Specific Core Nursing Content # 6: Patient Care Roles

Clinical Learning Outcomes

  • Demonstrate ability to effectively teach patients experiencing psychiatric disorders and their families.
  • Plan and evaluate for a continuum of care that provides safety, structure, and support for patients with psychiatric disorders.
  • Evaluate the continuum of care for a patient experiencing a psychiatric disorder.
  • Refer patients and families to advocacy organizations.
  • Assist patients to access self-help groups.
  • Discuss significance of role-modeling and identify consequences of healthy nurse self-care vs. avoidance of nurse self-care.

Teaching Strategies

Classroom Teaching Strategies

  • Review H. Peplau (1952) Six sub-roles of the psychiatric nurse which can be assumed at various times during a therapeutic relationship. These are: Nurse teacher, Mother surrogate, Technical nurse, Nurse manager, Socializing agent, Counselor/therapist
  • Principles of case management.
  • Principles of teaching and learning as applied to client education.
  • Devising and using a teaching plan.
  • Assessing the educational needs of clients.
  • The use of role play, simulation.
  • Use a Spiritual Assessment Model to complete a personal spiritual assessment in 3-5 pages
    a. SAS - Spiritual Assessment Scale (O'Brea), 2014
    b. HOPE - Spiritual Assessment Tool - www.aafp.org
    c. FICA - https://smhs.gwu.edu/gwish/clinical/fica/spiritual-history-tool
    After completing assessment, use the Betty Neuman Systems Model to identify strengths, stressors and nursing diagnoses.
  • Reflection Paper Assignment - Topic: Compassion Fatiuge; Supporting Myself Spiritually
    -Write a personal reflection about Compassion Fatigue. Include 1 scholarly article for support.
  • Students define Environmental Intelligence and describe how it applies to the nurse-client relationships.
  • Teach mindfulness techniques to help students "pause" and be present in situations.
    See Beauvais, N., O'Shea, E. and Griffin, M (2011) Emotional Intelligence and nursing performance among nursing students. Nursing Education Today, 31, 396-401.
  • Heart Math®:

    • Heart Math® is a program designed to build resilience and enhance coping skills in response to stress, challenges, and adversity through self-regulation and the use of biofeedback technology (Institute of Heart Math®, 2014).
    • Resilience is defined as the capacity to prepare for, recover from, and adapt in the face of stress, challenge and adversity(Heart Math®, 2014).
    • Domains of resilience include: emotional, physical ,spiritual, and mental (Heart Math®,2014).
    • Heart Math ® (2014) techniques include: depleting and renewing emotions, worksheet completion, biofeedback, focused breathing and emotional shifting.
  • Journal articles to supplement text:
    • Koivunen, M., Huhtasalo, J., Makkonen, P., Valimaki, M., Hatonen, H. (2012). Nurses' roles in systematic patient education sessions in psychiatric nursing. Journal of Psychiatric and Mental Health Nursing, 19 (6), 546–554.
    • Herrick, C. A. & Bartlett, R. (2004). Psychiatric nursing case management: past, present, and future. Issues in Mental Health Nursing, 25(6), 589-602.

Clinical Teaching Strategies

  • Discuss the use of patient advocacy groups with clients
  • Devise teaching plans for teaching two clients about their medications
  • Identify local resources for supporting clients with PMH problems
  • Discussion with clinical case managers
  • Shadow a Case Manager or Intensive Case Manager
  • Develop self-care plan to promote area of self-care/self-improvement. (i.e. set goal to increase nutrition, improve sleep, enhance spirituality, increase exercise, etc.)
  • Assign journaling as method to increase emotional intelligence.  Build self-awareness and reflective practice skills.
    See https://www.tru.ca/disciplines/eng309/nursing/nursing.htm
  • Students to explore concepts such as Time management, Forgiveness, Gratitude, Conflict resolution, Stress reduction, Cognitive reframing, mindfulness, Physical health, to overall Health and Well-being.
    See: Hensel, D and Laux (2014). Longitudinal study of stress, self-care and professional identity among nursing students. Nurse Educator, 39, 227-231.
    Regehr, C., Gloney, D. and Pitts, A. (2013). Interventions to reduce stress in university students:  A review of meta-analysis. Journal of Affective Disorders, 148 (1), 1-11.

Case Studies

  • Write report focusing on client issues that are continually raised at treatment team meetings, such as patient requests that their medication be discontinued.

Simulation Exercises

  • Role play or Standardized Patient exercise examining issues related to patient advocacy situations
  • Plan workload for nurse with a defined case load.

Assessment Strategies

Assignments with Rubrics

  • Devise teaching plan about medications for two clients
  • Report on issues raised by clients during treatment team meetings

Clinical Skills Checklist

  • Workload planning for case load management (Standard 4. Planning)
  • Develop and deliver teaching plan for client (Standard 5B. Health Teaching and Health Promotion)
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The American Psychiatric Nurses Association is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.