Los Angeles Valleycollegehealth SCIENCEDEPARTMENT

Los Angeles Valleycollegehealth SCIENCEDEPARTMENT




rotation 1 &2

Class meets: Thursdays 09:00 – 12:10


Instructor: Geraldine A. Weber, MN, RN,FNP Office: AHS room 104

Tel. 818 - 947-2839


Rev.01/16 am/gw


COURSE TITLE: Psychiatric-MentalHealthNursing Science110

TOTAL COURSEHOURS:3.25 Units (1.5 Units Theory; 1.5 Units Clinical; 0.25 Units SkillsLab)


Course /ClinicalDescription:

This course integrates the components of theory, clinical and simulation that focus on evidence-based,

patient-centered nursing care of the patient with Mental Health needs and disorders within acute care and

community based mental health settings. Emphasis will be placed on the assessment of risk factors affecting

patients’ health and wellness. Students will implement the nursing process and integrate Maslow’s Hierarchy of

Human Needs concepts to assess, analyze and prioritize the needs of the psychiatric patient to formulate,

organize and implement a plan of nursing care. Pharmacological principles specific to patients with mental

health disorders are discussed. The course builds upon concepts introduced in NS101, NS102, NS103, NS104

and NS105; Professional Standards patient advocacy, spiritual- cultural diversity, legal/ethical issues, and

effective communication and collaboration with members of the healthcare team.

Skills LabDescription:

This segment of the course is designed to assist students to develop prioritization anddecision making in a simulated patient care setting. Realistic simulations and scenarios will bepresented in a safe non-threatening environment. Clinical scenarios will guide the student in the transferof theoretical concepts into clinicalpractice.

Student LearningOutcomes:

At the completion of Nursing Science 110 Psychiatric Mental Health Nursing, the student will be able to:

Assess, analyze, and prioritize the needs of patients with acute and chronic mental illness/disorders to

formulae, organize and implement a plan of care.

Students WithDisabilities:

If you are a student with a disability requiring classroom accommodations, and havenot contacted SSD, you are advised to do so in a timely manner. The SSD office is located inthe “Student Services Annex”, Room 175 or call SSD at (818) 947-2681, or TTD (818) 947-2680to schedule a meeting with an SSD Counselor. If SSD has already sent a memo to yourinstructor describing the accommodations required by student for this class, please meet withyour instructor to discuss these arrangements prior to the beginning ofclass.


At the completion of the course the studentwill:

1.Apply Maslow’s Hierarchy of Human needs concepts, the nursing processand psychosocial assessments to assess, analyze, prioritize, formulate, organizeand implement a plan of care for adult patients with mental illness /disorder,including pharmacological and non-pharmacologicaltherapies.

2.Assess spiritual- cultural diversity as it affects the patient’s responses to nursingcare, treatment and the disease process.

3. Utilize therapeutic communication techniques that are spiritually, culturallyand developmentally

sensitive for mental healthclients.

3.ImplementtheNLNEducationalCompetenciesfortheAssociateDegreeNurse:Human Flourishing, Nursing Judgment, Professional Identity and Spirit ofInquiry.

4.Demonstrate beginning time management and leadership skills with effective useof resources when managing care for patients with mentalillness/disorders.

5.Use community resources to supplement the nursing care for clients with a disruptionof the wellness < - > illnesscontinuum.

6.Assess, analyze, prioritize, formulate, organize and implement patient needs andprovide nursing care related to physiologic and psychologic integrity for patients withmental illness/disorders.

7.Apply the principles of Quality and Safety Education for Nurses (QSEN): Patient-CenteredCare, Teamwork and Collaboration, Evidence-Based Practice (EBP), Quality Improvement(QI), Safety, and Informatics to guide the utilization of knowledge, skills and attitude(KSA).


At the completion of Nursing Science 110 Psychiatric Mental Health Nursing, the student will be able to: assess, analyze and prioritize human needs of clients with acute and chronic mental illness/disorders and to formulate, organize and implement a plan of care.


