RNSG 2363: Clinical (Advanced Concepts and Mental Health)

Spring 2017

Angelina College

RNSG 2363: Clinical (Advanced Concepts and Mental Health)

I.BASIC COURSE INFORMATION

A.Course Description:

Three hours credit. 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. Placement in second year nursing curriculum during the spring semester is required. 288 clinical hours. Prerequisites: RNSG 1412, 1343, 2360, and a current CPR card. Co-requisites: RNSG 2331 and 2213.

B.Intended Audience:

Sophomore working toward educational requirements for Associate of Applied Science in Nursing.

C.Instructor:

Name / Office Location / Phone Number / Email Address
Winifred Adams / HC 100 / 936-633-5265 /
Alysa Cummins / HC 212 / 936-633-5273 /
Carol Havis / HC 113 / 936-633-5272 /
Susan McKee / HC 217 / 936-633-3241 /
Nancy McClurg / HC 213 / 936-633-5277 /
Mary Bowers / HC 216 / 936-414-4756 /
Doris Weatherford / 936-633-5265 /
Melissa Abbott / 936-633-5265 /

Office Hours: See office posting.

Phone: Instructors may also be reached through Health Careers at 936-633-5265. If the instructor is not

available, please leave a message with the Program Secretary/voicemail, or the Program Coordinator/

voicemail, who will relay the message to the instructor.

II. INTENDED STUDENT OUTCOMES:

A.Core Competencies – (Basic Intellectual Competencies)

1. Critical Thinking Skills (CT) – to include creative thinking, innovation, inquiry, and analysis, evaluation and synthesis of information.

2. Communication Skills (COM) – to include effective development, interpretation and expression of ideas through written, oral and visual communication.

3. Empirical and Quantitative Skills (EQS) – to include the manipulation and analysis of numerical data or observe facts resulting in informed conclusions.

4. Teamwork (TW) – to include the ability to consider different points of view and to work effectively with others to support a shared purpose or goal.

5. Personal Responsibility (PR) – to include the ability to connect choices, actions and consequences to ethical decision-making.

6. Social Responsibility (SR) – to include intercultural competence, knowledge of civic responsibility, and the ability to engage in regional, national, and global communities.

B.Course Objectives for all sections –

Upon completion of this course, the student will have the knowledge and skills to:

Demonstrate the use of clinical reasoning, the nursing process, and evidence based practice outcomes as the basis for decision making in the care of adult advanced medical surgical patients, psychiatric/mental health patients, and their families (PLO #1) (DEC 1 & 2).
Exhibits behaviors that reflect commitment to the growth and development of the role and function of nursing consistent with the state and national regulations and with ethical and professional standards; aspires to improve the discipline of nursing and its contribution to society; and values self-assessment and the need for life- long learning (PLO #2) (DEC 1 & 4).
Accepts responsibility for the quality of nursing care and provides safe, compassionate nursing care using a systematic process of assessment, analysis, planning, intervention and evaluation that focuses on the needs and preferences of adult advanced medical surgical patients, psychiatric/mental health patients, and their families (PLO #3) (DEC 2 & 3).
Promotes safe practice guidelines within the therapeutic environment for adult advanced medical surgical patients, psychiatric/mental health patients and their families by: following scope and standards of nursing practice, practicing within the parameters of individual knowledge, skills and abilities; identifying and reporting actual and potential unsafe practices and implementing measures to prevent harm (PLO #4) (DEC 2).
Provides patient centered care by collaborating, coordinating and/or facilitating comprehensive care with an interdisciplinary/multidisciplinary healthcare team to determine and implement best practices for the adult advanced medical surgical patients, psychiatric/mental health patients and their families (PLO #5) (DEC 1,2,3).

III.ASSESSMENT MEASURES OF STUDENT LEARNING OUTCOMES:

Assessments for the Core Intellectual Competencies –

1. Critical Thinking Skills (CT) – Competency in critical thinking is assessed through student's ability to discuss patient case studies, identify patient care needs and complete written assignments.

2. Communication Skills (COM) Competency in speaking is assessed through oral contribution in small-group activities and interpersonal communication with patients, staff, instructors and peers.

3. Empirical and Quantitative Skills (EQS) – Competency in empirical and quantitative skills is assessed through administration of a dosage calculation exam prior to clinical.

4. Teamwork (TW) – Competency in teamwork is assessed through student's ability to participate in various group assignments.

5. Personal Responsibility (PR) –Competency in personal responsibility will be assessed through the student's preparedness for exams and class assignments.

6. Social Responsibility (SR) – Competency in social responsibility will be assessed through the student's performance on computerized exam questions relating to cultural and global health issues.

