CASE WESTERN RESERVE UNIVERSITY FRANCES PAYNE BOLTON SCHOOL OF NURSING SYLLABUS Fall 2008

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1 1 COURSE NUMBER: NURS 466 CASE WESTERN RESERVE UNIVERSITY FRANCES PAYNE BOLTON SCHOOL OF NURSING SYLLABUS Fall 2008 COURSE TITLE: Practicum In Role Of Clinician COURSE DESCRIPTON: (NURS 463 co-requisite): The course is an exploration of issues related to the role of the clinician in the enhancement of health-seeking behaviors of individuals and communities as they strive to achieve optimal levels of health. It examines the consultative, administrative, and educational processes in the practice of consultation and community education. NURS 466: The practicum course emphasizes the professional encounter between the psychiatric mental health clinical nurse specialist/nurse practitioner, staff and agency personnel providing mental health services, and clients receiving services in the context of an environment of care. Intrapersonal, interpersonal and extrapersonal variables that influence the health seeking behaviors of individuals, families and groups as they seek to attain, maintain or regain optimal levels of mental health are employed. CREDIT HOURS: PRE-REQUISITES: FACULTY: CLASS TIME: 3 semester hours (1 supervision, 2 clinical days) Enrollment in the Graduate Program in Psychiatric-Mental Health Nursing Consent of the instructor M. Jane Suresky, ND, PMHCNS-BC Office #: NO 3240 Phone #: mjs5@po.cwru.edu Office Hours: Tuesday & Thursday 1:30 PM 2:30 PM And by appointment Wednesday 12:30 1:30 PM FUNCTION: The psychiatric nurse clinician functions as a change agent in direct and indirect care through the role of practitioner, teacher, consultant, planner, evaluator and researcher.

2 2 OBJECTIVES: Upon successful completion of this course, the student will be able to: 1. Define the roles of the psychiatric clinical nurse specialist/nurse practitioner and respective theoretical foundations. 2. Demonstrate the psychiatric clinical nurse specialist/nurse practitioner role in a mental health care environment. 3. Identify staff and administration' s view of the psychiatric clinical nurse specialist/nurse practitioner in different clinical settings. 4. Analyze research literature that pertains to the psychiatric clinical nurse specialist/nurse practitioner role. 5. Demonstrate ability to use faculty and peer supervision for personal development as a psychiatric clinical nurse specialist/nurse practitioner and clinical leader. Educational Support: The course faculty is available to meet to discuss requests for academic accommodations after the student has registered with the Office of Disability Resources (ESS, Sears 470). Accommodations cannot be provided retroactively. Academic Integrity: All students are expected to maintain academic integrity, including the avoidance of cheating and plagiarism. Students are required to adhere to all academic integrity policies as published in the School of Nursing Handbook School of Nursing Bulletin, the University Bulletin ( and at Violations of academic integrity will be addressed by the course faculty in accordance with the policies on academic integrity. Conceptual Framework: Clients utilize psychological and sociological health-seeking behaviors to achieve an optimal health status. These acquired behaviors may be voluntary or involuntary, conscious or unconscious. Through an understanding of these health-seeking behaviors, the nurse is able to design nursing strategies and interventions which maximize the health potential of the client. Topical Outline: I. The Clinical Nurse Specialist (CNS)/Nurse Practitioner (NP) A. Entry into the environment of care B. Roles of the Advanced Practice Nurse C. Expectations of Staff and Administration D. Self evaluation and use of Clinical Supervision

3 3 II. Implementation of the Clinical Specialist/Nurse Practitioner Role A. Identification of Student Objectives B. Discussion of the Role in Various Clinical Settings C. Evaluation of Performance and Agency Utilization of the CNS/NP Role Teaching Strategies: Practicum Supervisory conferences Weekly Critical analysis logs Annotated bibliography Evidence-based practice paper presentation Evaluation Methods: Written self-evaluation Course evaluation by student Clinical supervisory conferences Final evaluation conference with instructor Participation in supervisory conferences Competence in practice role of clinician Evidence-based practice paper Readings/Texts: Bjorklund, P. (2003). The certified psychiatric nurse practitioner: Advanced practice psychiatric nursing reclaimed. Archives of Psychiatric Nursing, 17, p Burgess, A.W., Ed. (1998). Advanced practice psychiatric nursing. Stamford Conn:Appleton& Lange. Campbell, C., Musil, C & Zauszniewski, J. (1998). Practice patterns of advanced practice psychiatric nurses. Journal of the American Psychiatric Association, 4, p Critchley, D. L., & Maurin, J. T. (1985). The clinical nurse specialist in psychiatric mental Health nursing: Theory, research, and practice. New York: John Wiley & Sons. Hales, A., Karshmer, J., Williams, J., Mann, A. & Robbins, K. (2004). Preparing for prescriptive privileges: A standard for the psychiatric-mental health preceptorship. Perspectives in Psychiatric Care, 40 (3),

4 4 McCabe, S. (2002). The nature of psychiatric nursing: The intersection of paradigm, Evolution, and history. Archives of Psychiatric Nursing, 16, p Scharer, K., Boyd, M., Williams, C., & Head, K. (2003). Blending specialist and practitioner Roles in psychiatric nursing: Experiences of graduates. Journal of the American Psychiatric Nurses Association, 9 (4), Shea, C., Pelletier, L., Poster, E., Stuart, G. & Verhey, M. (1999). Advanced practice nursing in psychiatric and mental health care. St. Louis: Mosby. Snyder, M. & Mirr, M.P., Eds. (1995). Advanced practice nursing: A guide to professional development. New York: Springer Pub. Co. Wheeler, K., & Haber, J. (2004). Development of psychiatric-mental health nurse practitioner competencies: Opportunities for the 21 st century. Journal of the American Psychiatric Nurses Association, 10 (3), Optional: Lewis, A., & Levy, J.S. (1982). Psychiatric liaison nursing: The theory and clinical practice. Reston, VA: Reston Publishing Company, Inc. Menard, Shirley. (1987). Clinical nurse specialist: Perspectives on practice. New York: John Wiley & Sons. Scheele, A. (1979). Skills for success. New York: Ballantine. Schon, D.A. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books. Other Readings As Arranged.

