2019 Fall RNSG 2263 Clinical Mental Health CID

2019 Fall RNSG 2263 Mental Health Nursing
Tarrant County College

Course Information Document Fall 2019
Course Title: Clinical Foundations for Mental Health Nursing

Course Number: RNSG 2263
Course Coordinator
Victoria Anthony RN MSN ACNP-R

Assistant Professor of Nursing § Nursing Department
Tarrant County College River East Campus
245 East Belknap St. § Fort Worth TX 76102
817-515-2319
victoria.anthony@tccd.edu § www.tccd.edu
Warning: © 2019 TARRANT COUNTY COLLEGE
This document is copyrighted (All rights reserved.)
Note: This CID is for information purposes only and is not to be construed as a contract.
REQUIRED TEXTBOOKS FOR RNSG 2213
The instructor reserves the right to change any information contained in this document, when
necessary, with adequate notice given to students.
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Required Textbooks
Halter, M. (2018). Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical
Approach (8thed.). Elsevier Saunders: New York, New York. ISBN: 978-0-323-38967-9.
Lilley, L. L., Collins, S. R., & Snyder, J. S. (2017). Pharmacology and the Nursing Process (8th
ed.). St. Louis, MO. ISBN 978-0-323-35828-6.
Varcarolis, E., (2019). Manual of Psychiatric Nursing Care Planning (6thed.). St. Louis, MO.
Elsevier Saunders, New York, New York. ISBN: 978-0-323-47949-3.
Required textbooks are also available in an e-Book format.
ADDITIONAL REFERENCES
TCC Nursing Resources: http://www.tccd.edu/nursing
Texas Board of Nurse Examiners: http://www.txbon

This website includes documents and guidelines. Nurse Practice Act. Texas Statutes regulating
the practice of Professional Nursing, required to practice professional nursing.
Link to Nursing Student Guidelines
https://www.tccd.edu/documents/services/student-life/rights-and-responsibilities/student-
handbook/2018-2019-student-handbook.pdf
COURSE DESCRIPTION
A health-related work-based learning experience that enables the student to apply specialized
occupational theory, skills, and concepts. Direct supervision is provided by the clinical
professional. The supervision (faculty or preceptor) is generally in a clinical setting. Practical
experience is simultaneously related to theory. Clinical education is an unpaid learning
experience. Focus is on holistic human needs. Associate degree nurse role assimilation is
facilitated through the development of major concepts.
Prerequisites: RNSG-1413, RNSG-1360, and RNSG-1105
Co-Requisite: RNSG-2213 (If it is the second attempt at passing this course, then the co-requisite
may be waived.)
Learning outcomes are linked to SCANS requirements. Specific SCANS requirements are linked to the
class schedule.
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COURSE TYPE
Technical
COURSE GOALS AND LEARNING OUTCOMES

End-of-Course Outcomes: As outlined in the learning plan, apply the theory, concepts, and skills
involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions
within and among political, economic, environmental, social, and legal systems associated with
the occupation and the business/industry and will demonstrate legal and ethical behavior, safety
practices, interpersonal and teamwork skills, and appropriate written and verbal communication
skills using the terminology of the occupation and the business/industry.
COURSE OUTCOMES
Upon successful completion of this course, students will:
1. Demonstrate safety in displaying knowledge, skills, and attitudes that ensure a culture of
safety within the psychiatric/mental health environment by
a. implementing measures to promote a safe environment for patients and others (1a,
1b, 1c, 2c and 2e)
b. identifying patients accurately (1a, 1b, 1c, 2c and 2e)
c. performing nursing procedures and skills correctly (1a, 1b, 1c, 2c and 2e)
d. implementing and maintaining measures to prevent exposure to infectious
pathogens (1a, 1b, 1c,2c and 2e)
e. maintaining and monitoring for the chemical safety of the patient (1a, 1b, 1c, 2a-
e)
f. stating the rationale for and the effects of medications and treatments (1a, 1b, 1c,
2a-e)
g. maintaining and monitoring for the thermal safety of the patient (1a, 1b, 1c, 2b &
e)
h. assuring the psychological safety of the patient by using stress control methods
and therapeutic communication (1a, 1b, 1c, and 2a-e)
i. advocating for patient/family (1a-c, 2a–e)
j. implementing patient care according to legal, ethical, state, and national standards
(1a-c, 2a–e)
k. demonstrating therapeutic interaction with psychiatric/mental health patients and
the interdisciplinary team (1a-c, 2a–e)
2. Demonstrate professionalism in displaying the attitudes and values of the nursing

profession by
a. demonstrating responsibility and accountability for personal and professional
beliefs (1b, 1c, 2b, 2d and 2e)
b. adhering to policies and procedures of TCC, the Nursing Department, the course,
the clinical facility, and the Texas Nurse Practice Act (1a-c, 2a–e)
c. following faculty instructions (1a, 1b, 2b and 2e)
d. demonstrating professional behaviors, appearance, and attitude (1a-c, 2a–e)
e. interacting with patients, nursing faculty, and the healthcare team in a
professional manner (1a-c, 2a–e)
f. complying with the professional, ethical, and legal standards of nursing (1a-c, 2a–
e)
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g. maintaining patient confidentiality and professional boundaries (1a-c, 2a–e)

h. demonstrating evidence based clinical practice (1a-c, 2a–e)
i. demonstrating behaviors and attitudes indicating honesty, accountability,
trustworthiness, reliability, and integrity (1a-c, 2b)
3. Demonstrate a caring approach in providing genuine and empathetic care with

positive regard for self and others by
a. demonstrating caring behaviors in nursing process development and
implementation (1a-c, 2a-e)
b. participating in interventions that reflect caring behaviors (1a-c, 2a and 2b)
c. providing culturally sensitive healthcare to patients and their families (1a-c, 2a-e)
d. providing safe, compassionate, comprehensive nursing care to patients and their
families (1a-c, 2a-e)
e. facilitating wellness, coping mechanisms, and relapse prevention behaviors (1a-c,
2a-e)
f. assisting the patient to achieve optimum comfort and functioning (1a-c, 2a-e)
g. observing and identifying group process (1a-c, 2a-e)
h. demonstrating respect and acceptance of others (1c, 2b and 2d)
i. delivering care in a non-judgmental and non-discriminating manner
j. implementing holistic care (1c, 2b and 2d)
k. protecting patients’ autonomy, dignity, and rights (1c, 2b and 2d)
4. Demonstrate teaching in using teaching/learning principles to meet the needs of the

mental health patients and their families by
a. identifying learning needs of the patients and families related to risk reduction and
health promotion, maintenance, and restoration (1c, 2b and 2d)
b. collaborating with patient and interdisciplinary healthcare team to develop
teaching plans based upon patient/family learning styles and needs (1a-c, 2a-e))
c. using best practice standards and other evidence based findings in developing
teaching plans for patients/families (1a-c, 2a-e)
d. assessing learning needs and readiness of patients/families (1a-c, 2a-e)
e. identifying appropriate teaching methods (1a-c, 2a-e)
f. documenting teaching interventions and patient/family responses (1a-c, 2a-e)
g. educating the patient and family about therapeutic level(s) and effects, possible
side effects, and onset and duration of medication(s) (1a-c, 2a-e)
h. recognizing patient learning needs related to defense mechanisms and coping
skills (1a-c, 2a-e)
5. Demonstrate clinical reasoning in recognizing maladaptive behaviors and utilize

clinical reasoning skills when providing care for patients with mental health needs
and their families by
a. applying clinical reasoning and nursing science as a basis for decision making in
nursing practice (1a-c, 2a-e)
b. applying the systemic problem solving process to develop a comprehensive plan
of care for patient with mental health care needs (1a-c, 2a-e)
c. performing and documenting assessments using a systematic approach (1a-c, 2a-
e)
d. using data collection tools to obtain patient and family history (1a-c, 2a-e)
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e. identifying psychosocial, cultural, spiritual, environmental, occupational, and

developmental needs prioritizing and implementing components of the nursing
process utilizing a holistic approach (1a-c, 2a-e)
f. evaluating the achievement of patient outcomes (1a-c, 2a-e)
g. modifying the plan of care as needed (1a-c, 2a-e)
6. Demonstrate effective and therapeutic communication with mental health patients,

their families, and members of the interdisciplinary health care team by
a. demonstrating therapeutic relationships and therapeutic interactions with patients,
families, and members of the health care team (1a-c, 2a-e)
b. observing verbal and nonverbal messages (1a-c, 2a-e)
c. seeking to clarify information (1a-c, 2a-e)
d. demonstrating congruency in thoughts, words, feelings, and body language (1a-c,
2a-e)
e. demonstrating verbal and nonverbal communication skills that are relevant,
accurate, complete, timely, clear, understandable, and therapeutic (1a-c, 2a-e)
f. demonstrating written communications skills that are relevant, accurate, complete,
timely, legible, and meaningful (1a-c, 2a-e)
g. demonstrating spontaneous and non-defensive behaviors (1a-c, 2a-e)
h. demonstrating active listening, genuineness, observational skills, physical
attentiveness, and effective interviewing skills (1a, 1c and 2b)
i. maintaining eye contact when culturally appropriate (1a, 1c and 2b)
j. maintaining an open posture and leaning toward the patient when appropriate (1a,
1c and 2b)
k. reporting and documenting accurately and completely the patient’s status
including the diagnosis, nursing care provided, effects of medications and
therapies including patient’s responses, and interactions with the health care team
(1a-c, 2a-e)
l. maintaining open communication (1a-c, 2a-e)
m. recognizing and maintaining professional boundaries of the nurse/patient
relationship (1a-c, 2a-e)
7. Collaborate with the interdisciplinary team to implement the treatment plan of the
mental health patients by
a. interacting with patients, nursing faculty, practicing nurses, and student nurses’
colleagues in a professional manner (1a-c, 2a-e)
b. functioning as a member of the interdisciplinary (1a-c, 2a-e) team
c. working effectively in collaborative assignments (1a-c, 2a-e)
d. collaborating with the patient, the patient’s family, and mental health team to
coordinate the patient’s care (1a-c, 2a-e)
e. collaborating with the interdisciplinary team to make referral to appropriate
community agencies and mental health care resources to provide continuity of
care (1a-c, 2a-e)
f. referencing and conforming to delegation rules of the Texas Nursing Practice Act
(1a-c, 2a-e)
g. following chain of command (1a-c, 2a-e)
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COURSE ASSESSMENT
Student success is measured by a variety of assessment techniques aligned with course goals and
learning outcomes. Individual faculty members are responsible for designing evaluation
instruments to measure student mastery of course goals and learning outcomes and indicating the
nature of such evaluation instruments in the instructor’s class requirements.
STUDENT ACCESSIBILITY RESOURCES

Any student with a documented disability needing academic accommodations is required to
contact the Student Accessibility Resources (SAR) Office located on each campus to schedule an
appointment with the Coordinator of SAR. All discussions are confidential. Because SAR
accommodations may require early planning and are not provided retroactively, students are
encouraged to contact SAR as early in the semester as possible. SAR is responsible for
approving and coordinating all disability-related services. TCC professors will honor requests for
accommodation when they are issued by SAR.
SCHOLASTIC DISHONESTY
Students are responsible for adhering to the TCCD policy on scholastic dishonesty as stated in
the online student handbook at www.tccd.edu.
Academic dishonesty is a breach of the expected behavior of a health care professional and will
not be tolerated in the Tarrant County College Nursing Program. Divulging any examination
questions(s) or answer(s) to any individual, falsifying or plagiarizing any assignment or
examination can be construed as misconduct. A student in violation of any rule, policy, or
procedure of the TCC Nursing Program will be subject to the college disciplinary
procedure.
STUDENT CONTRIBUTION
Tarrant County College has established rules and regulations for student conduct and behavior.
The Course Information Document (CID) and Student Handbook list in detail these rules and
regulations. The Rules and Regulations of the Texas Board of Nurse Examiners are also to be
observed. Failure to abide by all rules and regulations may be grounds for dismissal from
the program.
RESOURCES
For additional information regarding the student handbook, academic calendar, course
evaluations, attendance policy, SCANS skills, Core Competencies, etc., see www.tccd.edu.
COURSE GOALS
The student is expected to complete the following course goals:
1. Assume responsibility for and accept accountability for personal and professional
beliefs and actions.
2. Follow TCC policies as stated in the Department of Nursing Student Handbook.
3. Demonstrate nursing knowledge, skills, attitudes and values of nursing at the basic
mental health nursing level including all “Criteria for Safe Performance”.
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4. Practice within the ethical, legal and regulatory frameworks of nursing and standards of
professional nursing practice.
5. Complete a sleep assessment with written paper.
6. Communicate relevant, accurate and complete information in a concise manner.
7. Complete a psychiatric (or mental health) patient assessment with a nursing care plan.
8. Complete a paper regarding culturally competent care of the mentally ill.
9. Record in a journal using designated criteria.
10. Participate in a simulation of symptoms of Schizophrenia: Hearing Voices.
11. Attend and document one AA 12-step Recovery Group and one therapeutic, group
process to complete a written assignment for each.
CRITERIA FOR SAFE CLINICAL PERFORMANCE

