MACC Catalog # NUR 111 CIP # 511601 Date: April 26, 2006 MOBERLY AREA COMMUNITY COLLEGE Common Syllabus NUR111 Mental Health Nursing Current Term Instructor: Office number: Office hours: Contact information: Classroom number: Class days and time: Catalog Description: NUR 111 Mental Health Nursing (1-3-4) This course addresses the physiological and psychosocial integrity of the client with a specific focus on the psychosocial aspects. Self-assessment and self-awareness are encouraged to enhance se3lfdevelopment and foster therapeutic relationships with an emphasis on multicultural diversity. Consideration is given to clients past and present patterns of behavior as they impact on alterations of mental wellbeing. Communication skills are further developed using theories of interpersonal relationships as a foundation. Student communication evolves from basic to therapeutic. Students use the nursing process as a tool for critical thinking in organizing, prioritizing, and managing individual plans of care. Students are assisted to address ethical and legal dilemmas in their roles as client advocates. Prerequisite or co-Requisite: A D N Students : Prerequisites: PSY 101 Prerequisites or Corequisites: NUR100, NUR101 and BIO205 Accelerated A D N Students: Prerequisites: Admission to the accelerated A D N program, BIO206 Corequisites: NUR202, NUR204, BIO26 Text: Curtis, Psychiatric Mental Health Nursing Success, 9th Edition, Davis, F.A. Publisher, ISBN: 978-0-8036-1879-4. E. M. Varcarolis, Manual of Psychiatric Nursing Care, 4th Edition, W. B. Saunders/Elsevier Publisher, ISBN: 978-1-4377-1782-2. 1 Varcarolis, Halter. Essentials of Psychiatric Mental Health . 9th Edition, Elsevier, Saunders Publisher. ISBN: 978-1-4160-0051-8. MACC Mental Health Concepts Nursing Syllabus. Other Required Materials: Clinical Sites: Mid-Missouri Mental Health Center, Boonville Valley Hope, Glore Psychiatric Museum. Equipment and techniques utilized for learning will include, but is not limited to, videotapes (both those prerecorded and those recorded in class of student activities), Power point presentation software, overhead projection, interactive video disc, role playing, Interference game, mental health nursing review jeopardy game, and individual teacher/student conferences. Purpose of Course: This second semester course addresses the physiological and psychosocial integrity of the client with a specific focus on the psychosocial aspects. Self-assessment and self awareness are encouraged to enhance self-development and foster therapeutic relationships with an emphasis on multi-cultural diversity. Consideration is given to clients past and present patterns of behavior as they impact on alterations of mental well being. Communication skills are further developed using theories of interpersonal relationships as a foundation. Student communication evolves from basic to therapeutic. With assistance a student learns to provide a milieu that is both safe and therapeutic. Students use the nursing process as a tool for critical thinking in organizing, prioritizing, and managing individual plans of care. Students are assisted to address ethical and legal dilemmas in their roles as client advocates. Course Objectives Upon completion of this course the student will be able to (verbally or in writing): 1. Demonstrate knowledge of these basic concepts of psychiatric mental health nursing: 1.1 Discuss the philosophy of mental health nursing. 1.2 Describe the roles and educational preparation of members mental health team. 1.3 Discuss the concepts of mental health and mental illness. 1.4 Compare and contrast major theoretical orientations that try to explain human behavior. 1.5 Describe the three levels of preventive psychiatry: primary, secondary, tertiary. 1.6 Discuss psychological, biological, and sociocultural factors influencing personality development. 1.7 Compare and contrast the concepts of human development as proposed by major developmental theorists. 2. Demonstrate understanding of these psychiatric principles: 2.1 Identify some early influences on mental health care. 2.2 Discuss the development of modern psychiatric nursing from its earliest roots to current issues. 2.3 Discuss the changes in the education of the psychiatric nurse that developed during the 1950's. 2.4 Contrast the psychiatric nursing roles before and after the use of psychotropic drugs. 2.5 Discuss the influence of the community mental health movement on the role of the 2 psychiatric nurse in the period that began in the 1960's. 3. 4. Demonstrate knowledge of these concepts relating to stress, anxiety, and adaptation: 3.1 Compare and contrast the major theories relative to stress. 3.2 Describe specific stress management techniques for both clients and self. 3.3 Discuss the relevance of measures such as biofeedback, guided imagery, humor and progressive relaxation to the reduction of stress. 3.4 Identify the characteristics of Peplau’s four levels of anxiety. 3.5 Differentiate between coping and defense mechanisms. 3.6 Compare and contrast fear and anxiety. 3.7 Identify ego-defense mechanisms. Identify the social, legal, and economic implications of mental illness. 4.1 Identify the basic rights of the mentally ill. 4.2 Differentiate involuntary and voluntary admissions and related discharges to psychiatric hospitals. 4.3 Describe the commitment process including justification for commitment. 4.4 Identify civil and personal rights retained by psychiatric clients. 