
Living situation (include other persons living with client; house, apartment, group home, etc.):
Educational and work history (eg, college, trade school, GED; current and past employment, when;
type of job or career; volunteer work; income):
Roles and relationships (Is the client fulfilling current roles? Are roles satisfying? Whom does the
client have relationships with? Are relationships supportive, satisfying, close, estranged, antagonistic,
troubled? Does the client lack relationships?):
Coping skills and defense mechanisms (effective and ineffective, eg, relief behaviors, “What do you
do to relax when you are upset or stressed?” “How do you solve a problem—think about it, spend time
alone, talk it over with a friend?”):
Interests and hobbies (include what the client currently does and what the client has done in the past,
when stopped and why):
How the client spends a typical day (outside the hospital, when the client is feeling good/well and
when having problems or stressed) OR inside hospital (Crestwood only-long term)
Level 2 Syllabus
Revised 8/2010
Teaching needs (determined from assessment) with Barriers to learning (eg, language or literacy
barrier, lack of motivation/available energy, inability to concentrate/pay attention, lack of insight,
defense mechanisms such as denial):
Client’s expectations for care (eg, “How can we help you?” “What would you like to accomplish
while in the hospital?”):
Priorities for nursing care:
based on 3 prioritized problems from psychiatric diagnosis, assign nursing dx, LT goals and ST
goals with interventions & rationals for each interventions (this carries a lot of points so see
grade sheet for instructions)
Discharge planning/community needs: (include what client needs to be successful in community
living, eg, placement, case manager, financial or legal help, transportation, socialization, etc; what
client needs to manage illness; what the client needs to improve quality of life) discuss this with the
client:
Updated 8-16-10
Level 2 Syllabus
Revised 8/2010
PSYCHOSOCIAL ASSESSMENT
GRADE SHEET
PLEASE ATTACH TO
ASSESSMENT
TOPIC
Points
possible
Demographics
Advance directives
Allergies
Ethnicity /culture ( address both issues
under this heading)
Diagnosis ( axis I thru IV=4 pt) Define
and reference Axis I & II=2 pts
Axis V GAF score (admission &
current from your assessment)
Admission criteria/history
Type of admission –voluntary or
involuntary
Reason for admission from chart
Reason for admission - client’s
perception
Precipitating factors of admission
Predisposing factors (risk)
Treatment history
Psychiatrist/medical PCP orders
List all current medications- use
TACTIS to elaborate on psych meds.
Be specific on why client is taking
meds
Medications-(address other 5 questions
under this heading) OTC drugs &
supplements
Lab values as directed
Substance use-address all questions
(should it be on Axis I?)
Physiologic and self care concerns
(address 1st 3 topics under this heading)
are they congruent with Axis III?
Review of systems – be sure to do vital
signs and address weight gain or loss.
Include sleep patterns and nutrition
Mental status(address each topic under
this heading)
12
appearance
Motor behavior
speech
Mood & affect
Thought process, cognition
Level 2 Syllabus
Revised 8/2010
5
5
15
3
3
4
3
12
12 from
pts
below
1
1
1
2
2
Points
earned
Faculty comments
Thought content inc. SI or HI
Sensorium & intellectual process
Judgment & Insight
Client’s self concept
Client strengths from assessment
Living situation (should this be in Axis
IV)
Education
work history
Roles and relationships
Coping skills and defense mechanisms
Interests and hobbies
Typical day outside the hospital when
client is feeling good OR Typical day
INside hospital when client is feeling
stress or having problems. (Crestwood
clients only-long term)
Teaching needs identified with barriers
to learning
Client’s expectations for care
Concept map of problems and or
symptoms associated with diagnosis
Priorities for nursing care-3 priority
problems from assessment
Priorities for nursing care give 1st
nursing diagnosis r/t and e/b
Long term goal #1 by discharge
Short term goal # 1during this shift
3 interventions with rationales for short
term goal 1
Evaluation for interventions for STG 1
Priorities for nursing care-give 2nd
nursing diagnosis r/t and e/b
Long term goal # 2 by discharge
Short term goal # 2 during this shift
3 interventions with rationales for short
term goal 2
Evaluation for of interventions STG 2
Priorities for nursing care-give 3rd
nursing diagnosis r/t and e/b
Long term goal # 3 by discharge
Short term goal # 3 during this shift
3 interventions with rationales for short
term goal 3
Evaluation for interventions STG 3
Discharge planning –community goal
80% to pass=113 points
And all areas must be addressed
Level 2 Syllabus
Revised 8/2010
1
1
2
1
2
1
1
1
2
2
1
2
5
1
4
Possible
39
points
from
below
3
2
1
6
1
3
2
1
6
1
3
2
1
6
1
5
141=
100%
Update 8-16-2010
N25: MISSED CLINICAL HOURS ASSIGNMENTS
As stated in the N25 syllabi, students who must miss clinical hours must complete make up assignment
to pass clinical portion of N25.
The following assignment equals one clinical day. More than one day absent must be at the discretion
of the instructor for allowable make up. Makeup guidelines as follows:
Step 1: Check out VCE workbook from Ann Marie
Step 2: Check out PMHN text from Ann Marie
Step 3: Complete all assigned lessons that are equivalent to clinical hours.
Step 4: Turn in completed assignment on assigned date prior to the end of N25 clinical
rotation (for extension of hours please discuss reasons with Ann Marie).
Assignment VCE Fortinash:
Lesson 1 page 43
Lesson 2 page 53
Lesson 3 page 61
Lesson 5 page 79
Lesson 6 page 87
Lesson 7 page 95
Lesson 12 page 147
Lesson 14 page 167
TOTAL
8 Hours
OR
Assignment VCE Varcarolis:
Lesson 1 page 43
Lesson 2 page 51
Lesson 3 page 59
Lesson 4 page 67
Lesson 5 page 75
Lesson 7 page 99
Lesson 8 page 109
Lesson 10 page 135
TOTAL
8 Hours
OR
TOTAL
Level 2 Syllabus
Revised 8/2010
In Richardson Case Study Text complete:
Case 3-3 Candice
Case5-5 Leah
Case 8-1 Len
Case 7-3 Edgar
Case 4-2 Margaret
Case 9-2 Francis
8 Hours
Level 2 Syllabus
Revised 8/2010