5 5 GUIDE TO PRACTICUM The student will: 1. Exercise the responsibility for giving feedback on his/her rational views and perception while the course is in progress. 2. Identify clearly those aspects of the clinician' s role which you will practice. 3. Write behavioral objectives for the identified aspects of the clinician s role. 4. Demonstrate knowledge of the agency' s philosophy, objectives, financial sources of support, information system, and evaluation system relative to client, program and staff. 5. Explore relationship between the clinician and clinical administration. Explore relationship between the clinician and agency administration. 6. Demonstrate competence in practicum. 7. Observe and where appropriate participate in the decision making process. 8. Assess degree and effect of consumer input. 9. Keep designated agency staff member fully informed of student' s activities. 10. Keep records in accordance with agency policy. 11. Elicit feedback from agency on progress. 12. Demonstrate awareness of behavior as perceived by the agency staff. 13. Modify behavior where indicated. 14. Participate constructively with classmates in a critical analysis of shared data in supervisory sessions. 15. Write a self-evaluation of progress at mid-term and at the conclusion of the semester (guide provided). 16. Write a final course evaluation (guide provided).

6 6 EXPECTATIONS HELD FOR THE STUDENT The student will: 1. Attend supervisory conferences and participate constructively in a critical analysis of shared data. 2. Maintain log of clinical practicum experiences. 3. Lead group discussion of practice data. SUPERVISION Supervision is provided weekly. Provide a copy of the log for the instructor. In preparation for this course, you have taken theory and practice in family, group and individual work and in consultation and collaboration. You are expected to review your previous learning in this program. GRADING Considerations in grading include: Quality of participation in supervisory conferences: 1/3 Competence in practice of role of clinician: 1/3 Evidence-based practice paper 1/3 A student must receive a grade of "P" or "C" in all areas to be graded in order to pass the course. The faculty member has the option of granting a grade of "Incomplete" for the semester until any unsatisfactory grades are improved to a satisfactory level. If the clinical component is not passed, the student will be required to repeat the course.

7 7 SUPERVISION 1. The purposes of supervision are safeguarding care of clients, promotion of student competence as a therapeutic agent, and maintenance of agency relationships. The focus of supervision is clinical judgement. The development of clinical judgement is evidenced by the students' ability to: a. assess, set goals, plan, implement, and evaluate their performance b. assess, set objectives, plan, implement, and evaluate client outcome c. refine communication techniques d. apply appropriate theory to practice as reflected in analysis/interpretation of data 2. Expectations for students in supervision: a. demonstrate ability to apply theory to clinical experience b. demonstrate openness in sharing accurate clinical data c. explore alternative formulations and approaches in assessing, planning, implementing and evaluating nursing interventions d. analyze relevant elements of interactions (positive and negative) in detail to promote learning e. assume responsibility for increasing self awareness and understanding of own behavior in interactions with others in a variety of situations, e.g., initial meetings, under stress, giving and receiving feedback f. analyze the effect of own behavior on others and of others' behavior on oneself g. validate perceptions with colleagues h. seek feedback regarding performance from and offer feedback to classmates and instructor.

8 8 Evidence-based Practice Paper Purpose: To examine research evidence for clinical interventions, which are used or can be used in psychiatric-mental health nursing practice. Outcome Measure: A 7-10 page word-processed manuscript (double spaced, one inch margins, excluding references) that is organized using the following structure: 1. Introduction to the problem (includes description of the problem, its prevalence, and significance or impact). 2. Definition of a clinical question. Examples include: How can a person hospitalized on the inpatient psychiatric unit be kept safe? How can aggressive episodes of behavior be prevented? How can respect and dignity be maintained? How can depressed persons be motivated? How can medication compliance be improved? 3. Description of your search strategy name the database used in your search (i.e. MEDLINE, PUBMED, PSYCHLIT, PSYCHINFO, AGELINE, etc.) the key word used in your search, and the total number of relevant articles. 4. Review relevant abstracts for the two(2) best and latest articles that addresses the identified problem. The articles must describe a research study. Please discuss your article selections with the professor to insure its appropriateness if there are any questions before you get too involved with writing the paper. 5. Summarize and critique the evidence in two articles. Note that the studies may present findings that are not consistent with what is done in a particular clinical setting. Discuss the findings in light of what you see in clinical practice and what is present in Psychiatric/Mental Health nursing textbooks. 6. State at least three recommendations for clinical practice that are based on the findings from research. 7. List the references using the APA format. Use APA 5 th ed. For style, grammar, and formatting the entire manuscript. Please pay attention to appropriate referencing of information within the manuscript and use citations. Remember that if you quote directly from published work, quotation marks and appropriate citations are required. Scoring: 1. Introduction Statement of clinical question(s) Description of search strategy Summary/critique of articles Practice recommendations Referencing/grammar/style/format 10 NURS466/Suresky/Revised Fall 2008