1.1 Identifies cultural, learning needs, developmental level and uniqueness of the psychiatric mental health

patient and family.(PCC, EBR, R)Objective met in Psychosocial Assessment:Love, Belonging, Self-Esteem

1.2 Demonstrates caring interventions sensitive to the psychiatric mental health patient’s

sexuality, culture, values and beliefs.(PCC, P) Objective met in DWS and NCP: Nursing Dx-Interventions

1.3 Demonstrates the role of advocacy for the patient with psychiatric mental health needs in acute and

community mental health settings.(PCC, C)Objective met in DWS and NCP: Nursing Dx-Interventions

*1.4 Maintains patient confidentiality in accordance with HIPAA and Agency guidelines.

(T/C,EBP,S,QI,P),Objective embedded throughout NCP and DWS

*1.5 Report suspicious behavior as outlined by the BRN abuse reporting requirements articles II and

III (refer to student handbook).(PCC, T/C,S,P) Objective met in Psychosocial Assessment- Love and Belonging “2C”



2.1Collects data via physical and Mental Status Exam, psychosocial assessment, observation, client/family interview, chart review that contributes to database for up to 2 patients (PCC, T/C,I,T) Objective met in DWS: Patient Data, Mental Status Exam and Psychosocial Assessment/Neuropathology


2.2Interprets relevant data, organize patient/family needs and formulate appropriate nursing diagnoses utilizing Maslow’s Hierarchy of Human Needs framework for psychiatric mental health patients/families in acute and community mental health settings.(PCC,R) NCP: NSG DX, DWS: NSG Dx and Lab/Diagnostic Test Section

2.3Utilizing the health and wellness continuum, differentiates nursing diagnoses for up to 2 psychiatric mental health patients/families in acute and community mental health settings.(PCC,EBR,R) Objective met in DWS and NCP: NSG Dx.

2.4Examine problems unique to the individual’s culture, gender and developmental level. (PCC,T/C, R) Objective met in Psychosocial Assessment: Love and Belonging and Self-Esteem


2.5Functions as a member of the healthcare team with a focus on health and wellness in planning care for patients with psychiatric mental health disorders/needs.(T/C, C)Objective met in DWS and NCP: NSG Dx- Outcomes/Goals

2.6Utilizes reasoning and critical thinking strategies to formulate, organize and implement a plan of care for patients/families with psychiatric mental health disorders/needs.(PCC, T/C,R)Objective met in DWS and NCP: NSG Dx- Outcomes/Goals

2.7Implement goals that are attainable, measurable and specific to meet the needs of patients with psychiatric mental health disorders/needs. (PCC,EBR, R)Objective met in DWS and NCP: NSG Dx- Outcomes/Goals


2.8Applies second semester time management skills for up to 2 patients with psychiatric mental health disorders/needs. (PCC, T/C,R)Objective met in DWS and NCP: NSG Dx-Interventions

2.9 Implement interventions with rationales that are evidence-based and demonstrates application of theoretical concepts.

(PCC, EBR, R) Objective met in DWS and NCP: NSG Dx-Intervention

2.10 Utilizes resources to organize the needs of patients’ health and wellness in acute and community psychiatric mental health care settings. (PCC, EBP, I, QI, R) Objective met in DWS and NCP: NSG Dx- Interventions

2.11 Demonstrates proficiency in previously learned and newly acquired therapeutic communication skills with patient’s in the mental health care settings.(PCC, EBP, QI, T) Objective met in DWS and NCP: NSG Dx- Interventions

2.12Implements teaching/learning principles based upon assessed learning needs, developmental level, culture, and the uniqueness of multiple patients/families. (PCC, T/C, EBP, R) Objective met in DWS and NCP: NSG Dx-Interventions

2.13 Demonstrates caring interventions that reflect cultural sensitivity and the promotion of physical, mental,

emotional spiritual health and wellness. (PCC, EBP, P) Objective met in DWS and NCP: NSG Dx-Interventions