Assessments for Course Objectives for all sections –

SCANS (Secretary of Labor‘s Commission of Achieving Necessary Skills):

Students are expected to demonstrate basic competency in academic and workforce skills. The following competencies with evaluation are covered in RNSG 2363:

SCANS SkillsEvaluation

Foundation SkillsCase Study/Teaching Plan

Required and suggested readings

Critical Thinking Case Studies

Oral presentation

Dosage Calculations Test

Workplace CompetenciesComputer assisted Instruction

Completion of Independent Study Projects

Written Case Study

Demonstrated Competency in Clinical

Assessments for the Course Objectives as determined by the instructor –

Same as stated above.

IV. INSTRUCTIONAL PROCEDURES:

A.Methodologies common to all sections

Audio visual aids

Conferences

Clinical Experiences

Computer assisted instruction

Group discussion

Role playing

Independent study

Case Study

Teaching Plans

BLACKBOARD instruction

B. Methodologies determined by the instructor

Not applicable for this course.

V.COURSE REQUIREMENTS AND POLICIES:

A.Required Textbooks, Materials, and Equipment –

Angelina College. CurrentACNP Student Handbook

Carpenito, Handbook of Nursing Diagnosis, 14ed.

Pagana, (2015). Mosby's Diagnostic and Laboratory Test Reference, (12thed.).

Gahart, B.L. (2014). Intravenous medications (30th ed.). St. Louis: Mosby.

Lewis, S., Heitkemper, M., & Dirksen, S. (2014). Medical-surgical nursing: assessment and management ofclinical problems. (9th ed.). St. Louis: Mosby.

Fortinash, K. M., & Holoday Worret, P. A. (2012). Psychiatric Mental Health Nursing. (5th ed.) St. Louis, Missouri: Elsevier Mosby.

Wilson, Shannon,Shields (2013). Prentice Hall Nurse’s Drug Guide (11th ed.).. Upper Saddle River, NJ: Pearson Education, Inc.

Recommended Textbooks, Materials, and Equipment –

Lewis, S. & O’Brien, P. (2014). Study Guide for Medical-surgical nursing: Assessment and management of

clinical problems. (9th ed.).

B.Assignments –

Computer Assisted Instruction (CAI) and Blackboard Resources:

This is a Blackboard enhanced course. Students will be expected to log on to Blackboard to receive assignments, calendars, course information and other materials:

1.Case Study/Teaching Plan

2.Care Plans

3.Daily Clinical Assignments

4.Patient Care Log

5.Dosage Calculations Test

6.CAIs/Adaptive Quizzing/ NCLEX questions

7.Written and oral assignments

8.Community Clinical Assignments (Psychiatric Nursing and Med-Surgical Nursing)

C. Course Policies – (This course conforms to the policies of Angelina College as stated in the Angelina College Nursing Program Student Handbookand theAngelina College Student Handbook.)

Academic AssistanceAcademic Assistance – If you have a disability (as cited in Section 504 of the Rehabilitation Act of 1973 or Title II of the Americans with Disabilities Act of 1990) that may affect your participation in this class, you should see Sellestine Hunt Associate Dean of Student Services, Student Center, Room 200. At a post-secondary institution, you must self-identify as a person with a disability; Ms. Hunt will assist you with the necessary information to do so. To report any complaints of discrimination related to disability, you should contact Mr. Steve Hudman, Dean of Student Affairs, in Student Center, Room 101, (936) 633-5292 or by email .

Angelina College (AC) admits students without regard to race, color, religion, natural origin, sex, disability, or age. Inquiries regarding the non-discrimination policies of AC should be directed to the Vice president and Dean of Instruction, 3500 South First , Lufkin, TX 75904, telephone is 936-633-5201.

Attendance –See Current ACNP Student Handbook

Additional Policies –

Clinical – Students must call the clinical instructor prior to clinical to report any absence. Instructors will accept telephone calls from only the student. Students who do not call the morning of the clinical absence must see the Nursing Program Coordinator or her designee. A total of two no call/no shows for clinical or clinical lab days while in the Nursing Program will result in dismissal from the Nursing Program. More than two absences per course in the clinical area will result in withdrawal from the clinical course in progress and all co-requisite courses according to Angelina College Policy.

Tardiness – Tardiness is simply defined as not being in the assigned area at the assigned time. To prevent class disruptions, tardy students will not be allowed to enter the classroom until a break. Students who are tardy a total of three (3) times in the clinical area will receive a clinical absence. Students who arrive later than 30 minutes past the scheduled designated clinical area time, may/will be sent home (instructor’s discretion) AND a clinical absence will be recorded.

Progression Policy –A student must earn a minimum grade of “C” or “P” in all required courses in order to progress within the nursing program. All nursing courses must be taken in the appropriate sequence.