4.5 Discuss implications of right to treatment, right to refuse treatment, and right to treatment in the least restrictive setting. 4.6 Differentiate between the rights of voluntary and involuntary clients. 4.7 Discuss legal issues basic to accountable nursing practice including informed consent confidentiality, record keeping and malpractice. 5. Demonstrate knowledge of communication as a basis for establishing a therapeutic relationship. 5.1 Discuss how differences between nurse and client in regard to perception, interpretation, and response may affect the nurse-client relationship. 5.2 Define and give examples of content, mood and interaction themes. 5.3 Discuss the importance of the responsive dimensions of: empathic understanding, genuineness, warmth, and unconditional positive regard. 5.4 Compare and contrast differences between social relationships and therapeutic relationships. 6. Demonstrate knowledge of various individual therapies used to create or maintain a therapeutic environment. 6.1 Identify the components, characteristics, and goals of a therapeutic milieu. 6.2 Discuss the nurse’s role and functions within the therapeutic milieu. 6.3 Discuss reasons why psychotherapy is used to treat depression. 6.4 Cite components common to all psychotherapies. 6.5 Describe the Freudian psychoanalytic theory and discuss how behavior and cognitive therapy differ from this form of psychotherapy. 7. Demonstrate knowledge of principles used in group therapy and family therapy. 7.1 Explain group norms and how they are developed. 3 7.2 Discuss the purposes, advantages, and disadvantages of group therapy. 7.3 Discuss Yaloms eleven curative factors of group therapy. 7.4 Discuss the purpose of family therapy. 7.5 Compare and contrast models of family therapy: structural, interact ional, developmental, systems. 7.6 Identify eight variables of the family that are instrumental in producing competent individuals. 8. Demonstrate knowledge of crisis theory and intervention. 8.1 Compare and contrast maturational, situational, and social crises. 8.2 Identify the three levels of prevention as stated by Caplan. 8.3 Describe the phases of crisis intervention. 9. Demonstrate knowledge of the principles of nursing care for individuals with patterns of withdrawal and distorted perceptions. 9.1 Differentiate among the various classifications systems of schizophrenia. 9.2 List Bleuler’s primary symptoms of schizophrenia. 9.3 Describe nursing interventions appropriate to the needs of the client who is suspicious, dependent, withdrawn, manipulative, or uncommunicative. 9.4 Discuss the theories of causation of schizophrenia. 9.5 Discuss the issues in tertiary prevention of schizophrenia in regard to the homeless mentally ill. 9.6 Identify various treatment modalities used with schizophrenic clients. 9.7 Discuss the nursing process as it applies to intervening with the schizophrenic clients. 9.8 Identify the major action, uses, adverse reactions, and nursing implications for antipsychotic agents. 10. Demonstrate knowledge of the principles of care for individuals with patterns of mood disorders, depression, and suicide. 10.1 Discuss the concepts of grief, mourning, and loss. 10.2 Describe Bowlby’s four phases of grieving. 10.3 Analyze the various theories regarding the development of depression. 10.4 Explain altered neurotransmissions in persons with depression and bipolar disorders. 10.5 Compare and contrast persons having unipolar disorders with persons having bipolar disorders. 10.6 Identify potential predictive behaviors indicative of suicide. 10.7 Describe the advantages, disadvantages, and indications for electroconvulsive therapy (ECT). 10.8 Identify the major actions, uses, adverse reactions, and nursing implications for the antidepressant agents. 10.9 Discuss the nursing process as it applies to intervening with clients with mood disorders. 11. Demonstrate knowledge of the principles of nursing care for children and adolescents 4 with patterns of conflict and stress. 11.1 Discuss the significant characteristics of the disorders of childhood and adolescence. 11.2 Describe the various theories regarding the development of disorders of childhood and adolescence. 11.3 Discuss appropriate treatment modalities as they relate to disorders of childhood and adolescence. 11.4 Relate the nursing process as it applies to intervening with children and their families. 12. Demonstrate knowledge of the principles of nursing care for individuals with patterns of compulsivity, somatization, altered identity, and emotional turbulence. 12.1 Analyze precipitating stressors that contribute to the development of neuroses. 12.2 Identify the behavioral, affective, somatic, interpersonal, and cognitive behaviors associated with neurosis. 12.3 Describe how neurotic behavior or symptoms represent coping neurosis. 12.4 Compare and contrast anorexia and bulimia. 12.5 Identify some of the most frequently used treatment modalities for neurotic behaviors. 12.6 Describe major actions, uses, adverse reactions, and nursing implications for antianxiety agents. 12.7 Define the concept of personality disorder. 12.8 Describe the behavioral characteristics of clients with personality disorders. 12.9 Discuss causative theories underlying personality disorders. 13. Demonstrate knowledge of nursing care for individuals with patterns of impaired brain function, substance abuse and human abuse. 13.1 Identify impaired functions of the brain caused by organic disorders. 