2.14 Demonstrates the effective use of therapeutic communication skills to develop a caring patient/family

relationship. (PCC, T/C, C) Objective met in DWS and NCP: NSG Dx- Interventions

2.15 **Safely calculates, administers, and manages medications for the patient with psychiatric mental health

disorders/needs incorporating knowledge from drug pharmacology, dosage calculations/ administration principles

and pathophysiology. (S, I, EBP, T) Objective met in DWS: medications, and NCP: NSG Dx-Interventions


2.16** Evaluates patient’s responses to pharmacologic and physiologic therapies/interventions.(PCC, S, R)

Objective met in DWS: Medication Evaluation of Effectiveness, NCP: NSG Dx.- Evaluation of Outcomes

2.17 Evaluates patient and family responses to teaching and learning.(PCC, R) Objective met in NCP: NSG Dx-

Evaluation of Outcomes(

2.18 Evaluates the effectiveness of individualized and measurable patient goals/outcomes.at 2nd semester level.

(PCC, EBP, R) Objective met in NCP: NSG Dx- Evaluation of Outcomes


3.1Demonstrates ongoing self-evaluation; identifies strengths and areas needing improvement.(EBP,P) Objective met in Daily Journal, Clinical Evaluation Tool: Mid-point/Final Student Self-Evaluation

3.2Acts as a clinical resource for peers.. (T/C, R) Objective met in Clinical Evaluation Tool: Mid-point /Final Student Self-Evaluation

3.3Applies knowledge and transfer of theoretical concepts into evidence-based clinical practice. (QI, EBP, S,R) Objective met in DWS: NSG DX- Rationale, NCP: Evidence Based Rationale

3.4 Contributes and participates in pre or post conference.(PCC, T/C, EBP, S,C) Objective met in Evaluation Tool: Mid-

point/Final Student Self- Evaluation

3.5** Demonstrates responsibility and accountability when utilizing information and technology to communicate,

manage knowledge, reduce errors and support clinical decision making.(I, QI, S, P) Objective imbedded

throughout NCP and DWS

3.6** Performs in a manner that reflects:

  • The LAVC Student Code of Behaviors and Professional appearance per the Nursing Student Handbook
  • CA-BRN Scope of Registered Nursing Practice
  • Agency Rules and Regulations(PCC, EBP, T/C, I, QI, S, P) Objective imbedded throughout NCP and DWS

3.7 Demonstrates reduced need for supervision as course progresses. (QI, R) Objectives embedded throughout NCP and


Spirit ofInquiry

4.1** Recognizes quality improvement projects and National Patient Safety Goals in various mental health care settings.

(QI, S. I, P) Objective met inDWS and NCP: NSG DX- Interventions- Patient Teaching, Evidenced Based


4.2 Demonstrates ability to research patient data by reviewing various data resources. (I, QI, S, EBP, C) Embedded throughout DWS and NCP

4.3 Provides oral report for assigned psychiatric mental health patient via SBAR to instructor, nurse and members of

the healthcare team (PCC, T/C, I, S, C) Objective met in DWS/ SBAR

4.4 Demonstrates intellectual curiosity by participating in professional developmental activities which promote lifelong

learning that improves quality of care for psychiatric mental health patients and families within acute and community

settings.(QI, EBP, P) Objective met in Clinical Evaluation Tool: Midpoint/Final Student Self-Evaluation

*These critical components must have a zero (0) or above in order to receive a passing grade forthe clinical component of thecourse.

This Table will assist the student on a weekly basis to understand what Course and Unit competencies willbediscuss.TheleftcolumncontainsCourseCompetencies,themiddlecolumncontains the Weekly Unit Competencies and the right column contains activities assigned to assist with transferof theory knowledgeinto clinical and skillslab.