Patient safety is of paramount importance in the delivery of patient care. Therefore, it is
necessary for the student and the nursing faculty to conscientiously assure safe nursing care
behaviors. With supervision, the student will demonstrate the three roles of the nurse (Provider
of Care, Manager of Care, and Member of the Profession) using the nursing process in meeting
human needs.
SAFE CLINICAL BEHAVIORS UNSAFE CLINICAL BEHAVIORS INCLUDE BUT ARE

INCLUDE BUT ARE NOT NOT LIMITED TO:
LIMITED TO:
1. Provides for the physical care and Violates or threatens the physical safety of the patient (e.g.,
safety of the patient. comes unprepared to clinical; fails to communicate suicidal
ideation).
2. Maintains and monitors for the Violates or threatens the microbiological safety of the patient
microbiological safety of the (e.g., violates aseptic technique; universal precautions; reports
patient. to clinical with personal illness).
3. Maintains and monitors for the Violates or threatens the chemical safety of the patient (e.g.,
chemical safety of the patient. fails to report adverse effects the patient is experiencing).
4. Assures the psychological safety of Violates or threatens the psychological safety of the patient
the patient by using stress control (e.g., uses non-therapeutic techniques repeatedly;
methods and therapeutic attacks/derogates individual's beliefs or values; provides
communication. inaccurate or incomplete information repeatedly in patient
teaching).
5. Accurately and/or adequately uses Inadequately and/or inaccurately uses the nursing process (e.g.,
the nursing process. fails to observe and/or report critical data in reference to
patients; repeatedly makes faulty judgments/decisions in
nursing situations).
6. Demonstrates the Violates previously mastered principles/ learning/objectives in
principles/learning/ objectives in carrying out nursing care skills and/or delegated medical
carrying out nursing care skills functions (e.g., fails to obtain accurate vital signs; performs
and/or delegated medical medication administration).
functions.
8. Assumes appropriate independence Assumes inappropriate independence in actions or decisions
in action. Manages required (e.g., performs competencies not yet tested). Repeatedly
patient caseload at each course unable to manage the required patient care load (e.g., fails to
level. seek help in emergency situations).
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SAFE CLINICAL BEHAVIORS UNSAFE CLINICAL BEHAVIORS INCLUDE BUT ARE

INCLUDE BUT ARE NOT NOT LIMITED TO:
LIMITED TO:
9. Seizes opportunities for growth in Fails to recognize personal limitations or incompetency (e.g.,
practice and recognizes personal refuses to admit errors noted by instructor/nursing staff; places
strengths and limitations. patient in life threatening or personal injury position).
10 Recognizes and accepts moral and Fails to recognize and/or accept moral and legal responsibility
legal responsibility for actions. for actions thereby violating professional integrity as expressed
in the ANA Code for Nurses (e.g., cannot identify legal
responsibility in specific nursing situations; covers own/other's
errors or fails to report them; shares confidential information
inappropriately, or chemical impairment).
COURSE SCHEDULE
The clinical practice is a total of 96 hours during the 16 week semester. Students may rotate to
different units, within the facility, depending upon availability and need. Students may also be
required to rotate to different clinical facilities. To effectively meet the stated performance
objectives, students’ clinical experiences may vary. Clinical written papers and teaching
assignments are based on RNSG 2263: “Clinical Foundations of Mental Health Nursing” course
objectives and outcomes.
ATTENDENCE POLICY
Attendance is critical in each clinical course. It is essential that the student be present in clinical
to allow enough time for completion of the clinical objectives, outcomes, and evaluations.
Notification of the instructor prior to being tardy or absent is required. The course instructor will
give their notification procedure to the student. Failure to notify the instructor of an absence is
grounds for dismissal from the course.
Tardiness: Tardiness constitutes unprofessional behavior. The definition of tardiness is five (5)
or more minutes late to the designated clinical start time. The instructor will determine if the
student can stay at clinical due to tardiness. If a student is sent home from clinical due to
tardiness, it will be counted as an absence.
The first tardy constitutes a verbal warning. The second tardy constitutes a counseling
summary. The third tardy constitutes an absence and may result in clinical failure.
Absences: The definition of a clinical absence is non-attendance for one clinical day or three (3)
occurrences of tardiness and failure to complete weekly EAQ assignments by the due date. The
first absence of clinical hours will necessitate an assignment with activity/activities as assigned
by your instructor. These activities may include, but are not limited to a day in the clinical area,
case studies, and self-directed activities. The selection of an activity will align on the individual
needs of the students. A second absence may result in inadequate time to meet course
objectives, outcomes and evaluation of performance and result in clinical failure. Note: If a
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student is ill, they will not be permitted to attend clinical; if a student comes to clinical and is
ill, they will be sent home (risk to patients and others)
Regular and punctual clinical attendance is expected at Tarrant County College. Student
absences will be recorded from the first day the class meets. In case of absence, it is the student's
responsibility to contact the instructor. Students absent on official school business are entitled to
make up coursework missed. In all other cases, the instructor will judge whether the student will
be permitted to make up work and will decide on the time and nature of the makeup. However,
the student is expressly responsible for any work missed regardless of the cause of the absence.
The student must discuss such work with the instructor and should do so immediately on
returning to school. Communication between the student and instructor is most important, and it
is the student's responsibility to initiate such communication. If students do not appear at the
prearranged time or meet the prescribed deadline for makeup work, the student will forfeit
rights for further makeup of that work. Students who stop attending clinical for any reason
should contact the instructor and the Registrar‘s office to officially withdraw from the class.
Failure to officially withdraw may result in a failing grade for the course.
Clinical attendance and participation are essential to student success. The following attendance
guidelines will apply:
 A student in an off-campus course missing a cumulative of 15 percent of the class
meetings and not keeping up with the course assignments may be dropped at the
discretion of the instructor.
Term # of Meetings 15% of class meetings Student dropped after X days
16 weeks 16 2.4 3
E-mail Communication
My TCC email via the myTCC Portal is the official e-mail account for communication for this
course. Students must log into https://my.tccd.edu/ and activate the account in order to use this
communication tool. Please delete old messages from your account so that you will not miss out
on any communication.
Identification
Students must wear and display TCC Picture Identification at all times while on campus and at
the clinical facility. When on campus for simulation or at clinical facility, the student must be
in compliance with the TCC Nursing student uniform dress code.
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Financial Aid Recipient

If you are a financial aid recipient, not completing this course will impact your financial aid
eligibility. Before you drop the course consult with the Student Financial Aid Office. If your grade
in this course is less than a “C,” consult with the Student Financial Aid Services Office regarding
the impact to your financial eligibility.
COURSE EVALUATION
All assignments are required for successful completion of this course. No assignments are
optional. If all assignments are not completed, the student will receive an “Incomplete” in the
course. All assignments are due on or before the time and date set by the instructor, unless the
student makes alternate arrangements with the instructor prior to the due date.
Ten percent (10%) of the total assignment points will be deducted, per day (including the week-
end) for an assignment submitted late, unless previous arrangements were made with the clinical
instructor. An additional 10% of the grade may be deducted for spelling, grammar, legibility and
neatness. All assignments, even if turned in late, must be submitted; otherwise a course grade of
“Incomplete” will be given.
(Example: An assignment is worth 50 points. If it is turned in 1 day late, 5 points will be
deducted from the points earned.)
Grade Evaluation
Once graded paperwork has been returned, students have one week to discuss the grade with the
instructor. After this time, the grade will not be changed. Grades are posted on Blackboard and
attendance is posted on Web Advisor. Please check these at least weekly and notify the instructor
within one week of posting the grades or attendance if there is a discrepancy.
The course is based upon the point system, not a percentage. The total points which can
earned during the course is 1000. The points achieved by the student are converted into
letter grades as follows:
A = 1000 – 920 B = 919 – 830 C = 829 – 750 D = 749 – 670 F = 699 or less
Students’ Evaluation of the Course and Instructor
Students’ evaluation of the course is important for the continuous quality improvement of the
program and the instructor. The course and instructor evaluation is completed at the end of the
semester, and takes approximately five minutes to complete. All responses are confidential and
are not available to the instructor, or the instructor’s supervisor, until all final grades are
submitted.
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Unprofessional Student Behavior

While Attending a Community Support Group
A student is expected to conduct him or herself in a professional demeanor.

This includes:
 Scheduling an appointment with the contact person for the purpose of
gaining permission to attend the support group
 Behavior while attending the community support group
 Refer to Nursing Department Student Handbook for explanation of
professional behavior.
******************************************************************
If the Nursing Department receives a complaint about a student’s
unprofessional behavior, the student will be given a failing grade for the
assignment. Secondly, the student will make an appointment with his or her
clinical instructor for the purpose of signing a counseling summary. The
purpose of the counseling summary is to document and file the event, in the
student’s file.
******************************************************************
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CLINICAL COURSE ASSIGNMENTS

Clinical assignments are due as designated by the Clinical Instructor. Assignments are
evaluated/graded by the rubric accompanying each individual assignment. A Formative and
Summative Evaluation will be completed during the clinical rotation and are based upon the
student’s individual contribution to the Mental Health Course Outcomes and Clinical
Performance.
Required Assignments Points

Journal (8 separate entries: 15 points each) 120
AA Support Group or Overeaters 50
Anonymous Written Observation
Culturally Competent Care 75
Sleep Assessment 50
Patient Assessment with Care Plan 105
Hearing Voices Simulation: On Campus 100
Summative Evaluation 500
*Students must achieve 375 points on the
Summative Evaluation to pass this course.
*If 375 points are not achieved on the
Summative Evaluation, assignment points
earned will not allow the student to pass the
course.
Summative Evaluation of Clinical Performance
The Summative Evaluation takes into consideration the student’s overall clinical performance.
Students will receive feedback via the Formative Evaluation form at mid-term. At the end of the
course, students will schedule a meeting, with their clinical instructor, for their Summative
Evaluation. Points earned by the student are reflected on the Summative Evaluation tool.
Students must earn a minimum score of 750 points to obtain a passing grade in this course.
Students must also earn a minimum score of “C” (i.e. 750 points) in the Mental Health Theory
Course (RNSG 2213) to progress to the next course within the TCC Nursing Program.
* Students must 375 achieve points or above on Clinical Summative Evaluation to pass this
course.*
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CLINICAL ASSIGNMENTS
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Journal Assignments
(8 total each worth 15 points)
The purpose of the journal is for self-reflection. Journaling is useful and simple to do. Writing
about one’s observations and feelings, within a mental health setting, can facilitate personal
insight.
There is no right or wrong way to journal. Your instructor will read and grade what you wrote.
Journal entries will be kept confidential, unless you reveal you are thinking of hurting
yourself, or someone else. The instructor will collect your journal at the time it is due. If you
forget to turn in your journal, it will be considered a late assignment. Refer to the section that
discusses the penalty for late assignments.
Keeping a diary of events, activities, and feelings can reveal personal information regarding
sources of daily stress. Experiences and feelings can also be described through other methods of
creative expression such as drawings and poetry. The dated entries may help gauge progress
being made in identifying sources of stress and adaptive methods of coping. Additionally, a
journal can be a source of healing and fun.
After the completion of each clinical day, write a journal entry which includes:
 Describe a clinical event that made an impression on you.

 Description of your thoughts and feelings about the event.
 Description the surrounding circumstances and the outcome of the event for you and/or
the patient/client.
 Identification of source of stress for patient and adaptive/maladaptive methods of coping.
 Include observations about nursing professionalism, standards of care, patient safety,
ethical behavior and other relevant concepts.
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Grading Rubric for Journal Assignments

Student Note: Include a grading rubric with completed assignment
Student Name: ______________________ Date: __________________
Criteria Possible Points Instructor Comments

Points Earned
(5 Journal Assignments = Explain why student did not receive
full credit for each section.
75 Points)
Comprehensive description of
clinical event
1 - 1.5
Students thoughts and feelings
discussed about event
1 - 1.5
Description of surrounding
circumstances:
1.5 - 2
 Outcome of event
 For the student
 For the patient
Identification of:
 source of stress for patient 1.5 - 5

 adaptive methods of coping
 maladaptive methods of
coping
Include observations about the

concepts of:
 nursing professionalism
1.5 – 5
 standards of care
 patient safety
 ethical behavior
TOTAL 15
Student Signature: Date: Instructor Signature:
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Sleep Assessment with Relationship to Psychiatric Disorder Assignment

The purpose of this assignment is to help the student nurse gain insight into the relationship
between mental disorders and sleep. Sleep disturbances can have adverse effects on a person’s
overall health, quality of life and safety. Many mood disorders have sleep disturbance as part of
the DSM-IV criteria for the disorder. Recognition and early treatment of sleep disturbances can
improve clinical outcomes for those suffering from mental disorders. (M.J. Halter, 2018.
Varcarolis’ foundations of psychiatric-mental health nursing: A clinical approach. (8th ed.)
Elsevier: St. Louis, Missouri.
Instructions:
1. Interview a patient and complete the Pittsburgh Sleep Quality Index, the Epsworth
Sleepiness Scale, and Medication Table as provided. (Worth 10 points)
2. Write a 2 page paper discussing the following (follow APA format; the cover sheet and
reference page do not count as part of the written discussion). (Worth 40 points)
 Find a research article describing the mental disorder of your patient.
 List the DSM-IV criteria for the mental disorder.
 Based on the completion of the PSQI and Epsworth and your research, discuss the
following:
o Discuss how the sleep disturbance affects the patient’s ability to function in the
social and occupational setting.
o Discuss how the disturbance in sleep can affect the patient’s recovery.
o Discuss how the psychotropic medications your patient is receiving can improve or
impair sleep.
o Discuss the how the use of sleep medications can improve or impair a patient’s
recovery.
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The Pittsburgh Sleep Quality Index
Student Name: ______________________________________________
Patient Initials: ______________________
Date of Care: _________________
Instructions:
The following questions relate to your usual sleep habits during the past month only. Your answers should
indicate the most accurate reply for the majority of days and nights in the past month. Please answer all
the questions.
1. During the past month, when have you usually gone to bed at night?
Usual bed time
2. During the past month, how long (in minutes) does it take for you to fall asleep each night?
Number of minutes
3. During the past month, when have you usually got up in the morning?
Usual getting up time
4. During the past month, how many hours of actual sleep did you get at night? (This may be different
than the number of hours you spend in bed).
Hours of sleep per night
For each of the remaining questions, check the one best response. Please answer all questions.
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5. During the past month, how often have you had trouble sleeping because:
(a) Cannot get to sleep within 30 minutes
Not during the Less than Once or three or more
past month once a week twice a week times a week
(b) Wake up in the middle of the night or early morning
Not during the Less than Once or Three or more
(c) Have to get up to use the bathroom
(d) Cannot breathe comfortably
(e) Cough or snore loudly
past month once a week twice a week times a wee
(f) Feel too cold

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(g) Feel too hot
(h) Had bad dreams
(i) Have pain

(j) Other reason(s), please describe
How often during the past month have you had trouble sleeping because of this?
6. During the past month, how would you rate your sleep quality overall?
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Very good
Fairly good
Fairly bad
Very bad
7. During the past month, how often have you taken medicine (prescribed or “over-
the-counter”) to help you sleep?
8. During the past month, how often have you had trouble staying awake while
driving, eating meals, or engaging in social activity?
9. During the past month, how much of a problem has it been for you to keep up
enough enthusiasm to get things done?
No problem at all
Only a very slight problem
Somewhat of a problem
A very big problem
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10. Do you have a bed partner or roommate?
No bed partner or roommate ______
Partner/roommate in other room
Partner in same room, but not same bed
Partner in same bed _________
11. How often do you feel tired during the following times during the day?
Morning:
0 1 2 3
most days often occasionally never
Afternoon:
0 1 2 3
Evening:
0 1 2 3
Page 21 of 102
Epsworth Sleepiness Scale
Initials:
Date:
Date of Birth:
Gender: Male/ Female
How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling
tired? This refers to your usual way of life in recent times. Even if you have not done some of
these things recently, try to work out how they would have affected you.
Use the following Scale to choose the most appropriate number for each situation:
0 - would never doze
1 - slight chance of dozing
2 - moderate chance of dozing
3 - high chance of dozing
Situation Chance of Dozing

Sitting and reading
Watching TV
Sitting, inactive in a public place (e.g. Cinema)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when given a chance

Sitting and talking to someone
Sitting quietly after lunch without alcohol
In a car, while stopped for a few minutes in traffic Score ________
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Write down all medication patient is currently taking:
Medication Dose Frequency
Page 23 of 102
Sleep Assessment with Relationship to Psychiatric Disorder Assignment Rubric

Student Name: ______________________ Date: __________________

Points Earned
(Assessment: PSQI and Epsworth Explain why student did not receive
Scale = 10 points) 50 full credit for each section.
PSQI and Epsworth Scale
 Scales completed as directed 2.5
 Includes all pertinent data 2.5
 Scales are recorded and 2.5
scored correctly
2.5
 Recorded information is
legible
Total Points 10
2 page Written Paper 40

(2 page Written Paper = 40 points)
 Research article is not over 2
5-8 years old
 DSM-IV Criteria Complete
and Correct 3
 Discussion includes:
o ability to function in
the social and 7.5
occupational setting
o how the disturbance
in sleep can affect 7.5
the patient’s
recovery
o how the psychotropic
medications your 7.5
patient is receiving
can improve or
impair sleep
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o how the use of sleep 7.5

medications can
improve or impair a
patient’s recovery
 APA formatted, grammar
and spelling correct
5
Total Points 50
Page 25 of 102
AA Group or Overeaters Anonymous Meeting Observation Assignment

12-Step Alcoholics Anonymous (i.e., AA) or Overeaters Anonymous Community Support
Groups
Community support groups are an example of a non-acute setting in which mental health needs
are addressed. These groups typically provide persons with education, personal support, and
important relationships for enhancement of coping with sobriety and improved quality of life.
Within this milieu, people may be enabled to avoid an acute altered heath state and subsequently
avoid re-hospitalization.
Each student is required to attend one Alcohol Anonymous (i.e., AA) 12-Step community
group or Overeaters Anonymous Community Group meeting. The completion date for this
assignment will be determined by the instructor. Students are required to contact the group
liaison to make sure the group is opened to visitors. For example, some of the 12-step groups are
opened (i.e., welcome visitors) while others are closed to visitors. It is the student’s
responsibility to make sure they are welcomed to attend.
Community 12-Step AA and Overeaters Anonymous Support Group Assignment Guidelines
When attending a community support group the student must:
1. Ask the instructor if the group chosen is an appropriate group to attend.
2. ONLY attend the group if there are TWO OR LESS students in attendance. NO
exceptions!
3. Arrive at least 15 minutes early. Do not attend the group if you arrive after the group is
in session.
4. Ask the group leader for permission to attend the group, even if previous permission had
been attained.
5. Do not giggle, converse among yourselves or otherwise cause a disturbance. Do not take
notes! Remember, you are a guest. Electronic, communication devices are not to be
used.
6. Thank the group leader and the members of the group for allowing you to attend, after the
group session is over.
7. WEAR APPROPRIATE ATTIRE! Do not wear the TCC uniform. Business
professional (e.g., slacks/shirt or blouse) is appropriate. Do not wear jeans, cotton tops
that show cleavage, T-shirts, or shorts, or short skirts (i.e. skirts more than 2 inches above
the knees. Hair should be combed and appropriately styled. Men should be clean shaven.
Beards and moustaches are to be neatly trimmed. Jewelry should be modest (i.e. No long,
dangling earnings, or large hoops.)
How do I find an AA meeting to attend?

Use the telephone directory of conduct an Internet search. Alcoholics Anonymous will also be
listed in the white pages of the local telephone directory. When you call AA, you will probably
speak to a 12 step volunteer who will give you the information you need. You may also hear a
recording that gives day, times and locations of area meetings plus the first name and telephone
number of members you may call for more information. Get the location of your meeting
Page 26 of 102
approved by your instructor. Make sure the meeting you attend is an opened meeting.
Remember that no more than two students, at a time, can attend the same meeting.
What is a meeting like?

The meeting lasts approximately 1 hour. It usually opens with the Serenity Prayer. Each
member of the group introduces himself or herself (example: “I’m John and I’m an alcoholic.”)
A speaker shares his/her recovery story, if it is a speaker –led meeting. If it is a discussion
meeting, there will be a topic of discussion and each person may share his/her experience on the
topic. The meeting usually closes with the Lord’s Prayer.
The student must find an open meeting to attend. AA is based on anonymity; do not share
members’ names within the assignment submitted.
How do I find an Overeaters Anonymous Group Meeting?

Go online and access www.oa-tricounty.org to find a meeting in Fort Worth, North Richland
Hills, Grapevine or Euless. The information phone number is: 817-303-2888.
The site with the most availability, with regards to days and time frames, is at
South Hills Christian Church
3200 Bilglade Road, Fort Worth, Texas 76133
Call to inform them you want to observe their group meeting. Ask how many students they allow
per meeting. Do Not exceed that number of students per meeting!
What is a meeting like?

The meeting lasts approximately 1 hour. Overeaters’ Anonymous is patterned after the Twelve
Step principles of Alcoholics Anonymous. It is designed to assist individuals with compulsive
eating habits by offering support and general guidance in development of a personal plan of
eating. Members share their experiences with compulsive eating, and there may be a topic of
discussion for meeting.
OA is based on anonymity; do not share members’ names within the assignment submitted.
Page 27 of 102
Twelve-Step Alcoholics Anonymous

Community Support Group Meeting Assignment
Student Date Attended: Time: ______

Name of Group:
____________________________________________________________________
Address:
________________________________________________________________________
Telephone Number of Support Group: __________________________________________
Name of Contact Person:
__________________________________________________________
The student may use additional pages as needed. The assignment is to be typed.
1. When did this support group come into existence?
2. What prompted the members to begin this self-help group?
3. How many members were present during the meeting? __________
4. How many observers (students) were present? Give the students’ names:
__________________________________________________________________
5. Include the following demographics: (Do not include the students who attended)
a. Number of men and women who attended:
 males ____________
 females: _____________
b. Approximate age range of participants: _____________
c. Race/or ethnicity of participants: ____________________
d. Number of new members: _______
e. Number of experienced members: ________
Page 28 of 102
6. Explain the main topic(s) of discussion.
7. Who led the discussion?
8. What leadership style(s) was used? Provide evidence for your answer.
9. What would you have changed if you had been the group leader?
10. Describe three (3) participants within the group.

 Complete one paragraph per individual ( 1 paragraph = 150-200 words)
 List the persons by numbers (i.e. Person #1, Person #2, etc.) Note each person’s
characteristics, personality, problems and include the following details:
a. Describe each individual’s appearance
b. Paraphrase what each person shared during the meeting (their stories).
c. Discuss your thoughts and feelings regarding each person’s story.
11. What did you find most interesting or thought provoking?
12. What did you learn from this experience?
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12-STEP AA COMMUNITY SUPPORT GROUP GRADING RUBRIC


Points Earned
Explain why student did not receive full
credit for each section.
Discussion of topic(s):
 Stated whether discussion 1.5 - 5
was free-flowing or was
specific to AA 12-step
program.
 Leadership style observed.

4.5 -10
 Inclusion of supporting data.
Complete description of three (3)

participants:
6.5 - 20
 Description included sub-
sections (#10: a- c)
Description of what was learned from

experience.
Summary included:
 Insightful reflection of
6.5 - 15
whether the community
group assessed was
therapeutic or non-
therapeutic.
 Provided supporting
evidence.
TOTAL 50
Page 30 of 102
Overeaters’ Anonymous
Community Support Group Meeting Assignment
Student Date Attended: Time: ______

Name of Group:
____________________________________________________________________
Address:
________________________________________________________________________
Telephone Number of Support Group: __________________________________________
Name of Contact Person:
__________________________________________________________
The student may use additional pages as needed. The assignment is to be typed.
13. When did this support group come into existence?
14. What prompted the members to begin this self-help group?
15. How many members were present during the meeting? __________
16. How many observers (students) were present? Give the students’ names:
__________________________________________________________________
17. Include the following demographics: (Do not include the students who attended)
a. Number of men and women who attended:
 males ____________
 females: _____________
b. Approximate age range of participants: _____________
c. Race/or ethnicity of participants: ____________________
d. Number of new members: _______

e. Number of experienced members: ________
18. Explain the main topic(s) of discussion?
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19. Who led the discussion?
20. What leadership style(s) was used? Provide evidence for your answer.
21. What would you have changed if you had been the group leader?
22. Describe three (3) participants within the group.
 Complete one paragraph per individual (1 paragraph = 150-200 words)
 List the persons by numbers (i.e. Person #1, Person #2, etc.) Note each person’s
characteristics, personality, issues and include the following details:
a. Describe each individual’s appearance
b. Paraphrase what each person shared during the meeting (their stories).
c. Discuss your thoughts and feelings regarding each person’s story.
23. What did you find most interesting or thought provoking?
24. What did you learn from this experience?
Page 32 of 102
OVEREATERS’ ANONYMOUS COMMUNITY SUPPORT GROUP GRADING RUBRIC


Points Earned
Explain why student did not
receive full credit for each section.
Discussion of topic(s):
 Stated whether discussion was 1.5 - 5
free-flowing or was specific to
AA 12-step program.
 Leadership style observed.