13.2 Compare and contrast the characteristic behaviors of clients with dementia and delirium. 13.3 Discuss possible etiologies of cognitive impairment disorders. 13.4 Identify myths associated with chronic cognitive impairment disorders. 13.5 Describe the nursing care of clients with cognitive impairment disorders. 13.6 Describe the underlying dynamics of substance abuse and the way these dynamics interrelate. 13.7 Compare contrast psychological, biological, sociocultural, and systems theories related to causation of substance abuse. 13.8 Identify some of the most frequently used treatment modalities for substance abuse. 13.9 Describe the dynamics of human abuse. 13.10 Identify groups of people at high risk for becoming victims of violence. 13.11 Discuss the nurse’s role and functions in treating violence in the family. Clinical Objectives for Mental Health Nursing Within the clinical setting, the student will: 1. Facilitate the maintenance of sensory function in the client using the nursing process. 1.1 Explain basic physiology of the nervous system 5 1.2 Observe and report signs of sensory or motor disturbances 1.3 Implement supportive nursing care to clients with sensorimotor disturbances 2. 3. Delineate the role of social problems as influencing factors in the cause of illness. 2.1 Identify social problems that are factors in some illnesses 2.2 Recognize limitations of nursing care in relation to serious social problems 2.3 Recognize that clients’ social problems will influence reactions to nursing care 2.4 Identify when an individual may be helped or hindered in recovery from illness by the community or the client’s family system 2.5 Identify primary resources for health promotion existing in the community Identify and demonstrate acceptance of the interrelatedness of emotions and mental illnesses. 3.1 Explain the general scientific principles which link emotional stress and physiological response 3.2 Identify the mechanisms of interrelatedness in common psychosomatic illnesses 3.3 Converse with the client without adding to their stress 4. Facilitate the maintenance of effective verbal and nonverbal communication. 4.1 Demonstrate an attitude of acceptance 4.2 Recognize own inability to be accepting and seek assistance as needed 4.3 Identify and accept positive and negative expressions, feelings, reactions 4.4 Utilize verbal interaction with clients considering clients’ interests 4.5 Identify normal human behavior which includes both positive and negative feelings as a way of dealing with stressors 4.6 Recognize and show acceptance of clients’ spiritual goals even though they may be in conflict with own 5. Promote the development of productive interpersonal relationships. 5.1 Define interpersonal relationships 5.2 Demonstrate ability to develop meaningful interpersonal relationships with clients, families, and facility personnel 5.3 Enter into interpersonal relationships and recognize this as an important part of nursing 6. Facilitate awareness of self and others as individuals with varying physical, emotional, and developmental needs. 6.1 Demonstrate self respect and belief in own personal worth 6.2 Demonstrate respect for others and belief in personal worth of others 6.3 Identify relationship of human needs and adaptive behaviors 7. Create and maintain a therapeutic milieu. 7.1 Assess the needs of the client, providing an environment to meet their needs 7.2 P Provide individualized nursing care for the client 6 Course Content: Mental Health Nursing includes the following content area: Mental health versus mental illness, theories and therapies relevant to psychiatric nursing, psychobiology, psychotropic medications, mental health nursing in varied settings, cultural relevance, legal/ethical issues, therapeutic relationships and communication, nursing process applied to the psychiatric client, stress and anxiety, various psychobiological disorders, lifespan issues, crisis intervention, chemical dependency, DSM-IV-TR classification, and psychiatric emergencies. Assessment of Student Learning: GRADE SCALE: Grading policies are within the guidelines and policies as established by the Moberly Area Community College School of Associate Degree Nursing, as outlined in the Associate Degree Nursing Student Handbook. Students must obtain an average of 78% in both the classroom and clinical settings. 1. Clinical performance will be evaluated using clinical objective, pre/post conference participation, anecdotal notes, and written assignments. Students must obtain 78% on both clinical written work and clinical performance. No late paperwork is accepted. If paperwork is submitted late, and extenuating circumstances exist ( as outlined in the Associate Degree Nursing Handbook), the Director of Allied Health along with the Lead and Clinical Instructor will consider the situation taking into account proper notification of the situation and documentation of the circumstances. 2. Classroom/Theory grade is based on the following percentages: Unit Exams 60% Comprehensive Final 30% Quiz/Classroom assignments 10% 3. Grading Scale: A=92-100 B=83-91 C=78-82 D=66-77 F= Below 66 Unit exams that are missed may be made up at the time determined between the instructor and the student following the student’s appearance before the A.D.N. faculty. Quizzes may not be make up, and there will be no extra credit offered for this course. Students are expected to come to class on time and prepared with the reading and outside classroom assignments. If you are not present in class when the homework assignments are collected, based upon the circumstances, the instructor has the option not award the points for the work completed. Exams and Quizzes: Seven unit exams will be given along with a comprehensive final. Quizzes can be given at any time, announced or unannounced. The policy of the Associate Degree Nursing Student Handbook will be followed regarding quizzes and exams. 