CourseCompetencies / Weekly / UnitCompetencies WeekI – / Activities
At the completion ofthiscourse, the student willbeableto:
1. Apply Maslow’sHierarchyof Human needs concepts,thenursing processandpsychosocial assessmentstoassess, analyze,prioritize,formulate, organizeandimplement a plan of careforadult clients withmentalillness /disorder,includingpharmacological andnon-pharmacologicaltherapies.
2.Assess spiritual-culturaldiversity as it affectstheclient’s responses tonursingcare, treatment and thediseaseprocess.
3.Utilizetherapeuticcommunicationtechniquesthat are spiritually,culturallyand developmentallysensitivefor mental healthclients.
4.Implement theNLNEducational Competenciesforthe Associate DegreeNurse:Human Flourishing,NursingJudgment,ProfessionalIdentity and Spirit ofInquiry.
5.Demonstrate beginningtimemanagement andleadershipskills with effective useofresources whenmanagingpatientcare.
6.Use community resourcestosupplement the nursingcarefor clients with a disruptionofthe wellness < - >illnesscontinuum. / “Foundations of Psychiatric-MentalHealth Nursing and Clinicalpractice”
1.1Identify common studentconcernsregarding the mental healthrotation;personal exposure to personswithmental healthproblems/needs.
(Ch.1 p.8-12)
1.2Interpret the ANA ScopeStandards of PracticeforPsychiatric Nursing (Ch.1 p.8-11)
1.3Discuss QSEN StandardsforMental Health Educationinrelation to Knowledge, SkillsAttitudes of thenurse.(Tabloski Ch. 7p.185-186)
1.4Identify Mental Health objectivesforHealthy People 2020 (p.6.Box1.1)
1.5Differentiate characteristicsofmental health and mentalillness.(p.3)
1.6a.) Compare and contrastMentalHealth and Mental Illness, pastandpresent. (p.3-5)
b.) Discuss historical eventsandeffects on treatment and deliveryofmental health care in relationto:
  • Period ofEnlightenment
  • DevelopmentofPsychopharmacology
  • 1963 Community MentalHealthCenters ConstructionAct/De-institutionalization
  • LPSAct-1970
  • 1996 ParityAct
  • the “revolving door” concept
1.7Interpret the meaning of“self-awareness” and “therapeutic use of self”asit relates to the practice ofPsychiatricMental HealthNursing.
1.8Examine the relationship betweentheJohari Window and the developmentof“self-awareness”.
1.9Apply the Six components of thenursepatient relationship to the role ofthepsychiatric mental-healthnurse. / Examine the cultural andethnicbackground of your family? Howdoesthis influence your beliefs aboutmentalIllness?
Requiredreadings: Videbeck, Sheila L.(2014)
Ch.1 Foundations; MentalHealth/Illness;HistoricalPerspectives; Ch. 5 TherapeuticRelationships; Ch. 6 TherapeuticCommunication; Ch. 7Client’s response to Illness
Tabloski, P.(2014)Ch. 7: QSEN standards- Mental Healthp.185-186
Required Videos/DVD’s:(239)”Restraints, Legal ConsiderationspatientRights.”
(240) Restraints: Safe Applicationofrestraints.”
National Alliance for the MentallyIll(NAMI)

Correlated ClassroomActivity
1.Describe images or ideas that cometomind when you think aboutmentalillness.Where do these images comefrom?Examine personal feelings, values andbeliefs.
2.Debate the following 21stCenturyHealthcare issues as they relate to patientswith mental illness:
  • Shortened hospitalstay
  • Severity ofillness
  • Homelessness
  • ACCESS (1993)toCommunity BasedCare
  • Cost containment/ManagedCare
3. Correlate concepts of “Therapeutic Use of
Self” and “Self-Awareness”
4.Draw the four quadrants of theJohariwindow (follow guidelines onp.82-84)and create a word portrait as a tooltodevelopself-awareness.
CourseCompetencies / Weekly/UnitCompetencies
Week 1Continued / Activities
Week 1continued
7. Assess, analyze, prioritize,formulate, organize andimplement patientneeds andprovide nursing care relatedto / 1.10 Interpret the various roles ofthe psychiatric nurse in thenurse-patient relationship:
  • Role ofteacher
  • Role ofcaregiver
  • Advocaterole
  • Parent-surrogate
1.11 Examine the effect ofthe following obstacles on thetherapeutic relationship:
  • Inappropriate boundaries
  • Encouragingdependence, non-acceptance &avoidance.
1.12 Examine individualcultural, developmental, genetics &biological factors with regards toindividual patient’s response to mentalillness. (Videbeck, Ch.7)
1.13Analyze the impact ofthe following personal characteristicswith regards to patient response tomental health needs/disorder:
(Ch. (Individual)
  • Self efficacy
  • Hardiness
  • Resilience andresourcefulness
  • Spirituality (Interpersonal)
  • Sense ofbelonging
  • Social network/social support
  • Familysupport (Cultural)
  • Beliefs about causes ofillness
  • Culturalassessment
  • Socioeconomicstatus
“Legal /Ethical Issues”
1.14 Describe the “Patients Bill of Rights” & how they are implemented within psychiatric settings. / RequiredReading: Videbeck, Sheila L.(2014) Ch.7
National MulticulturalInstitute

physiologicintegrity and
psychologic integrityfor
the patientsmental illness/disorders. / RequiredVideos/DVD’s(309)“Principles ofInterpersonal Communication” InsightMedia
8. Apply the principlesof Quality andSafety / (127) “People say that I’mcrazy”
Video “TherapeuticCommunication”
Education forNurses / film
Care, Teamworkand / (313) “Communicating withAngry People” the 7-6-5 Method”#200082
Based Practice(EBP),
Quality Improvement(QI), Safety, and Informaticstoguide the utilizationof / RequiredReadings: Videbeck, S(2014)
Ch. 7: Cultural/Spiritual beliefs– responses toillness
knowledge, skillsand
attitude(KSA). / Correlated ClinicalActivity
(To be completed in Week2)
Write one InteractionProcess
Analysis based on aNurse-
Analysis must reference textCh.6
Videbeck, Sheila L.(2014)
Ch. 9: Legal & EthicalIssues
Ch.11: Anger, Hostility,Aggression
Prior to Orientation dayview
considerations and PatientRights
Medcom Code #200132
Web sites: Mental HealthPatient’s
Bill ofRights

1.15 Identify circumstances thatwould result in restriction of patientrights.
  • Commitment (voluntaryvs. involuntary)
  • Release fromhospital
  • Mandatory Outpatienttreatment
/ Correlated ClinicalActivity
Review the legal section ofa
patient’s chart while on themental
health in-patientunit.
CourseCompetencies / Week 1continued
Weekly/UnitCompetencies / Activities
1.16 Explain each of thefollowing legal issues affecting the practiceof Psychiatric Nursing and“Patient Rights”: (Ch.9)
  • Conservatorship &Guardianship
  • “Least RestrictiveEnvironment”
  • “Seclusion and Restraints”
  • Confidentiality(HIPPA)
  • Tarasoff Case-1976 “DutytoWarn” (p.154 Box9.2)
  • InsanityDefense
  • Competency to standtrial
  • Reise Act(1987)
1.17Explain “Intentional Torts”as they relate to potential liability forthe Psychiatric nurse. (Assault,Battery, Falseimprisonment)
Anger, Hostility &Aggression
1.18 Using the Nursing Process, distinguish the Five phases ofthe Aggression Cycle andassociated behaviors:Triggering,Escalation,Crisis, Recovery Post- crisis (Ch.11, p.189-191) / Correlated Clinical OrientationSkills LabActivity
1.) Orient to Haiku program and psych course materials;
2.) Practice Self-defensetactics in MOAB (Managementof AssaultiveBehavior)
In groups of 3 – Workwith a partner-Practice therapeuticcommunication simulationscenarios- (nurse-patient) –The3rdstudent is to act asthe observer and evaluatethe interaction,make suggestions for changes– providefeedback.Then rotate to scenario #2and then #3(Simulation scenarios to bedistributed in skillslab)
Correlated Clinical Activity week 1& 2
1. Identify the nurse’s roleinrecognizing and managing hostileandaggressive behaviors and providingangersuppression to maintain a safe environmentin psychiatricsettings.
2. Formulate evidence –basednursinginterventions for management ofvariousphases of the aggressivecycle.
CourseCompetencies / Week2
Weekly/UnitCompetencies / Activities
2.1Discuss the impact of dysfunctionofvarious parts of the brain andneuro-transmitters in relation to developmentofpsychiatric, movement andcognitivedisorders.
2.2Identify the variousneurobiologicaltheories to explain the developmentofmentalillness:
  • Genetics/Heredity
  • Stress and the ImmuneSystem
  • Infection
  1. Examine the impact of apatient’sculture on the efficacy, implicationsforpatient education related to useofpsychotropic medications.
/ Requiredreading/DVD’s:Videbeck, Sheila L.(2014)Ch. 2, 3, 8 & 17(p.324, 330) Kee,Joyce, Review Ch. 27, 28 psychotropic medications
View Requirededucational DVD’s
(nursing library)
“Psychotropic MedicationsAssessment,Interventions & Treatment”ConceptMedia #200199
“Medication Issues in MentalHealth:Preventing Adverse DrugReactions”Concept Media #200094
CourseCompetencies / Weekly /UnitCompetencies / Week 2Activities
Week 2continued
2.4Compare and contrastpsychotropicclassifications, mechanisms ofaction,side effects, nursing considerationspatient teaching across thelifespan.
2.5Identify “Extrapyramidalsideeffects” for Antipsychotic drugs &thenursing implicationsfor:
  • AcuteDystonia
  • Pseudoparkinsonism
  • Akathisia
  • TardiveDyskinesia
2.6Discuss additional side effectsr/tneuroleptic medications & relatednursingimplications.
  • Agranulocytosis
  • Anticholinergiceffects
  • Weightgain
  • Elevatedprolactin
  • Hyperglycemia/diabetes
  • Cardiovascular adverseeffects
2.7Identify signs/symptomsofNeuroleptic Malignant Syndrome(NMS)Causes &treatment
2.8Distinguish the componentsofthe Psychosocial Assessment andthe
Mental Status Exam. (Videbeck, Ch.8)
  • Compare criteria forassessingadolescent, adult and elderclients.
  • Examine the differences forconducting a MSE with anadolescent,adult and elderclient.
2.9Compare/ContrastPsychosocialTheories and Therapies as they relatetothe development and understandingofmental health needs/disorders.
2.10Describe nursing interventionsusedwhen assessing suicidal/homicidalideation or intent inclients.
2.11Examine basic beliefs andapproachesof the various psychosocial theoriesandtreatmentmodalities.
2.12Discuss the Nurse’s role in eachofthe followingtherapies:
  • Individualpsychotherapy
  • GroupTherapy
  • Familytherapy
  • Educationgroups
  • Support groups
  • Self-help groups
/ Correlated ClinicalActivity
**Do Weekly for eachassignedpatient inclinical:
A.) Research all prescribedmedicationsfor assigned patient; correlaterelatedlabs; nursing implications forpatientteaching;
B.) Identify related safetyissues
C.) Include a teaching plan specific forpatient’s medicationregime.
D.) Evaluate patient’s responsetomedication.
*Write one InteractionProcess Analysis (IPA) based on aNurse- Patient interaction duringclinical andinclude:
  • Student-PatientGoals
  • Verbal & non-verbalresponses
  • Restates non-therapeutic inatherapeuticmanner
  • Analyze patient’s responses(textreferences)
  • Evaluates goals of (interactionIdentifies plan forfuture
  • Analysis of StudentInteraction(*Must use text references inVidebeck, Ch.6)
Videbeck, S(2014)
Ch. 8 “Mental Status &PsychosocialAssessment”
Videbeck Ch. 17 “SuicideAssessment”
Tabloski Ch 7. (p.179-181)“Psychological Assessment-OlderAdult”
Videbeck, Sheila L. (2014,Ch.3)Review “DefenseMechanisms”
p.45 NS104class
Tabloski, P (2014) Ch.7Stress/Crisis/Anxiety &Depression/Suicide in the olderadult
Correlated ClinicalActivityJournalwriting: include a discussion of at leastone group activity attended. How didthenurse or group leader contribute tothegroup?
In post conference (weekly)
SBAR presentation – present hand-off report to classmates and instructor.