4.5 -10
 Inclusion of supporting data
Complete description of three (3)

participants:
 Description included sub-
sections (#10: a- c). 6.5 - 20
Description of what was learned from

experience.
Summary included:
 Insightful reflection of
6.5 - 15
whether the community group
assessed was therapeutic or
non-therapeutic.
 Provided supporting evidence.
TOTAL 50
Page 33 of 102
Psychiatric/Mental Health Nursing and Culturally Competent Care

Teaching Assignment
Purpose of the Assignment:

The purpose of this assignment is to assist the student to understand the relevance of
transcultural nursing (www.madelline-leninger.com) and its application to psychiatric/mental
health nursing. This assignment will require the student to compare and contrast “mainstream”
American culture with a minority, ethnically diverse culture. The following conceptual
definitions are to be used to provide standardized definitions for the purpose of this assignment.
Additionally, the student is advised to read Chapter 5: Cultural Implications (Halter, 2018, pp. 77
– 88).
Culturally Competent Nursing Care

Cultural competence in health care is broadly defined as the ability of providers and
organizations to understand and integrate these factors into the delivery and structure of
the health care system. The goal of culturally competent health care services is to provide
the highest quality of care to every patient, regardless of race, ethnicity, cultural
background, English proficiency or literacy
https://hpi.georgetown.edu/agingsociety/pubhtml/cultural/cultural.html.
Mainstream (i.e. dominant) Culture Defined

The majority population of a culture generally sets the dominant culture (i.e. mainstream
culture). Historically, the dominant culture has often exercised control over law,
communication (designated language), political processes, educational institutions,
business practices and creative expression. A culture is dominant within society when
that culture establishes specific behaviors or a set of rituals, values and social norms.
Characteristics of a Minority, Ethnic culture

An ethnic minority is a group of people who differ in race or color or in national,
religious, or cultural origin from the dominant group — often the majority population —
of the country in which they live. The different identity of an ethnic minority may be
displayed in any number of ways, ranging from distinctive customs, lifestyles, language
or accent, dress, and food preferences to attitudes, moral values, health beliefs, and
economic or political beliefs espoused by members of the group.
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Psychiatric/Mental Health Standard 4: Planning of Care

The psychiatric/mental health nurse will develop an individualized plan of care in
partnership with the health care consumer (i.e. patient/client), family and others
considering the healthcare consumer’s characteristics … that may include, but are not
limited to values, beliefs, spiritual and health practices, preferences, choices,
developmental level, coping styles, culture, and environment. (ANA’s Psychiatric
Mental Health Nursing: Scope and Standards of Practice, 2014, pg. 50).
Assignment Objectives: The student will be able to

1. Compare and contrast the health beliefs (e.g., concept of autonomy, health practices, and
coping behaviors) and/or mental health illnesses of “main stream” American values and
culture with that of a minority, ethnic culture (e.g., Hispanic, Black, Asian, Vietnamese,
American Indian, Eastern Indian, Pacific Islander, etc.)
2. Use a minimum of one scholarly research article to support the need for transcultural
competent nursing care to provide safe, effective care to a patient from a diverse,
minority ethnic culture.
3. Provide a 15- 20 minute teaching presentation focused on the application of Leninger’s

Transcultural Nursing and the standards of care for psychiatric/mental health nursing.
4. Discuss how a nurse’s inability to implement culturally competent care can make a
patient with a psychiatric disorder, from a diverse background, more at risk for
ineffective, unsafe nursing care.
5. Develop a handout for each member of the clinical group that gives evidence to the
differences between the mainstream American values and those of a specific minority
ethnic group.
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CULTURALLY COMPETENT CARE TEACHING ASSIGNMENT GRADING RUBRIC

Criteria Possible Points Faculty Comments
Points Earned
Presented a minimum of 5 differences between 10
mainstream American culture and a specific
ethnic culture.
Cited a minimum of one scholarly, research 10

article that discussed patients from a specific
diverse background, diagnosed with a
psychiatric disorder, being more at risk for
unsafe, ineffective nursing care.
Used an appropriate teaching method(s), based 10

on Blooms Taxonomy, throughout the
presentation (i.e., knowledge, psychomotor, or
affective domain)
Presentation lasted a minimum of 15 minutes. 5
Provided a handout that addressed: 15

 objectives of the assignment
 provided APA citation and reference list
 provided a table of comparison between
the mainstream culture and a specific
ethnic culture
Handout was written grammatically correct 5
and contained no spelling errors.
Summarized how culturally competent care can 15
minimize a psychiatric/mental health patient’s
risk for unsafe, ineffective care.
Provided a copy of the article (s) cited. 5
Total Points 75 Faculty Signature and Date
Page 36 of 102
In-Patient Assessment and Nursing Care Plan Assignment

The In-Patient Assessment and Nursing Care Plan assignment is to be used by students whose
clinical rotation is in an inpatient psychiatric facility for the entire sixteen-week session.
NOTE: The student needs to approach a patient/client who is stable enough to sustain a
conversation for a prolonged period of time. Also, the interview may be interrupted by the
patient’s need to attend group therapy, sessions with his or her physician, etc. The assessment
may be completed through the scheduling of several short sessions.
The inpatient assessment requires the student to:
A. Establish a nurse-patient therapeutic rapport
(Review Section beginning on pages 50-56 for information regarding therapeutic
communication techniques, adaptive and maladaptive coping mechanisms.)
B. Obtain an understanding of the current problem
C. Obtain patient medical and psychiatric history
D. Complete a psychosocial assessment
E. Complete a Mini Mental Status Exam
F. Develop a Nursing Care Plan with a minimum of two psychiatric nursing diagnoses.
***************************************************************************
Patient Safety: Immediately report, to your clinical instructor or staff nurse, any patients with
the intent to harm themselves or harm others!
Do not hesitate to seek clarification if you are unsure of the patient’s intent of causing harm
to self or others. Be sure and discuss your concerns with your instructor and the staff.
Student Safety: conduct the patient interview in an opened area, where staff can see you.
Do not go to the patient’s room, or to an isolated area.
****************************************************************************
Page 37 of 102
PSYCHIATRIC PATIENT ASSESSMENT WITH CARE PLAN GUIDELINES AND

INSTRUCTIONS
PART I = 25 POINTS
STANDARD 1: ASSESSMENT
The nurse/patient interview provides structure for the assessment of the psychiatric patient. The
assessment interview is a goal-directed communication that provides an opportunity for the nurse
to experience who the patient is and to understand how he/she has developed through the course
of life events. The student will document findings.
During the assessment interview the student will:
A. Establish rapport: refer to pages 50-56 for information about therapeutic communication
techniques.
B. Obtain an understanding of the current problem
C. Obtain patient medical and psychiatric history
D. Obtain family medical and psychiatric history
E. Complete a psychosocial assessment
F. Complete a Mini Mental Status Exam
The nurse’s primary source for data collection is the patient. Secondary sources may include
family members, caregivers, friends, neighbors, other health care members, and medical records.
Some or all of this data may not be readily available. If that is the case, discuss this with your
Clinical Instructor.
Assessment of children should be accomplished by interview and observation. Watching
children at play provides important cues. Developmental levels should be considered in the
assessment of children and adolescents.
Adolescents are especially concerned with confidentiality and may fear that anything they say to
the nurse will be repeated to their parents. An explanation of confidentiality is critical. A brief
structured interview technique such as HEADSS interview (Halter, 2014, Box 7 – 2; p. 118, pg.
120, and 120b) may be useful as well as Chapter 11 (Halter, 2014, pg. 185-188) which offers
more on assessment of adolescents.
Many older adults often need special attention to be given to physical conditions and sensory
deficits. It is wise to identify these at the beginning of the interview so that accommodations can
be made. Physical and sensory limitations do not necessarily indicate cognitive deficits. With
the patient who is hard of hearing, speak slowly, clearly, slightly louder, and in lower tones. Use
of the Mini Mental Status Exam (MMSE) is helpful in determining cognitive deficits.
Page 38 of 102
A. Establish a Nurse-Patient Rapport

Approach the patient with dignity and respect considering the safety of the patient and yourself.
Introduce yourself. Clarify that you would like to spend some time with the patient and ask
questions about his or her background. Ask the patient for permission and explain
confidentiality. You will contract with the patient the time, place, and length of the interview.
You must demonstrate a genuine, empathetic, and positive regard. Utilize therapeutic
communication skills. If the first few patients are non-communicative, continue to look for a
patient who is open to conversation and willing to answer questions.
1. Obtain an Understanding of the Current Problem

Document the following information on the Demographic Data Form.
 Demographic Data:
This includes patient age and gender.
 Admission Data:
This includes the date and time of admission and type of admission (voluntary or
involuntary).
 DSM-V Psychiatric Diagnoses and Medical Diagnoses
 Predisposing Factors
This refers to conditions or situations that may make a person more at risk or susceptible
to disease. For example: heredity, age, gender, environment and/or lifestyle. In Mental
Disorders, genetics (heredity) puts a patient at a greater risk for development of the same
disorder.
 Precipitating Factors
This is referring to factors which caused or triggered the onset of the behavioral response.
For example: what happened that resulted in the patient being hospitalized? Document
the patient’s direct quote(s) about the behavior resulting in current hospitalization.
 Behavioral Responses
This is information gathered from the chart that describes how the patient was acting at the
time of admission and presently-during the time of the interview.
 Current Stressors
Use patient direct quotes.
 Patient’s Positive Strengths/ Coping Resources

Use direct quotes.
Page 39 of 102
2. Complete a Psychosocial Assessment

A psychosocial assessment provides additional information from which to develop a plan of care.
The psychosocial assessment interview elicits information about the systems in which a person
operates. The focus is on the patient’s perceptions and recollections of his current lifestyle and
life in general. The student will explore with the patient how he/she perceives the following
psychosocial areas as organized according to Maslow’s Hierarchy of Needs. Identify which
level/need the patient is primarily operating from at this time.
 Physiological Needs:
This includes how the patient maintains shelter, food, clothing, medical and dental care.
 Safety and Security Needs:
This includes legal problems, current or past abuse, finances, safe environment.
 Love and Belonging Needs:
This includes Childhood Family Dynamics, Current Family Dynamics, Primary

Relationships, Marital History, Social Support System, Culture, and Spirituality.
 Self-esteem Needs:
This includes occupational history, educational history, patient strengths and coping
behaviors.
 Self-actualization Needs:
This includes the patient’s hopes, plans, and dreams for the future. Ask the patient if he
or she had a “magic wand,” how his or her life would be different.
3. Developmental Assessment
The developmental assessment provides information about the patient’s maturational level.
These data are then reviewed in relation to the patient’s chronological age to identify
developmental strengths or deficits.
A. Identify appropriate and inappropriate behaviors related to developmental levels using
Erickson’s developmental stages (refer to Foundations CID and text). Based on these
behaviors, determine the patient’s developmental level.
B. Complete a Mini Mental Status Exam. This exam is especially helpful with patients who
have dementias of all types including Alzheimer’s dementia.
NOTE: See Mini Mental Status Exam beginning on page 33.
Page 40 of 102
Psychosocial Assessment Form

Student Name: _____________________ Date: ______________
Patient Initials: _____________
Identify patients’ needs based on Maslow’s Hierarchy. Utilize textbook for resource.
Physiological Needs
Safety Needs
Love and Belonging Needs
Self-Esteem Needs
Self-Actualization Needs
Page 41 of 102
Developmental Assessment Form

Student Name: _____________________ Date: ______________
Patient Initials: _____________
Identify appropriate and inappropriate behaviors related to developmental levels using
Erickson’s developmental stages (refer to Foundations CID and text).
Appropriate Behaviors Inappropriate Behaviors
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
7. 7.
Page 42 of 102
Administration of the Mini-Mental Status Examination (MME)
The Mini-Mental Status Examination offers a quick and simple way to quantify cognitive function and screen for cognitive loss. It tests
the individual’s orientation, attention, calculation, recall, language and motor skills.
Each section of the test involves a related series of questions or commands. The individual receives one point for each correct answer. To
score, add the number of correct responses.
Please complete on a nursing student. Before the examination, seat the individual in a quiet, well-lit room. Please ask him/her to listen
carefully and to answer each question as accurately as he/she can.
Any score greater than or equal to 25 points is effectively normal (intact).

Below this, scores can indicate severe (≤9 points), moderate (10-20 points) or mild (21-24 points) cognitive impairment.
Low to very low scores correlate closely with the presence of dementia although other mental disorders can also lead to abnormal findings
on MMSE. The presence of purely physical problems can also interfere with the interpretation if not properly noted. For example, a
patient may be physically unable to hear or read instructions properly, or may have a motor deficit that affects writing and drawing skills.
MME
Ask the patient, “Now I would like to ask you to perform some quick tasks. Is that okay?”
The individual receives one point for each correct answer.

To score, add the number of correct responses. Turn in all pages of MME with assignment.
ORIENTATION TO TIME CORRECT INCORRECT TOTAL

POINTS
What is today’s date?
What is the month?
What is the year?
What is the day of the week?
What season is it?
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ORIENTATION TO PLACE
What place is this?