7 Participation: Participation in all aspects of the Associate Degree Nursing Program curriculum is essential for the learning process. Participation guidelines are followed as outlined in the Associate Degree Nursing Student Handbook. Other Methods of Assessment: Student/instructor/peer interactions, role-playing, group projects, student-instructor conferences as desired by the student or deemed necessary by the faculty. A NCLEX Mental Health Nursing competency exam will be administered to each first year student before the completion of the second semester. This exam will test your nursing knowledge along with comprehension and application of the information through the use of the nursing process. This exam will be administered at the expense of the individual student. Description of Major Assignments: Textbook assignments, bibliography cards, media reviews, chapter worksheets, interaction papers, nursing process reports, mental status assessments, medication summaries, and observation papers. Program Assessment: The Associate Degree Nursing Program faculty continually strive to meet the needs of the associate degree nursing student through program improvements. This is a cooperative effort that includes faculty, students, the Missouri State Board of Nursing, and other entities as appropriate. Students are assessed on mastery of the course concepts and essential skills through the courses of the Associate Degree Nursing Program. Other program assessments are part of the Comprehensive Associate Degree Nursing Assessment Plan that includes clinical performance criteria, essential skills mastery, the Clinical Process Evaluation, NCLEX-RN Licensure, placement rates, follow-up surveys, and accreditation from the Missouri State Board or Nursing. Instructor Policies: The policies as outlined in the A.D.N. handbook will be followed for this course. Academic Dishonesty: MACC board policy is as follows: “Academic dishonesty by students damages institutional credibility and unfairly jeopardizes honest students; therefore, it will not be tolerated in any form.” Forms of academic dishonesty include but are not limited to the following: violations of copyright law, plagiarism, fabrication, cheating, collusion, and other academic misconduct. Incidents of dishonesty regarding assignments, examinations, classroom/laboratory activities, and/or the submission of misleading or false information to the College will be treated seriously. The procedure for handling academic dishonesty is outlined in the Student Handbook (Policy Handbook M.010). In cases of alleged academic dishonesty, the burden of proof is on the student, not on the instructor. Attendance Requirement: Any student who misses two consecutive weeks of class during a regular sixteen week semester or the equivalent proportion of the class time during a shorter session will be dropped from the class by the instructor unless acceptable justification is supplied. Additionally, any student who misses more than one-fourth of the entire number of in-seat class meetings in a regular 16-week session or the equivalent proportion of class time during a shorter session, may be dropped from that class by the instructor if, in the opinion of the instructor, the student does not have reasonable opportunity to 8 succeed in the class. Student attendance must be defined in a different manner for online, hybrid, and virtual courses. Student attendance in these courses is defined as active participation in the course. Online, hybrid, and virtual courses will, at a minimum have weekly mechanisms for student participation, such as any or all of the following methods: a. Completion of quizzes or exams b. Submission of assignments c. Participation in threaded discussions d. Communication with the instructor A student who does not participate in an online, hybrid, or virtual course for two consecutive weeks will be dropped by the instructor unless acceptable justification is supplied. Tardiness: Students are expected to all class sessions and clinical assignments. Students who are tardy to class or clinical experiences may be refused entry. Tardiness is disruptive to the classroom environment and may result in poor care in the clinical area. Mark-up and late work: Late work is not accepted for credit, expect with extenuating circumstances as lined out in the A.D.N. handbook. Make-up work will be accepted with proper documentation of reason for absence. Extra-credit work: There is no extra credit for this course. ADA Statement Students who have disabilities that qualify under the Americans with Disabilities Act may register for assistance through the Office of Access and ADA Services. Students are invited to contact the Access Office to confidentially discuss disability information, academic accommodations, appropriate documentation and procedures. For more information, please call either the Moberly office at (660) 263-4100 x 11240 or the Columbia office at (573) 234-1067 x 12120, or visit our web page at http://www.macc.edu/index.php/services/access-office. 9