Examinations –Students must be present and on time for all examinations which will be administered on-line in the computer lab or by paper and pencil. If absent, student must call the nursing office @ 936-633-5265 and leave a message, BEFORE the exam beginsto make arrangements for a make-up exam or no makeup exam will be scheduled. (See current ACNP Student Handbookfor makeup exam policy.)

Attendance at the final examination is required and may be rescheduled ONLY with the approval of the Vice President of Instruction. All exams (and written assignments) become the property of the Nursing Program.

Late Assignment - Assignments must be submitted according to instructor directions (online, printed, typed, etc.). Assignments failing to follow instructions/guidelines which are returned to the student will be considered late.

Assignments graded as Pass/Fail will not be accepted late, and will be recorded as a Fail.

All graded assignments (numerical or A, B, C) will be considered late 1 hour after the designated time and date. Ten (10) points will be deducted from the assignment's final grade for each 24 hour period after the due date, up to a maximum of 30 points or 3 days. After 3 days, work will not be accepted and a grade of "0 or F" will be recorded.

Late work will only be accepted for standard excused events such as hospitalization of self or immediate family, or death in the immediate family. See the AC Nursing Student Handbook for details. Other compelling reasons may be considered and granted by the individual instructor. Technological difficulties are not an excuse. (Approved 9/15)

Withdrawal and Dismissal –Students who wish to withdraw from the nursing program must do so with both the Nursing Program Coordinator and the Office of Admissions. If the student does not officially withdraw in the Office of Admission, an “F” will appear on the transcript for the course in progress at that time.

Computer Assisted Instruction (CAI) and Blackboard Resources–This is a Blackboard enhanced course. Students will be expected to log on to Blackboard to receive assignments, calendars, course information and other materials.

Additional Policies Established by the Individual Instructor. None

VI.COURSE CONTENT:

A.Required Content/ Topics –

Application of the theory, concepts, and skills through clinical assignments aligned with RNSG 2363.