What room is this?
What city are we in?
What county are we in?
What state are we in?
IMMEDIATE RECALL
Ask if you may test his/her memory. Then say “apple”, “penny”, “table” clearly and
slowly, about one second for each. After you have said all 3 words, ask him/her to repeat
them- the first repletion determines the score (0-3)
APPLE
PENNY
TABLE
ATTENTION CORRECT INCORRECT TOTAL

POINTS
(A) Ask the individual to begin with 100 and count backwards by 7. Stop
after 5 subtractions. Score the correct subtractions.
93
86
79
72
65
Page 44 of 102
(B) Ask the individual to spell the word “WORLD” backwards. The score is
the number of letters in correct position.
D
L
R
O
W
DELAYED VERBAL RECALL
Ask the individual to recall the 3 words you previously asked him/her to
remember.
APPLE
PENNY
TABLE
NAMING
Show the individual a wristwatch and ask him/her what it is. Repeat for pencil.
WATCH
PENCIL
REPETITION CORRECT INCORRECT TOTAL

POINTS
Ask the individual to repeat the following:
“No if, ands, or buts”
3 – STAGE COMMAND
Give the individual a plain piece of paper and say, “Take the paper in your hand, fold it in
half, and put it on the floor.
Page 45 of 102
TAKES
FOLDS
PUTS
READING
Hold up a piece of paper reading: “CLOSE YOUR EYES” so that the individual can see it
clearly. Ask him/her to read it and do what it says. Score correctly only if the individual
actually closes his/her eyes.
NOTE: PAGE 65
WRITING
Give the individual the piece of paper provided and ask him/her to write a sentence. It is
to be written spontaneously. It must contain a subject and a verb and be sensible.
NOTE: USE THE BACK OF PAGE 66 FOR PATIENT TO WRITE SENTENCE.
COPYING CORRECT INCORRECT TOTAL

POINTS
Give the individual the piece of paper provided and ask him/her to copy a design of two
intersecting shapes. One point is awarded for correctly copying the shapes.
(If the figure has ten corners and two intersecting lines).
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NOTE: SEE PAGE

USE THE BACK OF PAGE FOR PATIENT TO DRAW SHAPE.
TOTAL SCORE: _____________________
Student Interpretation of Score:
_____________________________________________________________________________________________________________________________________________
____
_____________________________________________________________________________________________________________________________________________________
____
_____________________________________________________________________________________________________________________________________________________
____
Page 47 of 102
CLOSE YOUR EYES
Ask patient to write sentence on back of this piece of paper.
Page 48 of 102
ASK PATIENT TO DRAW SHAPE ON THE BACK OF THIS PIECE OF PAPER.
Page 49 of 102
Psychiatric Nursing Care Plan Assignment Guidelines and Instructions

PART II = 80 points
Learning Objective:
The student will complete a thorough and accurate Nursing Care Plan based on National
Patient Safety Goals.
Instructions:
A. National Patient Safety Goals can be accessed by conducting a Google search for
National Patient Safety Goals. Click on the section labeled Behavioral Health. Then
choose the full chapter option to view all goals and statements made by the Joint
Commission.
B. Choose a safety goal relevant to your patient and use it to develop a care plan based upon
meeting the Joint Commission’s recommendations.
C. Link: https://www.jointcommission.org/assets/1/6/NPSG_Chapter_BHC_Jan2018.
STANDARD 1: ASSESSMENT
The nurse/patient interview provides structure for the assessment of the psychiatric patient. The
interview is a goal-directed communication that provides an opportunity for the nurse to
experience who the patient is and to understand how he/she has developed through the course of
life events.
Standard 2: Diagnosis
The nursing diagnosis has three structural components. The problem or unmet need describes
the state of the patient at present. The etiology, or probable cause, is linked to the diagnosis with
the words “related to”. The supporting data, or signs and symptoms, are grouped in the first
column of the nursing care plan.
Standard 3: Goals/Outcomes
These are the patient’s goals and outcomes that reflect the maximal level of patient health that
can realistically be achieved through nursing interventions. The outcome criteria are patient-
centered, individualized, and stated as goals on the nursing care plan. The goals are stated in
attainable and measurable terms and include the time estimate for attainment.
Standard 4: Planning/Implementation
This includes the planning and selection of evidence-based nursing interventions. Using
evidence-based interventions and treatments as they become available is the gold standard in
psychiatric mental health nursing care. Psychiatric mental health nursing practice includes four
basic level interventions: coordination of care, health teaching and health promotion, milieu
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therapy, and pharmacological, biological and integrative therapies. The psychiatric mental
health nurse coordinates the plan of care and provides documentation. Health teaching gives
information about coping, interpersonal relationships, social skills training, stress management,
mental disorders and treatments, activities of daily living, crisis intervention, and self-care
activities.
Standard 5: Evaluation
This includes the evaluation of the individual’s response to nursing interventions and treatment.
Ongoing evaluation allows for revision of nursing diagnoses, changes to more realistic outcomes,
or identification of more appropriate interventions when outcomes are not met.
Standard 6: Medication Administration Evaluation Form

This includes medication name (generic and trade), route, dosage and safe range, frequency and
class of medication. It also includes purpose and teaching for this patient’s therapeutic effect,
possible side effects, possible adverse effects and patient’s report.
Standard 7: Documentation Form

This includes patient’s appearance, behavior and communication. This includes all discharge
planning and teaching.
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Admission Assessment Form

Student Name: Date:
Unit:
Admission Date: Predisposing Factors: Precipitating Factors: Behavioral Responses:
Dates of Care: At Admission
Age: Gender:
DSM V
Diagnosis: (Mental and Physical Family History of Mental Disorders

Disorders)
Presently:
Type of Admission:
Stressors:
Patient’s Positive Strengths/ Coping

Resources:
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NURSING DIAGNOSIS ANALYSIS FORM

INSTRUCTIONS:
Grouping of Findings begins after you have researched the chart and begun basic data gathering. Use the first column of this Nursing Diagnosis
Analysis Sheet to list your cues/data/assessment findings. Cluster the data by number in the second column.
List one diagnosis for each cluster and prioritize them by Maslow’s Hierarchy.
Your groupings of findings must be validated as you refer to the DEFINING CHARACTERISTICS associated with each Nursing
Diagnosis located in your Nursing Care Plan book which correlates to the 2018 National Patient Safety Goals.
This is to include objective and subjective data as well as abnormal lab work/diagnostic studies. Do not include inferences. Sources are to be cited
in APA format.
Patient Initials: ______________
Cues/Data/
Assessment Findings
1. Cluster/Grouping Nursing Diagnosis Priority
2.
3.
4.
6.
7.
8.
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10.
11.
12.
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Psychiatric Nursing Care Plan Form
National Patient Safety Goals Psychosocial Nursing Diagnosis (Diagnostic Statement)
1 Goal with Outcome 5 Interventions 5 Rationales/Principles Evaluation of Goal

Criteria (Met, Not met or partially met)
Source Citation:
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MEDICATION ADMINISTRATION EVALUATION FORM
DATE: _____________STUDENT:_______________________________ PATIENT INITIALS: ___________ ALLERGIES: __________________________
Drug Names Pt. Dosage Pt Mechanism of Teaching Nursing Therapeutic Effect List One Common
(Generic & Trade) & Route Action/Purpose For this patient Considerations &/or For this patient Side Effect
Classification Frequency & For this Patient Lab/ Assessments (findings specific to
TIME prior to this patient
Safe dose/ DUE administering Patient Complaint
range of Side Effect
G
T
C
G
T
C
G
T
C
G
T
C
Student Signature: Student Initials: Date:
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MEDICATION ADMINISTRATION EVALUATION FORM
DATE: _____________STUDENT:_______________________________ PATIENT INITIALS: ___________ ALLERGIES: __________________________
Drug Names Pt. Dosage Pt Route Mechanism of Teaching Nursing Considerations Therapeutic Effect List One Common
(Generic & Trade) & & Action/Purpose For this patient &/or Lab/ Assessments For this patient Side Effect
Classification Frequency TIME For this Patient prior to administering (findings specific to
DUE this patient
Safe dose/ Patient Complaint of
range Side Effect
G
T
C
G
T
C
G
T
C
G
T
C
G
T
C
Student Signature: Student Initials: Date:
Page 57 of 102
DOCUMENTATION PAGE
Appearance: Discharge Plan/Teaching:
Behavior:
Communication:
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RESPONSES THAT PROMOTE COMMUNICATION

TECHNIQUE EXPLANATION / RATIONALE EXAMPLES
Using Silence Gives the patient the opportunity to collect and organize Sitting quietly and waiting attentively until the patient is able to put
thoughts, to think through a point, or to consider introducing a thoughts and feelings into words.
topic of greater concern than the one being discussed.
Silence is best used after rapport has been established with the
patient.
Accepting Conveys an attitude of reception and regard. “Yes, I understand what you are saying.”
Direct eye contact; nodding head.
Giving Recognition Acknowledges/indicates awareness; does not mean giving a “Hello, Mr. Smith. I noticed you walked to the nurse’s station and
compliment which reflects the nurse’s approval/opinion. back.”
“I see you were able to sit on the side of the bed today.”
Offering Self Makes oneself available on an unconditional basis which can “I’ll sit with you a moment.”
increase client’s feelings of self-worth.
“I’ll stay with you awhile.”
“I’ll help your dress, if you like.”
Giving Broad Allows the patient to take the initiative in introducing the topic; “Tell me what is going on with you today?”
Openings emphasizes the importance of the patient’s role in the
“Tell me what you are thinking.”
interaction.
“What brought you to the hospital?”
Offering General Offers the patient encouragement to continue. “Hmm”. “Yes, I see.”
Leads
“Go on.” “Oh.”
Making Observations Verbalizes what is observed or perceived. This encourages the “You seem tense.”
patient to recognize specific behaviors and compare
“I see that you are crying.”
perceptions with the nurse.
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Restating Restates the main idea of what the patient has said is repeated; Patient: “I can’t study. My mind keeps wandering.”
lets the client know whether an expressed statement is
Nurse: “You are having difficulty concentrating.”
understood and gives him/her the chance to continue, or to
clarify if necessary. Patient: “I couldn’t eat my dinner last night.”
Nurse: “You had difficulty eating yesterday.”
Reflecting Reflects questions or feelings to the patient so that they may be Patient: “What do you think I should do?”
recognized and accepted so that the patient may recognize that
Nurse: “What do you think you should do?”
his or her point of view has value. Can be effective when the
patient asks the nurse for advice.
Focusing Takes notice of a single idea or even a single word. Works “This point seems worth looking at more closely.”
especially well with a client who is moving rapidly from one
“You were describing your medical history.”
thought to another.
Exploring Delves further into a subject, idea, experience or relationship. “Please explain that situation in more detail.”
Can be helpful with patients who tend to remain on a
“Tell me more about…”
superficial level of communication.
Seeking Clarification Strives to explain that which is vague or incomprehensible and “I’m not sure that I understand. Please explain.”
and Validation searching for mutual understanding; Can clarify the meaning of
“Tell me if my understanding agrees with yours.”
what has been said to increase understanding for both patient
and nurse. “So, what I hear you saying is…. Is that correct?”
Using Touch Provides appropriate forms of touch reinforce caring feelings; Placing your hand over the patient’s hand.
Be sensitive to the differences of attitudes and practices of
Placing an arm around the patient’s shoulders.
individual patients.
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RESPONSES THAT BLOCK COMMUNICATION

Giving Reassurance Indicates to the patient that there is no cause for anxiety, “I wouldn’t worry about that if I were you.”
thereby devaluing the patient’s feelings. May discourage the
“Everything will be alright.”
patient from further expression of feelings if he/she believes
they will only be downplayed or ridiculed. Better to say: “We will work on that together.”
Rejecting Refuses to consider or showing contempt for the patient’s “Let’s not discuss…”
ideas or behavior. This may cause the patient to discontinue
“I don’t want to hear about…”
interaction with the nurse for fear of further rejection.
Better to say: “Let’s look at that a little closer.”
Giving Approval or Sanctions or denounces the patient’s ideas or behavior. “That’s the right thing to do.”
Disapproval Implies that the nurse has the right to pass judgment on
“That’s good. I’m glad that you….”
whether the patient’s ideas or behaviors are “good” or “bad”,
and the patient is expected to please the nurse. Acceptance of “You shouldn’t do that.”
the patient is then seen as conditional depending on the “That’s bad. I’d rather you wouldn’t…”
patient’s behavior.
Better to say: “Let’s talk about how your behavior invoked anger
in the other patients at dinner.”
Agreeing / Disagreeing Indicates accord with or opposition to the patient’s ideas or “That’s right. I agree”.
opinions; Implies that the nurse has the right to pass
“That’s wrong. I disagree.”
judgment on whether the patient’s ideas or opinions are
“right” or “wrong”. Agreement prevents the client from later “I don’t believe that.”
modifying his or her point of view without admitting error.
Disagreement implies inaccuracy, provoking the need for Better to say: “Let’s discuss what you feel about….”
defensiveness on the part of the patient.
Giving Advice Telling the patient what to do or how to behave implies that “I think you should…”
the nurse knows what is best and that the patient is incapable
“Why don’t you…”
of any self-direction. It nurtures the patient in the dependent
role by discouraging independent thinking. Better to say: “What do you think you should do?”
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Probing Persistent questioning of the patient. Pushing for answers to “Tell me how your mother abused you as a child.” “Tell me how
issues the patient does not wish to discuss. This causes the you feel about your mother now that she is dead.” “Now tell me
patient to feel used and valued only for what is shared with about…”
the nurse, and places the patient on the defensive.
Better technique: The nurse should be aware of the patient’s
response and discontinue the interaction at the first sign of
discomfort.
Defending Attempts to protect someone or something from verbal “No one here would lie to you.”
attack. To defend what the patient has criticized is to imply
“You have a very capable physician. I’m sure he only has your
that he or she has no right to express ideas, opinions, or
best interests in mind”.
feelings. Defending does not change the patient’s feelings
and may cause the patient to think the nurse is taking sides Better to say: “I will try to answer your questions and clarify
with those being criticized and against the patient. some issues regarding your treatment.”
Requesting an Asks the patient to provide the reasons for thoughts, feelings, “Why do you think that?”
Explanation behavior, and events. Asking “why” a patient did something
“Why do you feel this way?”
or feels a certain way can be very intimidating, and implies
that the patient must defend his or her behavior or feelings. “Why did you do that?”
Better to say: “Describe what you were feeling just before that
happened.”
Belittling Feelings Misjudges the degree of the patient’s discomfort can be Patient: “I have nothing to live for. I wish I were dead.”
Expressed viewed as a lack of empathy and understanding; May tell the
Nurse: “Everybody gets down in the dumps at times. I feel that
patient to “perk up” or “snap out of it.”
way myself sometimes.”
“I know exactly how you feel.”
Better to say: “You must be very upset. Tell me what you are
feeling right now.”
Making Stereotyped Uses meaningless clichés and trite expressions in a nurse- “I’m fine and how are you?”
Comments patient relationship.
“Hang in there. It’s for your own good.”
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Better to say: “The therapy must be difficult for you at times.

How do you feel about your progress at this point?”
Using Denial When the nurse denies that a problem exists, he or she blocks Patient: “I’m nothing.”
discussion with the patient and avoids helping the patient
Nurse: “Of course you’re something. Everybody is somebody.”
explore areas of difficulty.
Better to say: “You’re feeling like no one cares about you right
now.”
Introducing an Unrelated Changes the subject to take over the direction of the Patient: “I don’t have anything to live for.”
topic discussion; May occur when the nurse wants to discuss a
Nurse: “Did you have visitors this weekend?”
different issue with the patient or to get away from a topic
being discussed. Better technique: The nurse must remain open and free to hear
the client, to take in all that is being conveyed both verbally and
nonverbally.
DIFFERENCE BETWEEN ADAPTIVE AND NON-ADAPTIVE BEHAVIOR

The main difference between adaptive and maladaptive behavior is behavioral patterns used to cope with anxiety-producing situations.
Adaptive behavior allows the individual to develop and grow from experiences that were found to have been resolved successfully.
Maladaptive behaviors, on the other hand, are dysfunctional behaviors because they are not directed toward the solution of a problem,
but instead to the momentary relief of the person’s stress/anxiety level.
Adaptive Behavior
Adaptive behavior is positive and functional to the individual. It facilitates the reduction of anxiety. Adaptive behavior is a functional
adjustment to a condition that allows the individual to develop and grow. The individual does not deny, or run away from the
situation. The individual faces the situation. This is considered as healthy behavior. Adaptive behavior refers to behavior that enables
a person to get along in his or her environment with greatest success and least conflict with others.
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Maladaptive Behavior
Maladaptive behavior can be viewed as the direct opposite of adaptive behavior. It is a negative form of behavior which harms the
individual. When the anxiety that an individual feels is not lessened through the behavior of the individual, the behavior is considered
maladaptive. Instead of relieving the anxiety and tension, the individual may feel more anxious. Maladaptive behavior hinders the
development of the individual. The individual may feel he or she is unable to find a solution to the anxiety-producing situation. The
intensity of the perceived stress may lead to a disruption in the person’s life. An individual may encounter difficulties, not only in day-
to-day experiences, but also in his or her personal and work-based relationships.
http://www.differencebetween.com/difference-between-adaptive-and-vs-maladatpive-behavior
Adaptive and Maladaptive Coping Behaviors
PROBLEM-ORIENTED (Adaptive) Behaviors

 Tries to maintain some control over the situation
 Finds out more about the situation so he or she can handle it better
 Thinks through different ways to handle the situation
 Looks at the problem objectively
 Gets an objective opinion
 Tries different ways of solving the problem
 Draw on experience to help you handle the situation
 Tries to find meaning in the situation; learns from the experience
 Seeks advice
 Sets specific goals to help solve the problem
 Accepts the situation as it is, only after unable to change it.
 Talks the problem over with someone who has been in the same type of situation
 Settles for the next best thing
 Avoids making it worse by acting too soon, (knee-jerk reaction)
 Makes a plan; develops a strategy
 Meditates, uses yoga, biofeedback, self-hypnosis
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AFFECT-ORIENTED (MALADAPTIVE) Behaviors

 Hope things will get better
 Eat, smoke, chew gum, drink alcoholic beverages, take drugs
 Prays, “God will take care of it.”
 Gets nervous, worries, frets
 Seeks comfort or help from family or friends
 Wants to be alone
 Laughs it off, rationalizes things could be worse
 Tries to put the problem out of his or her mind
 Day dreams, fantasizes
 Prepares for the worse
 Gets mad, curses, swears, shouts
 Cries, gets depressed
 Goes to sleep, figures things will look better in the morning
 Withdraws from the situation; gives up trying
 Work off tensions with physical activity
 Takes out stress on someone or something else
 Resigns to the situation; gives up since nothing can be done
 Denies the situation; state it isn’t real; states it didn’t happen
 Does nothing in the hope the problem will take care of itself
 Blames someone else for his or her problems
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Part 1: Inpatient Assessment-Interview

Grading Rubric
Turn in Grading Rubric with Assignment
Part 1 Total Points Point Deductions Point Deductions Total
(25 Points) Possible for each Points
Section
Admission
Assessment Data 10 Points 8 - 6 points 5 - 0 Points
Requirements: Missing items or not Major gaps in

thorough: majority of sections
1. All sections or sections not
complete and 1. Type of admission thoroughly
thorough 2. DSM V diagnosis addressed.
3. Medical diagnosis
4. Family History of
mental disorders
5. Predisposing
factors
6. Precipitating
factors
7. Behavioral
responses
8. Positive coping
mechanisms
Psychosocial and Total
Developmental Total Points Possible Point Deductions Point Deductions Points
Assessments 15 points 14 - 6 5-0

thorough: majority of sections
1. All sections in 1. Psychosocial needs or sections not
assessment forms not addressed thoroughly
complete and completely addressed.
thorough 2. Developmental
2. Mini Mental Exam assessment not
completed addressed
3. Student completely
interpretation of 3. Mini Mental Exam
results included not completed and
scored as indicated
4. Student
interpretation of
results not included
Page 66 of 102
1.
Part 2 Total Points Point Deductions Point Deductions Total
(80 Points) Possible Points
Nursing Diagnosis Total
Analysis Total Points Possible Point Deductions Point Deductions Points
5 Points 4 - 1 Points 0 Points

thorough: requirements:
1. All cues, data, 1. Missing cues, data, 1. Missing cues,
assessment findings assessment findings data, assessment
listed 2. Data not clustered findings
2. Clustered the data correctly 2. Did not cluster
by number of 3. Nursing diagnosis data by number
nursing diagnoses inappropriate for safety 3. No Nursing
listed goals chosen Diagnosis listed
4. Priorities of 4. Incorrect prioritization 4. Did not prioritize
diagnoses indicated of diagnoses diagnoses
Nursing Diagnosis Total

Statement Total Points Possible Point Deductions Point Deductions Points
Requirements for full Missing items or not Major gaps in

credit is a correctly thorough: requirements:
written diagnostic
statement: 1. Nursing diagnostic 1. Incorrect
statement supported writing of each
1. Nursing Diagnosis) with some evidence nursing diagnosis
that is appropriate statement
for patient and 2. Partially 2. Inappropriate
supported by data appropriate for selection of
(EBP) patient (includes R/T unsupported
etiology) nursing diagnosis
2. R/T (Etiology)
Goal & Outcome Total

Criteria Total Points Possible Point Deductions Point Deductions Points
Requirements for full Missing items or not Major gaps in

credit is a correctly thorough: requirements:
written goal and
outcome statement: 1. Related to nursing 1. Not related to
diagnosis and nursing diagnosis
2. Correctly worded but and/or
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1. Related to nursing 3. Missing one or two 2. Incorrectly

diagnosis sections of SMART worded and/or
2. Correctly worded 3. Missing more than
(“Patient or client two sections of
will…) SMART
3. SMART
Specific
Measurable
Attainable
Realistic
Timed
Nursing Total
Interventions Total Points Possible Point Deductions Point Deductions Points
10 Points 8 - 6 Points 5 - 0 Points

A total of 5
interventions which 1.Inappropriate 1. Inappropriate
must: interventions interventions
2.Not applicable to your 2. Not applicable to
1. Advance the patient or your patient and
patient national 3.Not practical or 3. Not practical and
safety goal 4.Does not advance goal 4. Does not advance
2. Be practical safety goal
(something you could
do and would know
how to do)
3. Be patient-
appropriate (not just
copied from book
but applicable to
your patient)
Rationales Total
Total Points Possible Point Deductions Point Deductions Points

A total of 5
rationales, one for
each intervention Inappropriate rationales Inappropriate
which includes: and/or no source rationales and no
source
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1. Reason this
intervention will
advance your goal
2. Include source
(book & page # for
Evidence Based
Practice (EBP)
Evaluation of Goal Total


1. Statement of
evaluation:
Goal met, goal 1. Evaluation is not 1. Evaluation is not
partially met, or goal applicable to patient goal applicable to patient
not met. and/or goal and
2. Goal evaluation 2. Missing 1- 2 areas of 2. Missing more than
supported by criteria. two (2) areas of
evidence (as criteria.
evidenced by)
3. Disposition of goal
(plan of care):
continue,
discontinue, modify,
reevaluate, etc.
***Medications*** Total
Requirements: all Missing items or not Major gaps in

medication columns thorough: requirements:
complete and
thorough
1. Medication name 1. Missing 1-4 areas of 1. Missing 4 or

criteria; generic, requirements. more areas of
trade & classification documentation
2. Order checked 2. Not following requirements.
3. Safe Dose, Route, instructions will result in 2. Not following
point deduction instructions will
& Time
result in point
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4. Mechanism of according to degree of deduction

action and Purpose: infraction. according to
Chemical action degree of
infraction.
(how medication
works) and the
reason THIS patient
is receiving med.
5. Pt. teaching you
would perform for **Safety Concern**
this medication. The student cannot
give medications.
6. Nursing
The student may be
Considerations/ sent home at the
Nursing assessments discretion of the
or labs needed prior faculty for failure to
to giving med follow instructions.
7. Therapeutic effect:
lab values, vital
signs, or pertinent
information FROM
YOUR PATIENT’S
CHART OR
ASSESSMENT
related to this drug’s
action. Is it working?
How do you know?
8. List minimum of
two common side
effects and note
(circle) those that
patient experienced,
if any.
Narrative Total
Documentation Total Points Possible Point Deductions Point Deductions Points
Refer to nursing Requirements: Missing items or not Major gaps in

textbooks for thorough: requirements:
examples of correct 1. Date/time
nursing 2. Brief, concise
documentation. 3. Pt. focused (not Left out 1-3 items Left out 4 or more
nurse focused) items.
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4. Interventions
documented
appropriately &
reassessed
5. Signature of
student
Total Points: Part 1 =
Total Points: Part 2 =
Total Points for Assignment =
Faculty Comments: Faculty Signature and Date:
Page 71 of 102
Hearing Voices Clinical Simulation

Introduction
This simulation is designed to facilitate student learning into the lived experience of trying to function
and perform tasks with hearing voices which are distressing to those patients with mental disorders.
This is a Clinical Instructor driven simulation. All supplies: Hearing Voices Introductory DVD, MP3
players, quiz, puzzles and will be provided by Course Coordinator to the Clinical Instructor.
Student Learning Objectives
 Gain understanding of day to day challenges of functioning for those who suffer from psychiatric
disabilities.
 Experience hearing voices that are distressing.
 Gain increased empathy towards psychiatric patients who hear voices.
 Be able to change clinical practices to address the needs of patients who hear distressing voices.
 Recognize/experience adaptive and/or maladaptive coping strategies for patients who hear voices.
Simulation Materials
 Black ink pen

 Clinical course documents needed for experience: provided in CID
 Varcarolis’ Manual of Psychiatric Nursing Care Planning
 MP3 player: student must supply own earbuds
Overview of Simulation Experience
 Watching the 60 minute introductory lecture on the phenomenon of hearing voices that are distressing
by Dr. Patricia E. Deegan.
 Sign Consent to Participate Form
 The simulation experience: completing all work-stations in morning and afternoon sessions.
o 5 students will role-play being the patients who are hearing voices.
o 5 students will role-play being psychiatrists.
o Students will then switch roles, so everyone has the same experience.
 Post-conference with discussion period.
72
Simulation of Hearing Voices that are Distressing

STUDENT CONSENT TO PARTICIPATE
Student Name _____________________________________ Date ___________________
 I understand the training titled, “Hearing Voices That Are Distressing: a Training Experience
and Simulation” is a clinical learning experience.
 I understand it is recommended that people with a history of hearing voices not participate in
this learning experience.
 I understand that it is my responsibility to turn my MP3 player off if I am feeling distressed.
 I understand I will continue to participate in the learning experience and will responsible for
completion of the discussion/written assignment even if I choose to turn the recording off.
 I will not download anything onto the MP3 player assigned to me.
 I will be responsible for returning the MP3 player to my clinical faculty member in the same
condition I received it.
Student Signature ____________________________________________ MP3#: __________
Faculty Signature ____________________________________________
73
Workstation Overview
During each workstation experience, the creation of a rigid, disempowering environment will be
created.
Those acting as psychiatrists will pay more attention to gaining information from tests being given
than to the personal needs of the patients being tested. Psychiatrists need to act as if they know what is
best for everyone, for example: testing. When patients are being tested, if they are sitting blankly or
laughing aloud, psychiatrists are to reprimand them, for example: state, “I know you have
Schizophrenia but please, try to attend to testing. Stop staring at the paper and read. I know you can do
this if you would just concentrate.”
Work Station #1
Reading and Written Comprehension: Hearing Voices Simulation
Student Name _____________________________________ Date ___________________
Learning Objectives
1. Patients will read case study information.
2. Formulate a nursing care plan for this patient in the scenario. Use the format as given below.
3. You may use your Varcarolis’ Manual of Psychiatric Nursing Care Planning textbook as a
reference.
4. Time allowed to complete the care plan is 15 minutes.
Case Study and Nursing Care Plan

Ellen Hernandez, a nurse on the medical-surgical unit, meets her newly assigned client, Sandy
McDonald, a pretty, petite woman who was admitted for exploratory laparotomy. Mrs. McDonald
appears anxious and worried. She tells her nurse that she is concerned about the surgery tomorrow and
has been anxious for a week, ever since her doctor told her there is a possibility of finding a malignant
tumor. The client says, “I haven’t been able to pay attention to anyone since then. I’m afraid there will
74
be bad news.” Restlessly she adjusts the bedclothes. “Would you mind telling me your name again?”
she asks Ms. Hernandez.
The nurse reviews the next day’s surgical procedure with Mrs. McDonald. With some prompting, the
client is able to comprehend and follow the nurse’s directions. She suddenly begins tapping her fingers
on the over bed table and tells the nurse “I have a headache.” “Will I still have to have surgery?”
The nurse checks Sandy’s vitals and finds that her blood pressure and pulse are elevated. When her
husband arrives he appears as anxious as his wife. “I’m scared to death,” he says. “I’m just hoping the
diagnosis is good.”
Assessment
Objective Data
 Anxious
 Restless
 Tapping fingers on table
 Elevated pulse and blood pressure
Subjective Data
 Worried about the surgery tomorrow; has been anxious for a week
 “I haven’t been able to pay attention.”
 “I have a headache; will I still have to have surgery?”
 “I am afraid there will be bad news.
Nurse’s Personal Perspective
Ms. Hernandez has seen many clients who were anxious before surgery, and she feels confident she
can reduce Mrs. McDonald’s anxiety. Unfortunately, she does not have any influence on the surgical
outcome.
Instructions:
1. Formulate a Psychosocial Nursing Care Plan using the form below.
75
2019 Summer RNSG 2263 Mental Health Clinical CID
Nursing Diagnosis Data Analysis Form

Grouping of Findings is begun after you have researched the chart and begun basic data gathering. Use the first column of this
Nursing Diagnosis Analysis Sheet to list your cues/data/assessment findings. Cluster the data by number in the second column. List
one diagnosis for each cluster and prioritize them by Maslow’s Hierarchy. Your groupings of findings will be validated as you
refer to the DEFINING CHARACTERISTICS associated with each Nursing Diagnosis located in your Nursing Care Plan
book. This is to include objective and subjective data. Do not include inferences.
Patient Initials: ______________
Cues/Data/
Assessment Findings
4.
3.
4.
6.
7.
8.
10.
11.
12.
76
Psychosocial Nursing Diagnosis:
Goal and Outcome Criteria 4 Interventions 4 Rationale/Principle Evaluation of Goal
77
Work Station #2
Instructions
 Students who are not listening to distressing voices will be assigned as an emergency
room psychiatrist. (5 students)
 The remaining students will be patients in the emergency room waiting area and will be
listening to the voices. (5 students)
 Psychiatrists will go into the waiting area and choose a patient; who they will take into
their office.
 While in the office the psychiatrist will fill out a data assessment form and administer the
mini-mental exam.
 The psychiatrist will only have 15 minutes to obtain assessment information and
administer the exam; on each of the 5 student patients. (Total of 5 data assessments and
mini-mental exams.)
Materials Needed
 Black pen
 Data Assessment form in CID.
 Mini-Mental Exam found in CID.
78
Work Station #3
their office.
 The psychiatrist will only have 15 minutes to complete the Mental Status Questions; on
each of the 5 student patients. (Total of 5 data assessments and mini-mental exams.)
Fill out the Questionnaire form as provided below:
79
Mental Status Questions Patient Initials: ___________
1. Tell me what day it is. What is the date, year and day of the week?
2. I am going to say 5 numbers and I want you to repeat them back to me when I am done:
5, 23, 67, 2, 76.
3. I am going to say 4 numbers and I want you to repeat them to me backwards. For
instance, if I said 5, 22, 45, 6 you would say 6, 45, 22, 5. Do you understand?
Repeat these numbers: 23, 4, 76, 58.
4. Who is the president of the United States? Who is the vice president?
5. I am going to say 5 words. Try to remember them: cat, book, cigar, damage, rain.
6. Name the last 4 presidents of the United States. (Answer: Obama, Bush, Clinton, Bush)
7. Starting with the number 100, count backwards by seven (100, 93, 86, 79, 72, 65…okay
enough).
8. Can you remember and tell me the words I told you a few minutes ago?
9. What does “A rolling stone gathers no moss” mean?
10. What does “People who live in glass houses shouldn’t throw stones” mean?
80
Work Station #3
Puzzles
Instructions:
their office.
 Psychiatrists will observe and record patient success in completing Match Puzzles.
 Use form provided by clinical instructor.
Materials Needed
 Black pen
 Puzzles
81
FINAL GRADES FORM
&
COURSE SUMMATIVE EVALUATION FORM
82
RNSG 2263 MENTAL HEALTH

CLINICAL ASSIGNMENT AND SUMMATIVE EVALUATION
GRADES
Student Name: Instructor:
Semester/Year: Final Grade:
CLINICAL ASSIGNMENTS POSSIBLE TOTAL POINTS

POINTS EARNED
Journal (8 separate entries: 15 points each) 120
AA Support Group or Overeaters Anonymous 50

Written Observation
Culturally Competent Care 75
Sleep Assessment with Relationship to 50

Psychiatric Disorder
Patient Assessment with Care Plan 105
Hearing Voices Simulation: On Campus 100

PASS/FAIL
Clinical Assignments 500
Summative Evaluation 500
TOTAL POINTS FOR COURSE 1000
FINAL COURSE POINTS
83
CRITERION - REFERENCED STANDARDS OF CLINICAL PERFORMANCE

(Rating scale is based on the work of K. Krichbaum, 1994)
Independent Supervised Assisted Provisional Unsatisfactory
Criteria 90-100% 80-89% 70-79% 50% 0%
E Performs behaviors Performs behaviors Performs behaviors Not always Unable to
F purposefully and accurately with accurately with accurate; requires complete task
F accurately, reflecting occasional frequent supportive continuous cues. despite
E a sound theoretical supportive or or directive cues. Identifies fragments continuous cues.
C knowledge base each directive cues. Identifies principles of principles or Unable to
T time behavior is Applies theoretical but needs help applies them identify or
I observed. knowledge with applying them. inappropriately. apply
V occasional cues. principles.
E
N
E
S
S
Focuses on the patient Focuses on patient Focuses primarily Focuses entirely on Focuses entirely
while giving care. initially; as on task or on own task or own on own
A Appears relaxed and complexity behavior, not on behavior, not on behavior.
F confident. increases, tends to client. Appears client. Appears Appears frozen
F focus on task. anxious, fidgety. anxious, flustered. unable to move.
E Appears generally
C relaxed and
T confident;
occasional anxiety
may be observable.
S Performs safely each Performs behaviors Performs behaviors Performs safely Performs in an
A time behavior is safely each time safely each time under supervision unsafe manner
F observed. observed. observed. only. or unable to
E demonstrate
T behavior.
Y
I Requires no Requires occasional Requires frequent Requires continuous Requires
N supportive cues from supportive or supportive cues and supportive and continuous
I the instructor. directive cues to occasional directive directive cues to directive and
T accomplish task. cues to accomplish complete activity. supportive cues.
I task. Instructor may
A need to
T complete
I activity or task.
V
E
Demonstrates Demonstrates Demonstrates Demonstrate lack of Performs in an
E dexterity; spends dexterity, but uses partial lack of skill skill; uncoordinated unskilled
F minimal time on task. some unnecessary and/or dexterity in in majority. Wasted manner;
F energy to complete part of activity; energy due to disorganized.
I activity. Spends awkward incompetence. Unable to
C reasonable time on movements. Wastes Activities are complete
I task. energy due to poor disrupted or activity.
E planning, repeated omitted; performed
N behavior. with considerable
C delays.
Y
84
FORMATIVE EVALUATION TOOL

TARRANT COUNTY COLLEGE
RNSG-2263-CLINICAL-MENTAL HEALTH NURSING
Student Name:_________________________________ Semester: _______________________
This evaluation tool utilizes levels of performance to indicate the degree of competency in which the
student meets the course objectives. The levels of performance are I=Independent, S=Supervised,
A=Assisted, P=Provisional and U=Unsatisfactory. These levels are based on evaluation criteria.
See evaluation criteria table. We are using I-S-A-P-U for point distribution
Formative
OUTCOMES
Performance Outcomes
Safety – Demonstrate the knowledge, skills, and attitudes that ensure
a culture of safety within the psychiatric-mental health environment. Student Faculty
= 110 points (10 points each)
1. Implement measures to promote a safe environment for patients and
others.
2. Identify Patient’s accurately.
3. Correctly performs nursing procedures and skills.
4. Implement and maintain measures to prevent exposure to infectious

pathogens.
5. Maintain and monitor for the chemical safety of the patient.
6. State the rationale for and the effects of medications and treatments.
7. Maintain and monitor for the thermal safety of the patient.
8. Assure the psychological safety of the patient by using stress control

methods and therapeutic communication.
9. Advocate on behalf of patients/families.
10. Implement patient care according to legal and ethical, state and
national standards.
85
11. Demonstrate therapeutic interaction with psychiatric-mental health

patients and the interdisciplinary team.
Subtotal:
Professionalism-Demonstrate the attitudes and values of the nursing

profession. = 50 points
Student Faculty
(#1 is worth 10 points. #2-9 are worth 5 points each.)
1. Demonstrate responsibility and accountability for personal and

professional beliefs.
2. Adhere to policies and procedures of Tarrant County College, the
Nursing Department, the course, the clinical facility, and Texas Nurse
Practice Act.
3. Follow faculty instructions.
4. Demonstrate professional behaviors, appearance, and attitude.
5. Interact with patients, nursing faculty, and the healthcare team in a
professional manner.
6. Comply with the professional, ethical, and legal standards of nursing.
7. Maintain patient confidentiality and professional boundaries.
8. Demonstrate evidence-based clinical practice.
9. Demonstrate behaviors and attitudes indicating honesty,
accountability, trustworthiness, reliability, and integrity.
Subtotal:
Caring Approach – Provide genuine and empathetic care with
Student Faculty
positive regard for self and others. = 55 points (5 points each)
1. Demonstrate caring behaviors in nursing process development and
implementation.
2. Participate in interventions that reflect caring behaviors.
3. Provide culturally sensitive healthcare to patients and their families.
4. Provide safe, compassionate, comprehensive nursing care to patients
and their families.
86
5. Facilitate wellness, coping mechanisms, and relapse prevention

behaviors.
6. Assist the patient to achieve optimum comfort and function.
7. Observe and identify group process.
8. Demonstrate respect and acceptance of others.
9. Deliver care in a non-judgmental and non-discriminating manner.
10. Implement holistic care.
11. Protect patients’ autonomy, dignity, and rights.
Subtotal:
Teaching –Use teaching/learning principles to meet the needs of the
mental health patients and their families. = 40 points
Student Faculty
(5 points each)
1. Identify learning needs of patients and families related to risk

reduction and health promotion, maintenance, and restoration.
2. Collaborate with patient and interdisciplinary healthcare team to
develop teaching plans based upon patient/family learning style and
needs.
3. Use best practice standards and other evidence based findings in
developing teaching plans for patients/families.
4. Assess learning needs and readiness of patients/families.
5. Identify appropriate teaching methods.
6. Document teaching interventions and patients/families’ responses.
7. Educate the patient and family about therapeutic level(s) and effects,
possible side effects, and onset and duration of medicines.
8. Recognize patient learning needs related to defense mechanisms and
coping skills.
87
Subtotal:
Clinical Reasoning – Recognize maladaptive behaviors and utilize
clinical reasoning skills when providing care for patients with mental
Student Faculty
health needs and their families. = 80 points
1. Apply clinical reasoning and nursing science as a basis for decision
making in nursing practice.
2. Apply the systemic problem-solving process to develop a
comprehensive plan of care for patient with mental health care needs.
3. Perform and document assessments using a systematic approach.
4. Use date collection tools to obtain patient and family history.
5. Identify psychosocial, cultural, spiritual, environmental, occupational,

and developmental needs.
6. Prioritize and implement components of the nursing process utilizing
a holistic approach.
7. Modify the plan of care as needed.
Subtotal:
Communication - Demonstrate effective and therapeutic
communication with mental health patients, their families, and
members of the interdisciplinary health care team. Student Faculty
1. Demonstrate therapeutic relationships and therapeutic interactions

with patients, families, and members of the health care team.
2. Observe verbal and nonverbal messages.
3. Seek to clarify information.
4. Demonstrate congruency in thoughts, words, feelings, and body

language.
88
5. Demonstrate verbal and nonverbal communication skills that are

relevant, accurate, complete, timely, clear, understandable, and
therapeutic.
6. Demonstrate written communications skills that are relevant, accurate,
complete, timely, legible, and meaningful.
7. Demonstrate spontaneous and non-defensive behaviors.
8. Demonstrate active listening, genuineness, observational skills,

physical attentiveness and effective interviewing skills.
9. Maintain eye contact when culturally appropriate.
10. Maintain an open posture and lean toward the patient when
appropriate.
11. Accurately and completely report and document the patient’s status
including the diagnosis, nursing care provided, effects of medications
and therapies including patient’s responses, an interactions with the
health care team.
12. Maintain open communication.
13. Recognize and maintain professional boundaries of the nurse-patient

relationship.
Subtotal:
Collaboration – Collaborate with interdisciplinary team to implement
the treatment plan of the mental health patients. Student Faculty
1. Interact with patients, nursing faculty, practicing nurses, and student
nurses’ colleagues in a professional manner.
2. Function as a member of the interdisciplinary team.
3. Work effectively in collaborative assignments.
4. Collaborate with the patient, the patient’s family, and mental health
team to coordinate the patient’s care.
89
5. Collaborate with the interdisciplinary team to make referral to

appropriate community agencies and mental health care resources to
provide continuity of care.
6. Reference and conform to delegation rule of the Texas Nursing
Practice Act.
7. Follow chain-of-command.
Subtotal:
Formative
CLINICAL EVALUATION – LEVELS OF ACHIEVEMENT
Points assigned to each objective reflect the level of competence as follows:
Consistently performs at an independent level. Meets the described objectives
500-450
with self-direction.
Demonstrate consistent performance and improvement. Needs minimal

449-400
guidance to meet described objectives.
Satisfactory/safe level of performance. Meets objectives with consistent

399-350
guidance.
Unsatisfactory/Unsafe. Level of performance does not meet standards. Unable

to meet objectives without frequent, direct, intensive guidance and instruction
< 350
to avoid errors. * Students must achieve 350 points or above on Clinical
Summative Evaluation to pass this course.*
COMPETENCE POINTS COMMENTS
Safety Student Comments:
Professionalism
Caring Approach
90
Teaching
Clinical Reasoning
Communication
Collaboration
Total Points: Faculty Comments:
Student Signature: Faculty Signature:
Date: Date:
91
SUMMATIVE EVALUATION TOOL

TARRANT COUNTY COLLEGE
RNSG-2263-CLINICAL-MENTAL HEALTH NURSING
Student Name:_________________________________ Semester: _______________________
This evaluation tool utilizes levels of performance to indicate the degree of competency in which the
student meets the course objectives. The levels of performance are I=Independent, S=Supervised,
A=Assisted, P=Provisional and U=Unsatisfactory. These levels are based on evaluation criteria. See
evaluation criteria table. We are using I-S-A-P-U for point distribution
Summative
OUTCOMES
Performance Outcomes
Safety – Demonstrate the knowledge, skills, and attitudes that ensure a
culture of safety within the psychiatric-mental health environment. = Student Faculty
110 points (10 points each)
12. Implement measures to promote a safe environment for patients and
others.
13. Identify Patient’s accurately.
14. Correctly performs nursing procedures and skills.
15. Implement and maintain measures to prevent exposure to infectious

pathogens.
16. Maintain and monitor for the chemical safety of the patient.
17. State the rationale for and the effects of medications and treatments.
18. Maintain and monitor for the thermal safety of the patient.
19. Assure the psychological safety of the patient by using stress control
methods and therapeutic communication.
20. Advocate on behalf of patients/families.
21. Implement patient care according to legal and ethical, state and national
standards.
22. Demonstrate therapeutic interaction with psychiatric-mental health

patients and the interdisciplinary team.
Subtotal:
92
Professionalism-Demonstrate the attitudes and values of the nursing

profession. = 50 points
Student Faculty
10. Demonstrate responsibility and accountability for personal and

professional beliefs.
11. Adhere to policies and procedures of Tarrant County College, the
Nursing Department, the course, the clinical facility, and Texas Nurse
Practice Act.
12. Follow faculty instructions.
13. Demonstrate professional behaviors, appearance, and attitude.
14. Interact with patients, nursing faculty, and the healthcare team in a
professional manner.
15. Comply with the professional, ethical, and legal standards of nursing.
16. Maintain patient confidentiality and professional boundaries.
17. Demonstrate evidence-based clinical practice.
18. Demonstrate behaviors and attitudes indicating honesty, accountability,
trustworthiness, reliability, and integrity.
Subtotal:
Caring Approach – Provide genuine and empathetic care with positive
Student Faculty
regard for self and others. = 55 points (5 points each)
12. Demonstrate caring behaviors in nursing process development and
implementation.
13. Participate in interventions that reflect caring behaviors.
14. Provide culturally sensitive healthcare to patients and their families.
15. Provide safe, compassionate, comprehensive nursing care to patients
and their families.
16. Facilitate wellness, coping mechanisms, and relapse prevention
behaviors.
17. Assist the patient to achieve optimum comfort and function.
93
18. Observe and identify group process.

19. Demonstrate respect and acceptance of others.
20. Deliver care in a non-judgmental and non-discriminating manner.
21. Implement holistic care.
22. Protect patients’ autonomy, dignity, and rights.
Subtotal:
Teaching –Use teaching/learning principles to meet the needs of the
mental health patients and their families. = 40 points
Student Faculty
(5 points each)
9. Identify learning needs of patients and families related to risk reduction

and health promotion, maintenance, and restoration.
10. Collaborate with patient and interdisciplinary healthcare team to
develop teaching plans based upon patient/family learning style and
needs.
11. Use best practice standards and other evidence based findings in
developing teaching plans for patients/families.
12. Assess learning needs and readiness of patients/families.
13. Identify appropriate teaching methods.
14. Document teaching interventions and patients/families’ responses.
15. Educate the patient and family about therapeutic level(s) and effects,
possible side effects, and onset and duration of medicines.
16. Recognize patient learning needs related to defense mechanisms and
coping skills.
Subtotal:
94
Clinical Reasoning – Recognize maladaptive behaviors and utilize

clinical reasoning skills when providing care for patients with mental
Student Faculty
health needs and their families. = 80 points
8. Apply clinical reasoning and nursing science as a basis for decision
making in nursing practice.
9. Apply the systemic problem-solving process to develop a
comprehensive plan of care for patient with mental health care needs.
10. Perform and document assessments using a systematic approach.
11. Use date collection tools to obtain patient and family history.
12. Identify psychosocial, cultural, spiritual, environmental, occupational,

and developmental needs.
13. Prioritize and implement components of the nursing process utilizing a
holistic approach.
14. Modify the plan of care as needed.
Subtotal:
Communication - Demonstrate effective and therapeutic
communication with mental health patients, their families, and
members of the interdisciplinary health care team. Student Faculty
5. Demonstrate therapeutic relationships and therapeutic interactions with

patients, families, and members of the health care team.
6. Observe verbal and nonverbal messages.
7. Seek to clarify information.
8. Demonstrate congruency in thoughts, words, feelings, and body

language.
14. Demonstrate verbal and nonverbal communication skills that are
relevant, accurate, complete, timely, clear, understandable, and
therapeutic.
95
15. Demonstrate written communications skills that are relevant, accurate,

complete, timely, legible, and meaningful.
16. Demonstrate spontaneous and non-defensive behaviors.
17. Demonstrate active listening, genuineness, observational skills, physical

attentiveness and effective interviewing skills.
18. Maintain eye contact when culturally appropriate.
19. Maintain an open posture and lean toward the patient when appropriate.
20. Accurately and completely report and document the patient’s status
including the diagnosis, nursing care provided, effects of medications
and therapies including patient’s responses, an interactions with the
health care team.
21. Maintain open communication.
22. Recognize and maintain professional boundaries of the nurse-patient

relationship.
Subtotal:
Collaboration – Collaborate with interdisciplinary team to implement
the treatment plan of the mental health patients. Student Faculty
8. Interact with patients, nursing faculty, practicing nurses, and student
nurses’ colleagues in a professional manner.
9. Function as a member of the interdisciplinary team.
10. Work effectively in collaborative assignments.
11. Collaborate with the patient, the patient’s family, and mental health
team to coordinate the patient’s care.
12. Collaborate with the interdisciplinary team to make referral to
appropriate community agencies and mental health care resources to
provide continuity of care.
13. Reference and conform to delegation rule of the Texas Nursing Practice
Act.
96
14. Follow chain-of-command.
Subtotal:
Summative
CLINICAL EVALUATION – LEVELS OF ACHIEVEMENT
Points assigned to each objective reflect the level of competence as follows:
Consistently performs at an independent level. Meets the described
500-450
objectives with self-direction.
Demonstrate consistent performance and improvement. Needs minimal

449-400
guidance to meet described objectives.
Satisfactory/safe level of performance. Meets objectives with consistent

399-350
guidance.
Unsatisfactory/Unsafe. Level of performance does not meet standards.

Unable to meet objectives without frequent, direct, intensive guidance and
< 350
instruction to avoid errors. * Students must achieve 350 points or above
on Clinical Summative Evaluation to pass this course.*
COMPETENCE POINTS COMMENTS
Safety Student Comments:
Professionalism
Caring Approach
Teaching
Clinical Reasoning
97
Communication
Collaboration
Total Points: Faculty Comments:
Student Signature: Faculty Signature:
Date: Date:
98
Signature Forms
99
EBOLA
Yes No
1. In the last 21 days, have you traveled to any of the following
countries in Africa?
 Guinea
 Liberia
 Sierra Leone
 Democratic Republic of the Congo
 Mali
Yes No
2. In the last 21 days, have you had contact with a person with
known or suspected Ebola virus?
Student Signature: __________________________________________
Date: __________________________________
100
Student Contract
Sign and Give to Theory Instructor
Course Syllabus
 I have read the CID for RNSG-2213
 I have reviewed the policies regarding testing and tardiness or absence for exams.
 I understand the nursing chain of command, and know that if I have a question or
issue:
 I will contact my instructor first.
 If the issue is not resolved I will contact the course coordinator,
Victoria Anthony.
 If the issue is still not resolved, I will contact the
Assistant Dean, Sharon Livisay.
 I am aware of the expectation of academic integrity and will adhere to the TCC Honor
Code as well as TCC Nursing academic integrity requirements in my course work, which
is not limited to and includes clinical assignments, written work, and examination
situations.
My signature below represents my understanding of the syllabus and my intention to abide by

the policies of the course. I have had an opportunity to ask questions or to seek clarification on
matters discussed in the syllabus.
Signature: _________________________________ Date: ________________
Printed Name________________________________________________________
Last First
101
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2019 Fall RNSG 2263 Mental Health Nursing

Tarrant County College

Course Title: Clinical Foundations for Mental Health Nursing

Victoria Anthony RN MSN ACNP-R

Warning: © 2019 TARRANT COUNTY COLLEGE

This document is copyrighted (All rights reserved.)

Required textbooks are also available in an e-Book format.

Texas Board of Nurse Examiners: http://www.txbon

COURSE GOALS AND LEARNING OUTCOMES

2. Demonstrate professionalism in displaying the attitudes and values of the nursing

g. maintaining patient confidentiality and professional boundaries (1a-c, 2a–e)

3. Demonstrate a caring approach in providing genuine and empathetic care with

4. Demonstrate teaching in using teaching/learning principles to meet the needs of the

5. Demonstrate clinical reasoning in recognizing maladaptive behaviors and utilize

e. identifying psychosocial, cultural, spiritual, environmental, occupational, and

6. Demonstrate effective and therapeutic communication with mental health patients,

STUDENT ACCESSIBILITY RESOURCES

CRITERIA FOR SAFE CLINICAL PERFORMANCE

SAFE CLINICAL BEHAVIORS UNSAFE CLINICAL BEHAVIORS INCLUDE BUT ARE

SAFE CLINICAL BEHAVIORS UNSAFE CLINICAL BEHAVIORS INCLUDE BUT ARE

Term # of Meetings 15% of class meetings Student dropped after X days

Financial Aid Recipient

Students’ Evaluation of the Course and Instructor

Unprofessional Student Behavior

A student is expected to conduct him or herself in a professional demeanor.

CLINICAL COURSE ASSIGNMENTS

Required Assignments Points

(8 total each worth 15 points)

 Describe a clinical event that made an impression on you.

Grading Rubric for Journal Assignments

Criteria Possible Points Instructor Comments

 source of stress for patient 1.5 - 5

Include observations about the

Sleep Assessment with Relationship to Psychiatric Disorder Assignment

Sleepiness Scale, and Medication Table as provided. (Worth 10 points)

 Find a research article describing the mental disorder of your patient.

 List the DSM-IV criteria for the mental disorder.

social and occupational setting.

The Pittsburgh Sleep Quality Index

Student Name: ______________________________________________

Patient Initials: ______________________

Date of Care: _________________

Usual bed time

Usual getting up time

Not during the Less than Once or three or more

past month once a week twice a week times a week

(b) Wake up in the middle of the night or early morning

Not during the Less than Once or Three or more

past month once a week twice a week times a week

(c) Have to get up to use the bathroom

Not during the Less than Once or three or more

past month once a week twice a week times a week

(d) Cannot breathe comfortably

Not during the Less than Once or three or more

past month once a week twice a week times a week

(e) Cough or snore loudly

Not during the Less than Once or three or more

past month once a week twice a week times a wee

(f) Feel too cold

Not during the Less than Once or three or more

past month once a week twice a week times a week

(g) Feel too hot

Not during the Less than Once or three or more

past month once a week twice a week times a week