ISLAMIC UNIVERSITY OF GAZAISLAMIC UNIVERSITY OF GAZAFACULTY OF NURSINGFACULTY OF NURSING

MASTER OF COMMUNITY MENTAL HEALTH NURSINGMASTER OF COMMUNITY MENTAL HEALTH NURSINGSTANDARD OUTLINE FOR COURSE SYLLABUSSTANDARD OUTLINE FOR COURSE SYLLABUS

Course title:Course title: Contemporary mental health nursing Contemporary mental health nursingCourse InstructorCourse Instructor: Dr. Ashraf El-Jedi, RN, BSN, MSN, : Dr. Ashraf El-Jedi, RN, BSN, MSN,

DrPH.DrPH.Term: First semester 2009/2010Term: First semester 2009/2010

Course descriptionCourse description

• This course allows students to study current issues impacting upon the development and application of mental health nursing principles. It focuses on two central themes: 1) evidence-based nursing practice and 2) global mental health. It provides students with the most current, culturally competent, authoritative, and comprehensive resource available.

Learning objectivesLearning objectives

At the end of this course the participant will be able to:

• Identify different global issues in mental health nursing.• Be Familiar with trends in provision of care in mental health

settings.• Recognize the most recent Issues relating to policy, planning,

and clinical nursing practice.• Consider ethical issues when practicing mental health nursing.• Be Familiar with Human rights regarding mental

health/illness.• Identify the most current, culturally competent, authoritative,

and comprehensive international and local resource available.• Demonstrate understanding to the most up-to-date, evidence-

based, culturally competent, practice.

Course content scheduleCourse content schedule::

Teaching MethodsTeaching Methods::

• Lectures

• Discussion

• Demonstration

• Audiovisual aids

• Work group

EvaluationEvaluation

• Mid term exam 30%

• Assignment and project 20%

• Final exam 50%

• Total 100%

Course PoliciesCourse Policies-:-:

1- Students are expected to prepare for lectures by reading the assigned material and reviewing relevant literature.

2- Attendance of lecture is a requirement. (See the university policies regarding absence)

3- Students are expected to attend the exams. Any missed exam will result in a grade of zero (0) for that exam.

ReferencesReferences

• Gail Wiscarz Stuart (2009). Principles and Practice of Psychiatric Nursing. 9th Edition

• Stickley T & Basset T (2008). Learning about mental health practice. Jone Wiley & Sons Inc. England

Principles of Psychiatric Principles of Psychiatric Nursing CareNursing Care

• You are about to begin a voyage to places you have never been before: the world of psychiatric and mental health nursing, students learned about pieces of people-and infected toe, a congested lung, a troubling twitch, or maybe even a broken heart-but pieces nonetheless.

• Today, students learn about the wholeness of people: a physically ill child struggling to find safety in an abusive family, an adolescent coping with eating problems and self-esteem, a young adult grieving over the diagnosis of HIV/AIDS, or an elder, living alone, feeling confused and going to a nursing home.

• This is the exciting world of today's psychiatric nurse. It integrates the biological, psychological, sociocultural, environmental, legal, and ethical realities of life and weaves them together in a rich tapestry called Psychiatric-mental health nursing practice.

Role EmergenceRole Emergence

• The role of psychiatric nursing began to emerge in the early 1950s.

• An article by Bennett and Eaton in the American Journal of Psychiatry in 1951 identified the following problems affecting psychiatric nurses:

• Scarcity of qualified psychiatric nurses.• Underused of their abilities• The fact that "very little real psychiatric nursing is

carried out in otherwise good psychiatric hospitals and units".

Evolving FunctionsEvolving Functions

In 1958 the following function of psychiatric nurses were described (Hays, 1975):

• Dealing with patients' problems of attitude, mood, and

interpretation of reality.• Exploring disturbing and conflicting thoughts and

feelings.• Using the patient's positive feelings toward the therapist

to bring about psycho physiological homeostasis.• Counseling patients in emergencies, including panic and

fear• Strengthening the well part of patients.

The 1970s gave rise to the further development of the specialty. Psychiatric nurses became the pacesetters in specialty nursing practice. They were the first to do the following:

• Develop standards and statements on scope of practice.

• Establish generalist and specialist certification.

The 1980s were years of exciting scientific growth in the area of psychobiology. New focus was placed on the following:

• Brain-imaging techniques• Neurotransmitters and neuronal receptors• Psychobiology of emotions• Understanding the brain• Molecular genetics related to psychobiology.

Psychiatric nurses thus entered the Psychiatric nurses thus entered the 1990s faced with the challenge of 1990s faced with the challenge of integrating the expanding bases of integrating the expanding bases of neuroscience into the caring and neuroscience into the caring and holistic biopsychosocial practice of holistic biopsychosocial practice of psychiatric nursing.psychiatric nursing.

• By 2000 psychiatric nurses agreed that the knowledge base of the specialty is based on the integration of the biological, spiritual, social, and environmental realms of the human experience (Raingruber, 2003; Silverstein, 2006).

Contemporary PracticeContemporary Practice

• Psychiatric-mental health nursing is an interpersonal process that promotes and maintains patient behavior that contributes to integrated functioning. The patient may be an individual, family, group, organization, or community.

• The American Nurses Association's Psychiatric-Mental Health Nursing Scope and Standards of Practice (2007) defines psychiatric-mental health nursing as "a specialized area of nursing practice committed to promoting mental health through the assessment, diagnoses, and treatment of human responses to mental health problems and psychiatric disorders…. {It} employs a purposeful use of self as its art and a wide range of nursing psychosocial and neurobiological theories and research evidence as its science."

• The Center for Mental Health Services officially recognizes psychiatric nursing as one of the five core mental health disciplines.

• The other four disciplines are marriage and family therapy, psychiatry, psychology, and social work.

Nurse-Patient PartnershipNurse-Patient Partnership : :

• The contemporary practice of psychiatric-mental health nursing occurs within a social and environmental context. Thus the "nurse-patient relationship" has evolved into a "nurse-patient partnership" that expands the dimensions of the professional psychiatric nursing role. These elements include clinical competence, consumer-family advocacy, mutual responsibility, interprofessional collaboration, social accountability, and legal-ethical parameters. (Figure).

Figurer: Figurer: Elements of the Psychiatric-mental health Elements of the Psychiatric-mental health

nursing rolenursing role . .

Competent CaringCompetent Caring::

• The three domains of contemporary psychiatric-mental health nursing practice are direct care, communication, and management. Within these overlapping domains of practice, the teaching, coordinating, delegating, and collaborating functions of the nursing role are expressed (Figure ).

Figurer: Figurer: Psychiatric-mental health nursing practice Psychiatric-mental health nursing practice..

Psychiatric-mental health nurses are able to do Psychiatric-mental health nurses are able to do

the followingthe following::

• Make culturally sensitive biopsychosocial health assessments.

• Design and implement treatment plans for patients and families with complex health problems and co morbid conditions.

• Engage in care management activities, such as organizing, assessing, negotiating, coordinating, and integrating services and benefits for individual and families.

• Provide a " health care map" for individuals, families, and groups to guide them to community resources for mental health, including the most appropriate providers, agencies, technologies, and social systems.

• Promote and maintain mental health and manage the effects of mental illness through reaching and counseling.

• Provide care for physically ill people with psychological problems and psychiatrically ill people with physical problems.

• Manage and coordinate systems of care integration the needs of patients, families, staff , and regulators

Domains of Psychiatric-Mental Domains of Psychiatric-Mental Health Nursing PracticeHealth Nursing Practice

Levels of performance• Four major factors _ laws, qualifications, practice

setting, and personal initiative _ play a part in determining the roles engaged in by each nurse.

Laws• Nurse practice acts also address aspects of advanced

practice, including prescriptive authority (Staten et al, 2006). Nurses must be familiar with the nursing practice act of their state and define and limit their practice accordingly.

Qualifications

• Psychiatric_ mental health registered nurse (RN- PMH).

• Psychiatric _ mental health advanced practice Registered nurse (APRN – PMH): An advanced practice nurse may be either a clinical nurse specialist (CNS) or a nurse practitioner (NP).

Practice settingPractice setting

• Settings for psychiatric- mental health nurses include psychiatric facilities, community mental health centers, psychiatric units in general hospital, residential facilities, and private practice. Many psychiatric hospitals have become integrated clinical systems that provide inpatient care, partial hospitalization or day treatment, residential care, home care, and outpatient or ambulatory care.

• Community – based treatment setting have expanded to include primary care clinics, schools, prisons, industrial settings, managed care facilities, health maintenance organizations, hospices visiting nurse associations, home health agencies, emergency departments nursing homes, and shelters.

• Psychiatric- mental health nurses are quickly moving into the domain of primary care and working with other nurses and physic- cians to diagnose and treat psychiatric problems in patients with comorbid medical conditions.

• Treatment in a nonpsychiatric environment may be more efficient and more acceptable to patients and their families.

Personal initiativePersonal initiative • This is a very important factor

Psychiatric nursing agendaPsychiatric nursing agenda

• Psychiatric- mental health nursing continues to grow and evolve.

• More than 80,000 registered nurses are working in mental health organizations in the United States: half are employed in psychiatric hospitals and the other half are community based.

• There are more than 20,000 advanced practice psychiatric- mental health nurses with graduate degrees.

• To best meet the challenges of the next decade, psychiatric nurses need to focus their energies on three areas: outcome evaluation, leadership skills, and political action.

Outcome evaluationOutcome evaluation

• Psychiatric-mental health nurses must identify, describe, measure, and explain the process and outcomes of the care they provide to patients, families, and communities.

• "What difference does psychiatric nurse caring make?

Leadership skillsLeadership skills

• Psychiatric-mental health nurses need knowledge and strategies that enable them to exercise leadership and management in their work. Such leadership has a direct impact on the care patients receive. It also strengthens and expands the contribution of psychiatric nursing to the larger health care system Psychiatric-mental health nurses need knowledge and strategies that enable them to exercise leadership and management in their work. Such leadership has a direct impact on the care patients receive. It also strengthens and expands the contribution of psychiatric nursing to the larger health care system

Political ActionPolitical Action

• Increasing psychiatric nurses' political awareness and skills is necessary to bring about needed changes in the mental health care delivery system.