Clinical Experience / Activities
Skills Lab: EKG
1.Discuss various EKG strips.
2.Interpret meaning of and interventions for various EKG strips. / 1.Read: Lewis Chapter 36
2.Complete CAI – Cardiac Rhythm Recognition and bring quiz scores to skills lab
3.Attend skills lab
4.Complete practice strips
5.Client care in various clinical settings
Skills Lab: Ventilators
1.Discuss the nursing care of the patient with an artificial airway.
2.Define different modes of mechanical ventilation
3.Discuss the various settings on a ventilator panel. / 1.Read: Lewis pages 1613-1629
2. Sign up for Medscape and do and or same article under
3.
4. Attend skills lab
Skills Lab: Hemodynamic Monitoring
1.Discuss various hemodynamic monitoring.
2.Interpret meaning of and interventions for hemodynamic monitoring. / 1.Read: Lewis pages 1603 -1610
2.Attend skills lab
3.Client care in various clinical settings
Skills Lab: Care Planning and Case Study
Review the nursing process and apply to patient care.
1.Identify and discuss the phases of the nursing process.
2.Apply the nursing process in simulated and actual patient scenarios.
3.Apply use of the nursing process in Electronic Health Record (EHR) documentation. / 1.Review Carpenito or Ackley (care planning reference book)
2.Client care in various clinical settings
Skills Lab: Cardiac Medications and Advanced Dosage Calculations
1.Calculate flow rates and assess safe dosages for critical care IV medications.
2.Discuss various cardiac medications.
3.Identify medication treatment options related to EKG dysrhythmias. / 1.Read: LewisTable 33-8 p. 721, Table 34-5 p.739,
Table 35-7 p. 774, Table 36-9 p. 801.
2.Attend skills lab
3.Client care in various clinical settings
Clinical: Medical/Surgical/Acute Setting – Care Plans
1.Provide care for patients with complex physiological needs.
2.Observe emergency room triage activities. / Complete care plan(s) during your hospital clinical rotation as determined by your individual clinical instructor. Passing grade level is outlined in the Criteria for Grading Clinical Care Plan in the appendix of the syllabus. A nursing care plan is a systematized description of the care provided for a patient that reflects the use of the nursing process, including assessment, nursing diagnoses, planning, implementation, and evaluation of the patient's goal attainment. The overall goal of a nursing care plan is to ensure that care provided for a patient is consistent with the patient's needs and progress toward identified expected outcomes.
The key elements of a care plan are:
1.A thorough history of the present illness or status which includes all pertinent assessment data on one patient.
2.A list of prioritized problems/needs for the patient which reflect analysis of the status of the client, progress toward overall outcomes and any new data gathered by the health care team.
3.A list of overall, patient-centered goals.
4.At least two (2) overall nursing interventions which were used to address the care of this patient.
5.An evaluation of the effectiveness of the care plan and description of modifications made to the care plan, as appropriate.
6.A brief evaluation of the student’s progress for that day.
Students are expected to incorporate feedback on care plan entries into future entries. In that way, students should show continuous improvement in mastery of assessment abilities, prioritizing skills, ability to select relevant interventions and evaluate care.
Medical Surgical Community Rotations
Home Health / 1. Describe the roles of the home health nurse.
2. Describe the regulatory processes of home health care.
3. List factors essential to effective delivery of care in the home health setting.
4.Journal about your experiences in the home health setting.
5.Assess a client’s coping skills;(a) identify areas for teaching, (b) identify areas of strength, (c) identify psychosocial diagnosis. (Varcarolis Ch.29).
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
Management / 1.Identify the role of the nurse manager. What is the title and job description?
2.Identify the staffing model in the assigned unit and how the manager determines staffing patterns.
3.Identify the model of patient care used on the unit.
4.Identify the management style of the manager you are assigned to and the management approaches used to motivate their work group.
5.Discuss with the manager how priorities are set and assignments made.
6.Discuss with the manager budgetary considerations for the unit.
7.Identify and describe the organizational structure of this hospital.
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
Acute Psychiatric Rotation
(Rusk State Hospital, Burke Center, and Lufkin State School)
Read Fortinash - Chapters 2, 25, and 26 / 1.Assess an assigned client using Box 3-1 (pages 42-44, Fortinash).
2.Utilize therapeutic communication techniques and role play with a peer in a post conference setting. The role play will be evaluated by class members and instructors.
3.Be prepared to discuss and share therapeutic communication successes and concerns in post conference as appropriate.
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member ONLY if faculty are not present.
Community Rotation Psychiatric Area
Read Fortinash - Chapter 30 / 1.Apply the nursing process to the care of psychiatric clients in the community setting.
2.Apply the concepts of care associated with the model of community mental health.
3. Explore the role of the registered nurse in the psychiatric/mental health setting including the areas of case management and rural mental health.
4.Identify agencies that provide psychiatric community nursing care and identify the agencies' client population.
5.Utilize therapeutic communication techniques.
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
Clinical Communication Activity
Reference – Fortinash – pages 60-61 / 1.Respond to written prompts describing patient therapy and interactions.
2.Utilize therapeutic communication techniques and identify therapeutic and non-therapeutic responses with alternate responses.
3.Describe personal feelings and reflections of interaction related to nursing care given.
Bed Number Ten / 1.Read book at assigned time.
2.Respond to questions assigned on Blackboard.
Psych Scenarios / 1.Perform and record dramatization of therapy session demonstrating understanding of condition, nursing interventions, and medications.
2. Provide written care plan for assigned condition.
3. Demonstrate therapeutic communication techniques.
Hospice Agencies
Read Fortinash - Chapters 5, 26, 28, and 29 / 1.Review care plan for a terminally ill client.
2.Utilize therapeutic communication techniques.
3.Investigate bereavement support groups.
4.Describe implementation of agencyregulations for advance directives.
5.Record this information in the weekly journal entry and return the agency preceptor/facilitator form weekly.
6.Assess client’s coping skills;(a) identify areas for teaching, (b) identify areas of strength, (c) identify psychosocial diagnosis. (Fortinash, Chapter 5 and 28)
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
School Settings
Review Fortinash - Chapter 7 and 17
This is not a school nurse rotation. / 1. Describe the psychosocial developmentof the students in the setting.
2. Identify potential nursing diagnosis of childhood and adolescence for the
students observed.
3. Discuss interventions used in the setting including medications.
4. Utilize therapeutic communication techniques.
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
Day Treatment Programs and Alzheimer’s Units
Read Fortinash - Chapters 16 / 1. Identify nursing diagnosis common to clients with delirium and dementia.
2. Discuss criteria for admission to the program or facility.
3. Describe treatment modalities usedin the settings.
4. Utilize therapeutic communication techniques.
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
Substance Abuse/Chemically Impaired Agencies
Read Fortinash - Chapter 15 / 1. Identify nursing diagnosis common to clients with substance abuse problems.
2. Discuss criteria for admission to the program.
3. Describe treatment modalities usedin the settings.
4. Record this information in the weeklyjournal entry.
Turn in the completed forms: Agency Evaluation of Student and Student Evaluation of Community Experience on Monday following rotation to designated faculty member.
Health Fair / 1. Provide culturally and developmentally appropriate direct patient teaching on a variety of mental health topics.
2. Evaluate essential teaching components and design visual/printed materials that support verbal instruction.
3. Evaluate peers on planning and implementation of teaching project with emphasis on personal responsibility for project completion.

VII. EVALUATION AND GRADING: