Essential Psychiatric Mental Health and

Essential PMH Competencies
Essential Psychiatric, Mental Health and

Substance Use Competencies
for the Registered Nurse
Developed by the Psychiatric Mental Health Substance Abuse
Essential Competencies Taskforce of the
American Academy of Nursing Psychiatric Mental Health
Substance Abuse Expert Panel
The original concept for this document was conceived at the meeting of
the Psychiatric Mental Health Expert Panel during the Academy of Nurs-
ing 33rd Annual Meeting and Conference, Integrating Physical and Mental
Health Care, held in Miami, Florida, November 9-11, 2006. Judith Haber
and June Horowitz co-chaired the Expert Panel meeting at the time dis-
cussion took place regarding the need for a document centralizing rec-
ognized competencies and curricula associated with psychiatric mental
health nursing practice. The Expert Panel also recognized the need for a
document that identified psychiatric mental health competencies for gen-
eralist nursing practice. Catherine Kane and Margaret Brackley agreed to
Co-Chair a taskforce to write these competencies. They were joined by
Madeline Naegle, Sandra Talley, Marian Newton, Jeanne Clement, Patricia
D’Antonio, and Elizabeth Poster. This initial group was charged with using
“a model similar to the Hartford Foundation model for building capacity
in geriatric nursing to develop PMH/Behavioral Health Competencies for
non-PMH RNs and APRNs.” Other contributing members of the Taskforce
were Edna Hamera, Elizabeth LeCuyer, Mona Shattell, Geri Pearson, Re-
becca Harmon and Theodora Sirota. The Taskforce convened by telecon-
ference on April 13, 2007, and met monthly by teleconference through Fall
2008. A full draft of the document was completed and sent for editing to
Geraldine Pearson and Beth Vaughn Cole. On March 24, 2009, the Task-
force convened by teleconference and agreed to distribute the draft to the
membership of the International Society of Psychiatric Nursing (ISPN), the
American Psychiatric Nurses Association (APNA), and the International
Nurses Society on Addictions. The draft was displayed on the websites
of ISPN and APNA through 2009. Comments, suggestions, edits and revi-
sions were welcomed and the feedback was incorporated into this docu-
ment. The appendices to this document include materials that informed
the content of these Essentials and websites for resources.
AcknowledgEments
The Taskforce wishes to acknowledge the University of Virginia for access
to COLLAB, where documents could be accessed by all members. Fur-
ther recognition is due to the nursing organizations that contributed to the
work of this taskforce through their reviews, opinions, and encouragement.
The Taskforce also wishes to acknowledge the Schools of Nursing that
supported teleconferencing by their faculty members and the members
0
Archives of Psychiatric Nursing, Vol. 26, No. 2 (April), 2012: pp 80 –11 80

ESSENTIAL PMH COMPETENCIES 81
of professional organizations who reviewed and provided feedback to this

document.
Essential Psychiatric, Mental Health ment (Gamm, Stone, Pittman, 2003). According to
and Substance Use Competencies for the landmark “Global Burden of Disease” study, 4
the Registered Nurse of the 10 leading causes of disability for persons
The Essential Psychiatric, Mental Health and ages 5 and older are mental health disorders. In the
Substance Use Competencies for the Registered United States, psychiatric disorders collectively
Nurse provides the framework for educational account for more than 15 % of the overall bur-
preparation of generalist professional nurses to den of disease from all causes and slightly more
provide appropriate and effective care for per- than the burden associated with all forms of can-
sons with mental illness, substance use disorders, cer (Murray & Lopez, 1996). Major depression is
and persons at risk for these conditions and who the leading cause of disability in the United States
can promote the mental health of all persons in and addiction, bipolar illness, schizophrenia, and
their care. The format of these Competencies obsessive-compulsive disorder rank close behind.
draws from the American Association of Colleges Major psychiatric disorders are associated with
of Nursing’s (2008) document, The Essentials of considerable morbidity and mortality, and suicide
Baccalaureate Nursing Education and from the represents one of the leading preventable causes
American Association of Colleges of Nursing’s of death worldwide. In addition, estimates of the
Recommended Baccalaureate Competencies and total overall costs of substance abuse in the United
Curricular Guidelines for Geriatric Nursing Care States—including health- and crime-related and
(2010). However, the competencies presented here loss of productivity—exceed half a trillion dol-
apply to the preparation of professional nurses in all lars annually (NIDA, 2008). A growing number of
types of nurse education programs that prepare stu- Americans, 20 million (8.3%) 12 years and older
dents to practice within the licensed parameters of are current users of illicit drugs and roughly 7 mil-
the Registered Nurse. Throughout this document, lion abuse prescription drugs. Nicotine dependence
the term “Psychiatric Mental Health Nursing” in- and alcohol related disorders each afflict approxi-
cludes nursing care of persons with substance use mately 20% of the US population. There is a grow-
disorders as well as those who have medical or ing appreciation that mental health, and the brain
surgical conditions that are accompanied by psy- and behavioral disorders that affect it, are dynamic,
chosocial stressors. Curricula should be designed ever-changing phenomena that, at any given mo-
to prepare students to demonstrate these competen- ment, reflect the sum total of every person’s ge-
cies. Diploma, Associate Degree and Baccalaure- netic inheritance and life experiences.
ate programs should seek to assure the inclusion of The majority of individuals who are diagnosed
the described content areas and skill sets. with mental illnesses and substance use disorders
seek help outside of specialty behavioral health
Introduction systems (Hoge et al., 2005). Nurses are likely to
Psychiatric disorders, including substance use encounter persons with these disorders and those
disorders, affect a majority of people receiving at risk in a variety of settings, especially primary
nursing care in the United States. They afflict all care. Therefore, it is essential for registered nurs-
age groups, with an estimated 20 % of children and es to be prepared to recognize symptoms of psy-
adolescents age 9 to 17, and as many as 25 % of chiatric disorders and to intervene appropriately.
those 65 and older suffer from these disorders each Further, nurses in primary care are also likely to
year. Of those who experience psychiatric disor- encounter persons with mental health needs related
ders only a small percent actually receive treat- to stresses that accompany medical and surgical
82 ESSENTIAL PMH COMPETENCIES
conditions. Likewise, persons with prior substance mote mental health and decrease the risks for psy-
use histories may relapse with the stress of physi- chiatric illness, most registered nurses practicing
cal illness. Although these persons may not be today have limited preparation in the principles of
diagnosed with specific psychiatric disorders, ap- psychiatric nursing care. Many nursing education
propriate responses by registered nurses can enable programs no longer require a course in psychiatric
individuals in stressful situations related to acute nursing, are not current on addiction knowledge,
or chronic physical conditions to cope effectively and do not include appropriate therapeutic inter-
with the associated mental health risks. Inappropri- active skills or emphasize these skills across all
ate responses or failure to recognize possible men- clinical courses consistently. A renewed focus on
tal health needs often supports the continuation of psychiatric, mental health and substance use treat-
ineffective coping and possibly lead to the onset ment knowledge and skills in professional nurs-
of a psychiatric disorder or exacerbation of prior ing education and practice is necessary to address
illness. current needs. All generalist nurses practice under
Psychiatric nursing was the first area of nursing the license of Registered Nurse. Thus, the purpose
practice to be identified as a nursing specialty and of this document, Essential Psychiatric, Mental
has a long history of preparing nurses to care for Health and Substance Use Competencies for the
people with mental health problems. Hildegarde Registered Nurse is to assist nurse educators to in-
Peplau, the eminent psychiatric nursing scholar, corporate specific psychiatric nursing content into
first documented the importance and efficacy of curricula.
strong interpersonal skills for nurses in her seminal The International Society of Psychiatric Nurs-
book, Interpersonal Relations in Nursing. Peplau ing (ISPN), and The American Psychiatric Nurses
emphasized that these skills were important for all Association (APNA) and the International Nurses
nurses to acquire in order to effectively care for any Society on Addiction have identified a core curric-
patient, not only psychiatric patients. Peplau rec- ulum and terminal objectives for entry level profes-
ognized that mental health problems could occur sional nurses in the area of psychiatric and mental
across all nursing specialty areas and all clinical health care. AACN’s The Essentials of Baccalau-
settings. Further, The Annapolis Coalition (Hoge et reate Education for Professional Nursing Practice
al., 2005) recommended that for the vast number of (AACN, 2008) provided a framework for devel-
the helping professions, behavioral health compe- oping, defining, and revising the competencies in
tencies must be identified, training systems devel- the present document. This document addresses
oped, and provider competencies assessed with the the professional values, core competencies, core
same sense of urgency that is applied to the spe- knowledge, and role of the professional nurse car-
cialty behavioral health workforce. This directive ing for persons with psychiatric and substance use
applies even more urgently to registered nurses disorders and persons at risk for these disorders.
across all health care settings. Without appropri- These core values, competencies, and knowledge
ate education and experience, the registered nurse are vital in ensuring that all registered nurses are
will not consider the possibility of co-occurring prepared to provide accessible, evidence-based,
psychiatric illnesses when a patient presents for quality care for all persons with psychiatric, men-
primary or emergency care. Recognition of psy- tal health and substance use disorders.
chiatric symptoms can enable the registered nurse
practicing in a non-psychiatric setting to intervene
by encouraging the individual to seek appropriate
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ESSENTIAL PMH COMPETENCIES
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U.S. Department of Health and Human Services. (2000). across the lifespan, cultures and contexts.
Healthy People 2010. Washington, DC: U.S. Depart- 5. Understand the various contexts of care,
ment of Health and Human Services. including the site of care, the nature of the
care, and the religious, spiritual, his- both in individual practice, as a member
torical, political, social, and professional of a professional team, and as a leader of
perspectives brought to bear on that care therapeutic and educative groups
6. Recognize the complicated intersection of
clinical, legal, and ethical issues involved
Essential II: Basic Organizational
in the care of patients (both adults and
and Systems Leadership for Quality
children) with psychiatric disorders.
in Registered Nursing Practice
7. Broaden the traditional clinical paradigm
to include prevention, early intervention, Rationale
rehabilitation, and recovery and resil- Psychiatric and addictions nurses have histori-
ience-oriented approaches to care. cally fostered leadership and change. The intrap-
ersonal, interpersonal, and group dynamic theories
Sample Content
developed and pioneered by mid-century nursing
• Selected concepts and ways of knowing thought leaders still remain central to understand-
from a broadly defined body of knowl- ing the processes within a range of systems that
edge in the humanities, social sciences, promote or inhibit quality care. The body of re-
and natural sciences. search supporting the creation and maintenance of
• Coursework to move toward competence the therapeutic milieu applies to promoting safe,
in a second language caring, and healing environments in every health-
• Active reflection upon knowledge and care setting. Decades of interdisciplinary mental
insight gained in learning experiences health initiatives still provide the core background
outside the nursing curriculum when prac- for practice in ever changing health care environ-
ticing in a variety of cultures, organiza- ments.
tions, and communities. The educational program prepares the gradu-
• Integrated meanings constructed in ate practicing in all settings, including psychiatric
memoirs, biographies, auto-biographies, mental health, addictions treatment, behavioral
movies and other emerging web-based health and general care settings, to:
technologies into content and clinical
experiences. 1. Create and support a therapeutic milieu
• Reflection upon and assessment of the for the safe implementation of treatment
dimensions of complex and relational ac- 2. Recognize group dynamics in order to
tions, values, and outcomes both in indi- engage effectively in collaborative treat-
vidual practice, as a member of a profes- ment models that include patients and
sional team, and as a leader of therapeutic families as well as other professionals and
and educative groups. assistive personnel
3. Recognize intrapersonal and interpersonal
Sample Strategies for Learning dynamics that interfere with quality treat-
• Encouraging active reflection upon ment
knowledge and insight gained in learning
Sample Content
experiences outside the nursing cur-
riculum when practicing in a variety of • Principles of therapeutic milieus
cultures, organizations, and communities. • Principles involving the collaborative pro-
• Integrating meanings constructed in cess and multidisciplinary team function
memoirs, biographies, auto-biographies, • Principles surrounding the dynamics of
movies and other emerging web-based interpersonal and interdisciplinary rela-
technologies into content and clinical tionships
experiences. • Leadership strategies for assessing and
• Providing opportunities to reflect upon improving treatment of a range of psychi-
and assess the dimensions of complex and atric disorders
relational actions, values, and outcomes • Relevant models to improve interpersonal
dynamics pacities of these vulnerable populations in order to

• Relevant models to improve group dy- protect the rights of patients in relation to access
namics to treatment, health disparities and eligibility for,
or participation in, investigations. These risks oc-
Sample Strategies for Learning cur frequently for psychiatrically ill and substance
• Provide experiences in multidisciplinary dependent patients, and it is imperative that pro-
treatment meetings to review and evaluate fessional nurses safeguard patient rights where an
treatment plans. actual or potential conflict of interest, misconduct,
• Assess group dynamics of an inter-profes- or the potential for harm are identified.
sional team The educational program prepares the gradu-
ate practicing in all settings, including psychiatric
Essential III: Evidence-Based mental health, addictions treatment, behavioral
Knowledge in Registered health and general care settings, to:
Nursing Practice
1. Describe the limitations and challenges
Rationale of available research in the areas of ad-
Nursing practice is grounded in the analysis, diction, behavioral health treatment and
interpretation and application of empirical and psychiatric- mental health nursing inter-
research evidence. In the last decade, the spe- ventions
cialties of nursing, addiction and psychiatry have 2. Demonstrate the application of relevant
welcomed a burgeoning of scientific research in research findings to behavioral, addiction
neurophysiology, pharmacotherapy and approach- and psychiatric-mental health nursing
es to behavioral change. Now, advances in science interventions, and measurable patient
and research more consistently provide founda- outcomes
tions for practice. Evidence-based practice models 3. Demonstrate basic elements of the re-
provide systematic processes for the delivery of search process in seeking best evidence,
care and its evaluation based on scientific evidence critiquing research and deriving appropri-
for psychiatric and mental health nursing practice ate nursing interventions
(Institute of Medicine, 2003b). 4. Describe the needs of vulnerable psy-
In the context of care, specific educational com- chiatric populations in relation to ethical
ponents such as communication and the nurse- and legal principles and obligations and
patient relationship are applied to practice and for the protection of human subjects in
should be grounded in addictions and psychiatric research
nursing’s empirical and research generated evi- 5. Use clinical practice guidelines as
dence. In collaboration with others, graduates are evidence for specific interventions with
prepared to participate in documenting and inter- patients, their families and communi-
preting evidence for improving patient outcomes ties with needs related to psychiatric or
(AACN, 2006b). substance use illness, or mental health
Scholarship for the generalist graduate involves promotion.
identification of practice issues central to mental 6. Develop nursing care plans for psychiat-
health, addictions and psychiatric nursing; evalu- ric, addictions treatment and behavioral
ation and application of evidence from research in health settings based on best evidence,
psychiatry, psychiatric nursing and social sciences clinical judgment, available resources and
related to behavior; and evaluation of measurable, patient preferences
behavioral outcomes demonstrated by patients, 7. Use new evidence to contribute to, and
families and community groups. participate in, the ongoing improvement
Ethical and legal precepts guiding research con- of nursing practice in psychiatric and ad-
ducted with patients are of particular concern giv- dictions treatment settings
en the vulnerabilities of persons with psychiatric 8. Evaluate quality of care from the perspec-
disorders across the life span. The graduate must tive of outcome indicators and document-
understand the complexities and compromised ca- ed findings
Sample Content it is during the transitions (or “hand offs”) between

• Research evidence in psychiatric, mental systems and as patients, families, and communities
health, and substance use disorders as- move among different kinds and levels of care that
sessment, prevention and intervention the need to maintain continuous and safe healing
• Definitions, principles and models of environments is most often compromised.
evidence-based psychiatric and mental The educational program prepares the gradu-
health nursing practice ate practicing in all settings, including psychiatric
• Ethical and legal aspects of research pro- mental health, addictions treatment, behavioral
cesses related to vulnerable populations health and general care settings, to:
with behavioral health problems 1. Understand both the strengths and weak-
• Implication of principles of information nesses of patients, families, and commu-
literacy with vulnerable populations nities` experiences of different informa-
• Skills in accessing evidence based tion and patient care technology in both
resources in behavioral/mental health, the medical and the behavioral health care
including data base searching, critical systems.
appraisal, and application to clinical situa- 2. Create and maintain continuous and safe
tions healing environments during the transi-
tions (or “hand offs”) between systems
Sample Strategies for Learning and as patients, families, and communities
Access, analyze and use of levels of evidence move among different kinds and levels of
as found in textbooks, case studies, reviews of care.
the literature, research critiques, controlled trials, 3. Demonstrate knowledge of the different
evidence-based clinical practice guidelines (www. regulations that impact the use of technol-
guideline.gov) ogy in both the medical and behavioral
health care systems.
• Development of PICO (Patient popula-
4. Understand the ways in which web-based
tion, Intervention, Comparison of inter- information informs patients and families’
vention with usual state/care, Outcomes) knowledge about and preferences for dif-
project ferent forms of care and treatment.
Essential IV: Information Sample Content
Management and Patient Care
Technology in Registered • Privacy and confidentiality issues in the
Nursing Practice use of information and patient care tech-
nologies
Rationale • Interstate practice regulations and state
The critical knowledge and skills involved with and federal laws that regulate information
information and patient care technology become sharing
more complicated when considering the care of pa- • Information and patient care technology
tients, families, and communities whose needs in- safeguards that facilitate the maintenance
tersect with both the medical and behavioral health of continuous and safe healing environ-
care systems. While some receive care within inte- ments during transitions
grated systems, most move between different sys- • Constructing and maintaining continu-
tems with different technologies and regulations ous healing and safe environments during
about confidentiality and access to information. the transitions (or “hand offs”) between
Course work and clinical experiences should pre- systems and as patients, families, and
pare graduates to navigate between systems. They communities move among different kinds
should also prepare graduates to understand and and levels of care.
to intervene at those points where the where flow
of critical information most often breaks. As the Sample Strategies for Learning
IOM’s Crossing the Quality Chasm (2001) reports, • Provide opportunities for students to fol-
low patients and /or families as they move psychiatric/mental health care.
between and/ or back and forth between 3. Evaluate state and national health care
medical and behavioral health care sys- policies related to psychiatric/mental
tems. health, mental illness, and substance use
• Participate in the construction and disorders and their impact on costs and
implementation of continuous healing and regulation.
safe environments during the transitions
(or “hand offs”) between systems and as Sample Content
patients, families, and communities move • Relationships among issues of health
among different kinds and levels of care. disparities, mental health insurance parity,
• Compare, contrast, and analyze the kinds and systems of “carve outs” for managed
and quality of data on NIH related web- mental health care
sites and consumer websites such as those • History and current issues of mental
maintained by the National Association health care policy
on Mental Illness (www.nami.org), Na- • Relationship among the advocacy of in-
tional Institute of Drug Abuse (www.nih. dividual nurses, psychiatric mental health
nida.gov) or Alcoholism (www.nih.niaaa. nursing organizations and patients’ and
gov) or the Child and Adolescent Bipolar families’ political and self-help advocacy
Foundation (www.bpkids.org). groups
• Relationships among social justice and
Essential V: Health Care Policy, mental health policy, finance, and regula-
Finance, and Regulatory tion
Environments in Registered
Nursing Practice Sample Strategies for Learning
• Review several federal and state policies
Rationale
that impact the delivery of health care for
Policy, finance, and regulatory environments mental illness and substance use disor-
strongly influence psychiatric and addictions care ders.
and mental health promotion because of the his- • Participate in a service learning project
tory of discrimination and the stigmatization of with local National Alliance on Mental
persons with mental illnesses. Currently, such care Illness (NAMI), Recovery, or MADD
is delivered within fragmented, poorly reimbursed chapters.
systems. Consequently, primary care practices and
schools now often serve as providers of mental Essential VI: Inter-professional
health and substance use disorder treatment, as a Communication and Collaboration
last resort. Legislative parity in insurance coverage for Improving Patient Mental
has only recently been enacted, and it remains to Health Outcomes in Registered
be seen how this legislation will be implemented in Nursing Practice
actual practice with clinicians, patients, and fami- Rationale
lies. Effective inter-professional communication and
The educational program prepares the gradu- collaboration is essential given the holistic rela-
ate practicing in all settings, including psychiatric tionship of physical and mental health. Research
mental health, substance use treatment, behavioral data provides strong support for the increasing
health and general care settings, to: morbidity among patients in primary care with un-
1. Analyze the political, legal, social, and met mental health needs: these needs are neglected,
regulatory influences on the development overlooked, avoided or devalued, placing patients
of health policy related to psychiatric/ at risk for poor physical health care outcomes, for a
mental health, mental illness, and sub- range of common psychiatric syndromes or for ex-
stance use disorders. acerbation of pre-existing or co-morbid psychiatric
2. Protect patients’ rights in the delivery of conditions. Additionally, data also show how the
physical health care needs of patients with primary Sample Strategies for Learning
psychiatric disorders are themselves to often ne- • Engage in discussions and dialogue with
glected, overlooked, avoided or devalued. Patients patients and their families that set the
with serious and persistent mental illnesses have a framework for participatory decision-
significantly greater mortality rate than their peers, making
and, for those with substance use disorders, a high • Engage in case study discussions and dia-
prevalence of co-occurring conditions. logue about patients’ mental health needs
Nurses must have the knowledge and skill to in- with other non-mental health specialty
tegrate their patients’ physical and mental health professionals
care needs in a holistic manner. Nurses also need • Engage in simulations of integrating
the knowledge and skills to communicate effec- patients’ physical and mental health needs
tively with other health care professionals about • Engage in case study discussions and dia-
the multidimensional nature and details of patients’ logue about patients’ mental health needs
health status and needs. Nurses need to assume with recovering patients, their families
leadership for initiating and maintaining collab- and non-mental health specialty profes-
orative efforts with other health care professionals, sionals
recognizing that various members of the health • Engage in simulations of practice incor-
care team come from unique disciplinary practice porating the Recovery Model.
spheres that often do not include an emphasis on
Essential VII: Clinical Prevention
patients’ mental health needs or outcomes.
and Population Health for
The educational program prepares the gradu-
Optimizing Health in Registered
ate practicing in all settings, including psychiatric Nursing Practice
mental health, addictions treatment, behavioral
health and general care settings, to: Rationale
Mental health promotion and substance use
1. Integrates physical and mental health disorder prevention among individuals, families,
needs in their care of patients, families, groups and communities remain critical to initia-
and communities tives aimed at optimizing health. Epidemiological
2. Works with patients, families, and health- and intervention studies highlight the need and the
demand for such among individuals experiencing
care providers to promote inter-profes-
trauma and pro-dromal symptoms, among families
sional collaborative strategies to address
under stress or with histories that suggest a height-
the mental health needs of patients in
ened risk of mental illnesses or substance use, and
non-psychiatric care settings.
among populations coping with displacement, mi-
3. Works with patients, families, and health-
gration, and disasters.
care providers to advocate for appropriate Individually focused mental health interventions
and effective assessment and management such as screening, counseling, and stress reduction
of patients’ mental health needs with the strategies are relevant throughout the life-span; and
inter-professional team. they have a strong evidence base of support in im-
proving health as well as mental health outcomes.
Sample Content Population focused mental health interventions
– including the identification of sub-populations,
• Participatory decision-making among families, and individuals who would benefit from
clinicians, patients, and families around mental health promotion, or who have heightened
mental health and physical care needs risk of developing psychiatric disorders, suicidal-
• The Recovery Model of mental health and ity, or homicidal impulses – remain essential for
addictions care mobilizing the necessary resources, networks, and
• Intra-professional, inter-professional supports necessary for the kinds of community out-
and systems relationships that support reach necessary in day-to-day life.
or inhibit the integration of physical and The educational program prepares the gradu-
mental health care needs. ate practicing in all settings, including psychiatric
mental health, addictions treatment, behavioral and evaluating mental health/substance

health and general care settings, to: use clinical prevention interventions
• Participation in population-focused activi-
1. Recognize the protective and predictive ties that that include protecting vulnerable
factors that influence the mental health of populations – such as those with mental
individuals, and populations. illness and substance use – in the event of
2. Demonstrate an understanding of the disasters
relationship of genetics and genomics to • How institutions, such as day care cen-
mental health, mental illness, substance ters, group homes, state mental hospitals,
use disorders, prevention, screening, or homeless shelters, can develop and
diagnostics, prognostics, selection of implement policies to minimize transmis-
treatment, and monitoring of treatment sion of communicable diseases.
effectiveness.
3. Conduct basic environmental exposure Sample Strategies for Learning
history, including that of exposure to psy- • Develop a plan that attends to a popula-
chological trauma, violence and domes- tion’s mental health needs in the event of
tic abuse, to identify current and future a disaster
physical and mental health problems • Conduct a community assessment of
4. Use evidence-based clinical prevention mental health needs
practices to guide mental health teaching,
health counseling, screening, outreach, Essential VIII: Professionalism and
disease and outbreak investigation, crisis Professional Values in Registered
and disaster preparedness, referral, and Nursing Practice
follow-up for patients across the lifespan Rationale
5. Collaborate with other health care provid- Professionalism and professional values are the
ers, patients, families and communities foundation of the nurse-patient relationship, and all
to provide culturally appropriate mental nursing practice.
health and substance abuse prevention The educational program prepares the gradu-
strategies ate practicing in all settings, including psychiatric
6. Implement and evaluate population- mental health, behavioral health and general care
focused mental health interventions with settings, to:
attention to effectiveness, efficiency, and
1. Understand the history of the nurse-pa-
equity
tient relationship within the profession
2. Recognize one’s own and others’ at-
Sample Content
titudes, values, and expectations about
• Seven competencies of Psychological mental illness. Engage in reflective
First Aid: practice about one’s own beliefs and
a. active listening skill values, including stereotypes and biases
b. normalize reactions (e.g. racism, ageism, gender bias and
c. teach stress management techniques homophobia), and the impact on the care
d. recognize adaptive coping versus mal- of patients with mental illness
adaptive coping practices 3. Model professional values in dress,
e. identify and mobilize sources of inter- demeanor, and conduct of relationships in
personal support the practice environment
f. apply crisis communication techniques 4. Demonstrate quality care outcomes
with individual disaster survivors and by documenting the application of the
disasters workers American Nurses Association Scope and
g. explain the potential to create greater Standards of Psychiatric-Mental Health
distress in those we seek to assist Clinical Nursing Practice.
• Clinical practice guidelines for planning 5. Incorporate new knowledge and the re-
sults of quality improvement activities to individual and family members.

improve the care of patients with mental 1.2 Utilize evidence based rating scales that
illness in both the medical and behavioral are culturally sensitive.
health care systems.
6. Articulate the value of membership in Sample Content
professional organizations, pursuing • Understands current and previous psychi-
lifelong learning, and engaging in self- atric treatments, inclusive of substance
renewal abuse and dependence (e.g., pharmaco-
7. Advocate for social justice to reduce the therapy, psychotherapy, suicide attempts,
stigmatization of patients with mental hospitalizations, ECT, substance rehabili-
illnesses, the disparities in access and tation)
inequities in resources in mental health • Conducts mental status exam
delivery systems, and the ways in which • Identifies substance use/abuse/depen-
these issues impact vulnerable persons dence that is current or in remission
• Identifies trauma issues from abuse, mili-
Sample Content tary service, accidental events, etc.
• History of psychiatric nursing • Identifies psychotropic medication use
• Professional versus social boundaries and drugs with psychiatric related symp-
• Stigma toms
• American Nurses Association (2008). • Identifies current suicidal or homicidal
Scope and Standards of Psychiatric-Men- ideation and eminent risk.
tal Health Clinical Nursing Practice
• Appreciative inquiry 2.0 Use family history to recognize the
• Reflective practice addressing stereo- relationships of genetics and genomics to
types, discrimination and bias (racism, mental health and psychiatric symptoms.
ageism, gender bias, incarceration, social 2.1 Analyze extent of risk for behavioral and
class and sexual orientation. psychiatric disorders based on the family
• Informed consent with vulnerable popula- history.
tions 2.2 Recognize the relationship of family
• Professional and legal requirements members’ experience of psychiatric/
around privacy and confidentiality of substance abuse symptoms and diagnoses
mental health communication and records and the mental health of the consumer
Sample Strategies for Learning Sample Content

• Directed experiences with writing and • Obtains and analyzes a family history to
speaking publically about the effects of determine whether the family should be
psychiatric / mental health nursing on referred for genetic services.
health care outcomes • Recognizes unusual characteristics that
• Participation on ethics review committees suggest a genetic abnormality.
• Analyzing the ethical and legal dimen- • Identifies genetic risk for common mental
sions of clinical situations illnesses.
• Uses standardized symbols for genetic
information.
Essential IX: Registered Nursing • Recognizes the complex interactions
Practice within families coping with members
who have psychiatric disorders
1.0 The program prepares the graduate to
conduct a comprehensive and focused 3.0 Apply principles of neuroscience and
psychiatric assessment, including sub- brain chemistry as they relate to the ori-
stance use: gins and the treatment of disorders.
1.1 Detail psychiatric, emotional, behavioral, 3.1 Gain knowledge of major classes of medi-
social and substance use issues in the cations and drugs of abuse in relation to
mechanisms of action, actions, common illicit and prescription drugs and related
side effects, drug interactions, and nurs- side effects, drug interactions, and nursing
ing implications regarding the following interventions
psychotropic medication classes and com-
mon drugs of abuse: 4.0 Communicate effectively with the patient
a. antipsychotics (typical and atypical) and the patient’s support network
b. antidepressants 4.1 Recognizes the complex nature of
c. mood stabilizers therapeutic interaction with persons who
d. anti-anxiety agents have psychiatric and physical co-morbid
e. medications to treat phases of addic- conditions such as depression and cardiac
tion illness.
f. stimulants 4.2 Identifies the patient’s support network
g. cognitive enhancers and includes them in communication
h. sedative-hypnotics about the patient’s illnesses, needs, prog-
i. analgesics ress, and recovery.
j. commonly abused illicit drugs ( mari- 4.3 Utilizes clear and positive communica-
juana, cocaine etc.) tion skills such as listening, interpreting,
3.2 Develops beginning skills in adminis- gathering and providing information, and
tration of psychotropic medications to confronting in assessing and providing
include obtaining medication history, therapeutic intervention for managing
lab monitoring, and assessing potential patients’ and families’ needs and concerns
adverse effects such as: about symptom management, medication
a. anticholinergic delirium adherence and health promotion.
b. agranulocytosis 4.5 Collaborates with patient and members of
c. neuroleptic malignant syndrome his or her support system in developing ,
d. extrapyramidal symptoms assessing and refining the patient’s overall
e. Steven Johnson syndrome plan of care.
f. Tardive Dyskinesia 4.6 Maintains professional boundaries and
g. signs of metabolic syndrome ethical behavior
h. serotonin syndrome.
i. hypertensive and hypotensive crises Sample Content
3.3 Understands potential side effects • Learning Theories: Provide patient infor-
a. Medication reconciliation mation based on patient readiness to learn
b. Motivational interviewing for improv- and allow patient choice as is possible
ing adherence (example, medication may need to be
c. Include exercise and diet interventions taken such as antipsychotic depot medica-
d. Common drug interactions tion but patient may choose best day or
time of day)
Sample Content • Motivational Interviewing: express empa-
• instruments and guidelines to identify thy, develop discrepancy, avoid argu-
and manage symptoms of medication ments, roll with resistance, support self
misuse, abuse or dependence and well efficacy
as side effects and evaluation of efficacy • Defense Mechanisms: understand pro-
of psychotropic medications in common cesses used by patients to regulate anxiety
psychiatric condition associated with the illness process
• information regarding dual diagnosis as • Family dynamics in chronic psychiatric
well as co-morbid conditions in persons illness
with mental illness
• content about pharmacology, pharmacoki- 5.0 Incorporate patient self-determination and
netics, and pharmacogenetics of psycho- adherence strategies into patient-centered
tropic medication and commonly abused care.
5.1 Defines self determination and adherence for anxiety, depression, and delirium in
as related to patient centered care. patients with terminal illnesses.
5.2 Describes common strategies that support 6.4 Recognizes the significant stressors
self determination and adherence into pa- inherent in the end-of-life process of a
tient centered care in psychiatric illness. family member or friend for persons with
5.3 Implements interventions with patients psychiatric illness.
support self determination and adherence
5.4 Recognizes attitudes regarding “self- Sample Content
medication” and addresses with patient • Uses Standardized instruments and
and family guidelines to identify and implement the
individual plan of care for side effects and
Sample Content evaluates efficacy of psychotropic medi-
• Patient Self Determination Act 1991 cations in common psychiatric conditions
• Self determination as related to patient • Reflects on and improves clinical skills
centered psychiatric care in working with persons with psychiatric
• Patient as active consumer and partner in and substance abuse disorders
care • Interviews classmates, neighbors, and a
• Recovery model of mental health and range of clients assigned in inpatient and
substance use disorders rehabilitation community settings to develop appre-
• Common examples of self determination: ciation of personal and environmental
right to decision making, right to infor- variables such as culture, religion, socio-
mation, right of consent, right to refuse, economic status and family beliefs
right to be heard, right to know and have • Defines and recognizes dual psychiatric
opinions considered diagnoses and co-morbid conditions
• Illness and authority as potential barriers • Develops knowledge about pharmacol-
to self determination ogy, .pharmacokinetics, and pharmaco-
• Ethical, legal, economic, and practical genetics of psychotropic medication and
concerns that influence self determination related side effects, drug interactions, and
• Psychiatric Advanced Directives nursing interventions
• Common strategies that support self • Practices communication skills while
determination and adherence into patient caring for patients receiving psychotropic
centered care in illness medications and then reflects on process
• Explanations of benefit vs potential harm recordings.
without intervention
• Explanations of benefit vs potential harm 7.0 Deliver appropriate patient-centered
in relation to drug misuse or abuse by teaching to patients experiencing psychi-
patient atric disorders and their family members
• Motivational interviewing regarding self 7.1 Provides person-centered teaching to any
determination and adherence individual with behavioral health, addic-
tion problems or psychiatric diagnoses
6.0 Identifies and distinguishes psychiatric appropriate to their developmental stage,
symptoms as a basis for developing or age, culture, socioeconomic status, or the
changing a plan of care for persons who setting where nursing care is provided.
have a terminal illness. 7.2 Considers the mental health status of the
6.1 Identifies potential causes of anxiety and person and its influence on comprehen-
recognize exacerbations of the psychiatric sion and learning information about all
symptoms in patients with a terminal ill- aspects of health with particular attention
ness and coexisting psychiatric diagnoses. to mental health in all teaching activities.
6.2 Assesses anxiety, depression, and de- 7.3 Grounds all teaching strategies in prin-
lirium in patients with terminal illnesses. ciples of health literacy defined as “the
6.3 Promotes adherence to the plan of care degree to which individuals have the ca-
pacity to obtain, process, and understand • Decision making and critical thinking in
basic health information and services relation to empirical and research evi-
needed to make appropriate health deci- dence
sions” (US Department of Health and • Skills in accessing resources to research
Human Services, 2000). in behavioral/mental health, including
7.4 Implements teaching strategies after data base searching, critical appraisal, ap-
identification of psychiatric disorders that plication to clinical situations
influence learning.
7.5 Applies principles of health literacy that 9.0 Monitor client outcomes to evaluate the
include the following: effectiveness of bio-psychosocial inter-
a. Understanding of conceptual models ventions.
defining health literacy across the 9.1 Selects appropriate standardized psychi-
lifespan atric/addiction evaluation instruments and
b. Assessment of health literacy consider- uses them
ing behavioral health/psychiatric issues 9.2 Demonstrates reliability in planning and
influencing level of understanding implementing schedules for evaluations
c. Planning interventions for low literacy 9.3 Articulates general improvement or
patients based on effective interven- decomposition of client social behavior,
tions mental function, and symptoms.
d. Assessing effectiveness of interven- 9.4 Addresses adherence issues in monitoring
tions and evaluating care delivery
Sample Content Sample

Content
• Principles of person-centered teaching • Standardized measurement instruments

• Principles of health literacy such as:
• Assessment of psychiatric status and • AIMS
comprehension • Hamilton Depression Scale
• Principles of self-care and continuing care • Multnomah
management • Brief Psychiatric Rating Scale
• GAF
• Fagerstrom Scale
8.0 Implement evidence-based nursing • AUDIT
interventions as appropriate for promot- • CIWA
ing health and managing the acute and • Methods for monitoring and evaluating
chronic care of patients, maintenance and throughout the continuum of care
recovery across the lifespan. • Means to distinguish between pharmaco-
8.1 Understands basic research processes in logical indices, social indices, and medi-
behavioral health cal indices of improvement or regression
8.2 Interprets evidence and applies to practice • Methods for eliciting client perspectives
in psychiatric settings on holistic functioning
8.3 Implements evidence-based practice
8.4 Identifies and applies the “best clinical 10.0 Implement patient-centered transitions of
practices” in addictions and psychiatric care and discharge planning to persons
nursing. and families experiencing psychiatric
disorders and addiction.
Sample Content 10.1 Plans and implements care in diverse
• Information literacy: implications for settings including acute inpatient and
communities, vulnerable populations community based settings of care
• Principles of Quality Improvement 10.2 Participates in care management and case
• Nurse Sensitive Quality Indicators, per- management of psychiatric care
formance measures 10.3 Evaluates the continuum of care of a
• Nursing Roles in the Research Process person experiencing a psychiatric disorder
10.4 Analyzes congruency of acuity of a per- to improve care to people with psychiatric
son’s psychiatric needs to settings of care disorders.
10.5 Plans for a continuum of care that pro- 12.4 Describes best practices that promote
vides safety, structure, and support for safety and create a just and safe environ-
persons with psychiatric disorders ment
10.6 Describes psychiatric home case manage- 12.5 Demonstrates conflict resolution and ag-
ment gressive behavior management.
10.7 Participates in continuing care manage- 12.6 Identifies the side effects and adverse
ment of individuals and families in the effects of psychotropic medications used
home or “aftercare” setting in psychiatric and non-psychiatric patient
10.9 Refers consumers, dyads and families to populations
advocacy organizations 12.7 Accurately assesses patients for suicide
10.10 Assists consumers and their families to and homicide potential.
access support groups
Sample Content Sample Content

• Planning and implementing discharge • Basic safety principles for delivering care
planning to these patients, especially the safe use
• Care and Case management in psychiatric of psychopharmacologic agents
care • Factors that create a culture of respect and
• Examples of continuity of care cultures of safety
• Principles of psychiatric home case man- • Situations in which patients may be sus-
agement ceptible to harm and abuse from self and
others
11.0 Provide nursing care based on evidence • Knowledge of best practices to promote
that contributes to safe and high quality safety for providers and these patients
patient outcomes within healthcare micro- • Methods that prevent verbal, physical and
systems. psychological harm to these patients
11.1 Identifies the research process in behav- • Methods that help eliminate error and
ioral health including interpretation of processes for quality improvement
evidence and application to practice in
psychiatric settings. 13.0 Revise the plan of care based on an
11.2 Applies evidence-based practices in ongoing evaluation of patient outcomes.
mental health that result in best clinical 13.1 Identifies unusual changes in behavior
practices and intervenes appropriately
11.3 Understands ethical and legal consider- 13.2 Applies evaluation strategies to monitor
ations in the nurse’s role in research patients a psychiatric context.
13.3 Considers implications of changing an in-
Sample Content dividualized plan of care for people with
mental disorders.
• Role of evidence based practice guide-
13.4 Describes best practices in evaluating
lines as they impact outcomes in common
and revising plans of care for people with
psychiatric diagnoses
mental disorders
12.0 Create a safe care environment that re-
sults in high quality outcomes for persons Sample Content
with mental disorders including substance • Common adaptation and coping to per-
use disorders. sistent psychiatric and substance related
12.1 Identifies safe and unsafe practices within disorders
a psychiatric care environment. • Symptom sment with those who have
12.2 Applies strategies to reduce harm to self addiction and/or serious and persistent
and others in a psychiatric context. psychiatric disorders
12.3 Engages in a quality improvement process • Concepts of co-morbidities

• Symptom management with those who laborative working relationships with the
have co-occurring chronic conditions (e.g. consumer, their families and with other
medical conditions and psychiatric disor- members of the multidisciplinary team.
ders, and substance abuse and psychiatric 15.4 Describes the principles, functions and
disorders). care provider roles of the Assertive Com-
• Concept of relapse and relapse prevention munity Treatment, Case Management,
• Maintain therapeutic relationship Recovery and Rehabilitation models
• Identify common mechanisms of adapta-
tion and coping used by persons experi-
Sample Content
encing a chronic psychiatric disorder
• Plan, implement, and evaluate a relapse • Therapeutic communication
prevention plan for those experiencing a • Collaboration
chronic psychiatric disorder • Support groups
• Methods of monitoring behavior and • Assertive Community Treatment Model
mood for changes requiring intervention • Recovery Model
• Strategies for modifying interactions with • Relapse Counseling
persons exhibiting behavioral changes
16.0 Demonstrate the application of psycho-
14.0 Demonstrate clinical judgment and motor skills for the efficient, safe, and
accountability for patient outcomes when compassionate delivery of patient care in
delegating to and supervising other mem- Psychiatric Mental Health Nursing
bers of the healthcare team Practice.
14.1 Understands principles of delegation, 16.1 Demonstrates critical thinking skills to
supervision, and team functioning explore role of psychiatric nurse in rela-
14.2 Applies appropriate strategies for delegation to health promotion, disease preven-
tion, supervision, and maximizing team tion, community resources, and ethical/
effectiveness legal/economic considerations relating to
14.3 Demonstrates awareness of the complex care.
relationship between decision-making and 16.2 Applies nursing fundamental skills to
delegation care of persons with alterations in physio-
logical function related to psychiatric
Sample Content dysfunction such as eating and elimina-
• Definition of delegation tion problems.
• Principles of delegation and supervision 16.3 Demonstrates knowledge, theory, and
• Methods for evaluating how tasks and skill in teaching about disease process,
relationships influence delegation to a medication management, and non-
specific individual pharmacologic methods such as crisis
intervention, problem solving, and stress
15.0 Coordinate and manage care for a group management approaches.
of individuals with psychiatric disorders 16.4 Demonstrates correct principles and tech-
in order to maximize health, indepen- niques of safety in medication administra-
dence, and quality of life. tion by common routes.
15.1 Uses therapeutic communication tech- 16.5 Reflects knowledge of common psycho-
niques in care practices with persons motor skills and legal aspects of care such
experiencing common psychiatric symp- as restraints usage, CPR, and assisting
toms such as hallucinations, delusions, with nursing care during procedures such
and alogia as electroconvulsive therapy.
15.2. Demonstrates competent generalist group 16.6 Applies nursing fundamental skills to care
participation/ leadership skills in working of persons with alterations in physiologi-
with persons experiencing, or at risk for, cal function existing along with common
psychiatric illness psychiatric problems
15.3 Demonstrates the ability to establish col- 16.7 Conducts assessment, planning, interven-
tion, evaluation, and documentation on a 17.0 Develop an awareness of complementary

regular schedule with completeness and modalities and their usefulness in promot-
accuracy. ing health for persons coping with or at
16.8 Uses physical assessment skills to evalu- risk for psychiatric disorders.
ate and integrate physical and psychoso- 17.1. Assesses complementary modalities being
cial functioning. used by individuals with psychiatric and
16.9 Promotes safety with correct reporting substance use disorders.
and interventions when someone becomes 17.2. Evaluates the evidence for complemen-
violent toward others or self. tary modalities with persons who have
psychiatric disorders.
17.3. Advocates for complementary modalities
Sample Content consistent with a person’s worldview to
• Knowledge and theory of pathophysiol- promote stress management and promote
ogy and skill in nursing interventions healthy coping behaviors.
regarding: 17.4. Investigates the possible adverse and/or
• disease process regarding common psy- interaction of alternative/complementary
chiatric diagnoses* modalities with conventional psychiatric/
• medication management to treat common addictions care.
psychiatric diagnoses
• non-pharmacologic methods (crisis Sample Content
intervention, problem solving, and stress • Complementary methods for: stress
management) to treat common psychiatric reduction, methods to promote sleep and
diagnoses relaxation
*schizophrenia • Practice –based evidence for complimen-
*bipolar/depression tary modalities
*Alzheimer disease and related dementias • Identification of cultural manifestation of
*alcohol and drug abuse stress
*anxiety disorders (obsessive compulsive • Theories in mind-body relationships
disorders, post traumatic stress disorders) • Pathophysiological understanding of the
• Correct principles and techniques of interrelationship of anxiety/depression
safety in medication administration by with immune and endocrine systems
common routes • Define complimentary modalities that are
• Intravenous compatible with conventional treatments
• IM, SC, Oral and alternative treatments that are used in
• Dermal patch lieu of conventional treatments. The most
• Skills and legal aspects of care such as: frequent complimentary modalities are:
• application of restraints acupressure, aromatherapy, biofeedback,
• CPR guided imagery, healing presence, humor,
• assisting with nursing care during proce- journaling, music therapy, meditation,
dures such as relaxation, and therapeutic touch/healing
• electroconvulsive therapy touch.
• DNRs, advanced directives
• Nursing process conducted on a regular 18.0 Develop an appreciation of patients as
schedule with completeness and accuracy well as healthcare professionals’ spiritual
• Physical Assessment skills are used to beliefs and values and how those beliefs
evaluate both physical and psychosocial and values impact health care.
functioning. 18.1 Describes importance of spiritual care as
• cardiovascular, neurological, a right for persons receiving healthcare.
dermatological 18.2 Discusses crisis factors such as fear and
• mental status loneliness often experienced during seri-
• relevant labs for baseline and monitoring ous illness that stimulate need for spiritual

care. level of risk (ANA) involved in experi-

18.3 Discusses role of spiritual care when cure ences of depression, suicide, psychosis,
is not an expected outcome of illness. aggression (violence) and substance abuse
18.4 Discusses the essential nature of spiritu- and dependence across the life span and
ality to healthcare workers who care for across clinical encounters/sites of care
persons who are seriously ill. 19.2 Recognizes the complex interaction of
18.5 Defines need area of spiritual care in or- various physical conditions and common
ganizations at a time when moral, ethical, psychiatric syndromes, emphasizing the
and spiritual concerns arise secondary to role of personal, environmental, cultural
limited allocation of resources. and spiritual factors involved for each
18.6 Lists common clinical areas for spiritual individual client
care intervention such as acute care; pal- 19.3 Applies knowledge of signs and symp-
liative care, long term care, addiction and toms of common psychiatric syndromes
recovery and mental health sites. in observing, assessing, and planning
18.7 Values importance of patient variables nursing care, including:
such as culture, religion, pharmaco- a. Psychosis
genomics, and socio-economic factors on b. Depression
medication outcomes. c. Suicidal ideation/behavior
18.8 Values importance of developing appreci- d. Rage/aggression
ation of patient variables such as culture, e. Delirium
religion, socio-economic status and fam- f. Dementia
ily beliefs g. Substance abuse/dependence
h. Acute drug intoxication/poisoning
Sample Content i. Acute substance withdrawal
• Spiritual resources viewed as helpful to j. Anxiety, including PTSD and panic
the mental health care consumer in times k. Side effects or adverse effects of psy-
of crisis chotropic medications
• Interventions to assist patients find mean- l. Drug interactions, psychiatric side
ing in suffering thru lens of spirituality effects or adverse effects of medications
essential to holistic care used to treat physical conditions
• Increased level of trust in health care m. Nicotine dependence
provider when provided opportunity to n. Common geriatric syndromes
discuss spirituality 19.4 Uses evidence-based instruments to
• Spiritual care as essential aspect of holis- assess risk for or level of co-morbidity of
tic care and incorporates hopes, fears, and physical conditions and common psychi-
beliefs atric syndromes:
• Recognize and respect health care pro- a. Mini-mental Status exam
vider spirituality (e.g. Folstein)
• Nurture spirituality to enhance compas- b. Full Mental Status Exam
sionate care provider functioning c. Depression Scales (e.g. Beck)
• Spiritual distress includes disturbances d. Anxiety Scales (e.g. Beck)
in the belief or value system that provide e. Suicide Assessment Scales
strength, hope and meaning to life f. Substance Use/Abuse Scales (e.g.
• National groups in nursing and medicine Cage, Trauma, CIWA etc.)
researching and applying spiritual aspects 19.5 Applies appropriate therapeutic interac-
ofeffect on illness and recovery tion skills and strategies to assess and
• Clear definition of spirituality vs. religion manage symptoms of common psychiatric
syndromes co-occurring with physical
19.0 Recognize and manage common psychiat- illness
ric syndromes. 19.6 Applies psychiatric nursing skills and
19.1 Assesses and responds appropriately to strategies including medication, close
observation, restraint and referral as nec- 20.2 Modifies communication to account for
essary to manage symptoms of common variations in the patient’s ability to com-
psychiatric syndromes co-occurring in prehend and respond during a disaster.
clients with physical illnesses, emphasiz- 20.3 Provides a safe, calm environment to aid
ing client dignity and the legal and ethical coping skills in disaster situations.
implications of these actions
19.7 Documents accurately all observations, Sample Content
assessments and interventions related to
• Therapeutic interpersonal communication
managing symptoms of common psychi-
• Crisis Intervention
atric syndromes in physical care settings
• Differentiating normal emotional respons-
19.8 Collaborates with the interdisciplinary
es from psychiatric symptoms
team to plan further assessment and man-
• Knowledge of individual and group re-
agement of symptoms of common psy-
sponse to different types of crisis
chiatric syndromes for clients in physical
• Information about immediate and long
care settings.
term response to crisis
Sample Content
• Knowledge about signs and symptoms of 21. Engage in caring and healing techniques
common psychiatric syndromes, and co- that promote a therapeutic nurse-patient
occurring disorders relationship with patients who have men-
• Knowledge about risk factors for com- tal disorders, altered mental status and/or
mon psychiatric syndromes co-occurring unusual behaviors.
with physical illness in general and with 21.1 Applies therapeutic communication
particular physical illnesses techniques in care practices with persons
• Skills development in administering, scor- experiencing common psychiatric symp-
ing and analyzing data from evidence- toms such as hallucinations, delusions,
based assessment instruments and decreased production of speech.
• Knowledge about therapeutic communi- 21.2 Demonstrates caring concern for people
cation rationales and skills to assess and suffering from psychiatric disorders.
manage symptoms of common psychiatric 21.3 Engages the patient with mental health
syndromes in clinical care settings problems and psychiatric disorders in an
• Knowledge and skills development active partnership based on therapeutic
regarding application of mechanical or alliance.
chemical means to manage symptoms of 21.4 Assumes responsibility and accountability
common psychiatric syndromes for one’s own behavior within a therapeu-
• Knowledge about pharmacological side tic nurse-patient relationship
effects and adverse effects of psychotro- 21.5 Maintains professional boundaries while
pic medications and possible psychiatric implementing a therapeutic nurse-patient
adverse effects of medications used to relationship.
treat physical illness 21.6 Role models tolerance of variations in
• Interdisciplinary collaborative skills behavior in people with mental disorders
development and respect for the diversity of human
experience
20.0 Understand the nursing role and partici-
pate in disaster planning and response Sample Content
with an awareness of environmental • Variations in therapeutic nurse-patient re-
factors and the risks they pose to self and lationships and relationship development
patients. with patients with altered mental status
20.1 Recognizes and responds effectively to and mental disorders.
all patients across the lifespan affected by • Strategies that promote safety while
trauma and stress. implementing a caring nurse-patient rela-

tionship • Learning theory

• Self awareness techniques to help the • Prominent psychiatric treatment mo-
student nurse alter behavior thatcreates dalities (individual, family, and group
barriers to therapeutic nurse-patient rela- therapy)
tionship with patients who have mental • Medication management including symp-
disorders toms, side effects, and client education
needs
22.0 Demonstrate tolerance for the ambiguity • Communication skills
and unpredictability of the world and its • Use the research literature to critique
effect on the behavioral health of popula- evidence based interventions
tions nurses care for. • Prepare and deliver a poster presentation
22.1 Understands the nature of ambiguity and on psychiatric mental health clinical
its influence on health care systems issues
22.2 Prepares to cope with unpredictability in
patients, health care systems, and their Practicum-based Activities
own ecosystem, • Role-playing with peers
• Develop a nursing care plan
Sample Content • Develop a family genogram using self or
• Knowledge about the effects of crisis on peers
individuals and groups in a variety of • Practice psychiatric interviewing with
settings where behavioral health care is peers
provided by nurses • Clinical and classroom experiences that
• A model of crisis intervention that ac- focus on medication effects, side effects,
knowledges that an unpredictable world common drug interactions, lab monitor-
may adversely influence behavioral health ing, and approaches to medication admin-
status istration
• Knowledge about prioritizing behavioral • Videotape client interactions
health needs in a time of crisis. • Use journals to explore role of spirituality
• Skill development in understanding the in nursing care
personal influence of ambiguity and an • Identify elements of counter-transference
unpredictable world as they provide nurs- and transference that influence care
ing care. • Use videos, web sites, and simulations as
• Development of creative problem solving enhancements to lectures
skills applicable to times of crisis and • Invite consumers (clients or family mem-
unpredictability in a variety of settings bers) to speak to students
• Awareness of global crises and implica-
tions for nursing intervention
Patient-Centered Activities
SUGGESTED STRATEGIES FOR LEARNING
• Interview family members regarding the
Knowledge stress of coping with the mental illness of
• Psychiatric assessment a family member
• Psychosocial assessment • Attend a support group for families cop-
◦ Mental status ing with the mental illness of a family
◦ Family assessment member
◦ Use of screening instruments • Invite clients and family guests to class-
◦ Influence of physical health on mental room to talk from first person about issues
health such as adherence, self determination,
◦ Neurobiology of the brain culture and disparities experienced
• DSM IVTR Diagnoses • Evaluate a continuum of care for a client
• Definition of co-morbidities experiencing a psychiatric disorder
• Motivational interviewing • Evaluate a client’s living situation for
safety, structure, and support II• Role play identifying and reporting errors
• Participate in discharge planning meetings and near misses to a person higher in the
with client and family members present chain of command
• Conduct an assessment for medication •
III Defining the potential situations that lead
side effects to ambiguity and unpredictable responses
• Conduct a suicide/homicide assessment IV that involve behavioral health
• Role play multiple responses to changes • Understand human response in unpredict-
in client behavior able events as it interacts with behavioral
• Examine alternative meanings of client health
behavior • Clinical and classroom teaching that
• Clients and family guests to talk from first integrates behavioral health responses oc-
person curring in populations faced with unpre-
dictable events
System-Centered Activities • Attend Twelve Step meetings
• Visit group homes and mental health sup-
port groups
• “Shadow” a psychiatric home care nurse
APPENDICES:
• “Shadow” a nursing member of a Psy-
chiatric Assertive Community Treatment . Essentials of Psychiatric Mental
(PACT) team Health Nursing in the BSN
• Environmental scan for potential sources Curriculum: A Joint Project of the
of safe and unsafe patient care envi- ISPN Education Council and SERPN
ronment for vulnerable clients such as Division; April, 2005
suicidal, cognitively impaired, detoxing . Mental Health Competencies; OHSU
• Participate in a team to develop strategies OCNE PMH competency task group;
to reduce harm to self and others 6/15/05
• Participate in training to learn methods of
resolving conflict and managing aggres- . Substance Use Websites
sive behavior . Mental Health Websites

I

APPendiX i
essentials of Psychiatric mental health nursing in the bsn curriculum:
A Joint Project of the isPn education council and serPn division; April, 2005
During the period from 1998 to 2004, the significance of mental health issues in contributing to the
mortality and morbidity of populations world-wide has been increasingly documented. It has been iden-
tified that approximately 450 million people suffer from mental or neurological disorders or from psy-
chosocial problems such as those related to alcohol and drug abuse (World Health Organization, 2001).
The World Health Organization (WHO) has also identified that “understanding how inseparable men-
tal and physical health really are, and how their influence on each other is complex and profound... WHO
(also states that) mental health – neglected for far too long – is crucial to the overall well-being of ind-
ividuals, societies and countries and must be universally regarded in a new light (WHO, 2001, pix).”
Mental health has also been identified as a national health priority by Healthy People 2010 (http://www.
healthypeople.gov) and the US Surgeon General (http://www.surgeongeneral.gov). This report, devel-
oped by a consortium of 400 national membership organizations, state and territorial health depart-
ments, and key national associations of State health officials, identified nine priority health indicators
indicators related to mental health/substance abuse concerns. The priorities include: tobacco use, substance
abuse, responsible sexual behavior, mental health, injury and violence, and access to health care. Fur-
thermore, in 1999, the first ever White House Conference on Mental Health was convened. The U.S. Surgeon
General presented the first report (DHHS, 1999) on the mental health of the nation in which the
inextricably intertwined relationship between mental health, physical health and well-being were noted. The
report presented a challenge to the nation, communities, health care providers, and policy makers to take
health action as mental health issues are important health concerns for all ages. This landmark report was an
undeniable call to make the mental health needs of the nation imperative.
Although the opportunities for mental health care world-wide vary according to each setting’s re-
sources and priorities, the avenues through which mental health needs must be addressed are at the primary,
secondary and tertiary levels. Even as the United States has been identified as a nation with a high level of
mental health resources (WHO, 2001; The President’s New Commission on Mental Health [President’s
Commission], 2003), it is still plagued by a “lack of national priority for mental health and suicide pre-
vention, and fragmentation and gaps in care (across the life span) (President’s Commission, 2000, p. 3).”
The International Society of Psychiatric Mental Health Nurses (ISPN) recognizes and supports the im-
portance of mental health to the overall well-being of each individual. As part of this understanding, our
international organization identifies that the task of promoting mental health is multifaceted. In addition
to providing direct care, professional education, consultation, combating stigmatization, improving access,
furthering research, advocacy and policy development are each facets for improving mental health care.
Because a comprehensive approach to mental health care is multidisciplinary and collaborative, Nursing
has an integral role in affecting the mental health of millions of people through the use of unique skills,
and by nature of the numbers of nurses who interact with clients in a variety of settings. The Presi-
dent’s Commission Report (2003), The World Health Report 2001 (2001) and the most recent Mental Health,
United States, 2002 (Department of Health and Human Services [DHHS], 2004) identify that nurses play
a key role in the delivery of mental health care at all levels of intervention and that there is a need to im-
prove and expand this workforce providing evidence –based mental health services and supports.
As part of their leadership role, ISPN has identified that the educational preparation for the practice
of psychiatric nursing begins at the pre-baccalaureate level (DHHS, 2004). Communication and thera-
peutic interpersonal relationships are critical components that must underlie all nursing skills. Given the
critical role of nurses in all areas of health care, their ability to affect the emotional wellbeing of clients
regardless of the setting and the need for exemplary mental health service delivery (informed by effec-
tively prepared nursing professionals) the following curriculum is recommended for implementation.
Table 1. Guidelines for Undergraduate Education in Psychiatric Mental Health Nursing (PMHN)
**see definitions below
Core Nursing Learning Outcomes Defined as
Content Essential PMHN Content Clinical Competencies
1. Growth & a. Principles of cognitive, emotional, a. Demonstrate competent

Development and psychological growth with generalist assessment of the
corresponding developmental milestones developmental needs of patients
b. Recognition of major disorders experiencing psychiatric
occurring in childhood/ adolescence disorders.
1. Mood disorders b. Recognize normative versus
2. Eating disorders non-normative behavioral
3. Conduct disorders patterns in terms of
4. ADHD developmental milestones.
5. Pervasive developmental disorders c. Plan and implement and evaluate
6. Substance abuse/dependence disorders age appropriate care for patients
c. Recognition of major disorders with psychiatric disorders.
occurring in adulthood
1. Mood disorders
2. Psychotic disorders
3. Personality disorders
4. Substance abuse/dependence disorders
5. Anxiety disorders
d. Recognition of major disorders
occurring in older age
1. Depression
2. Dementia
3. Delirium
2. Neurobiological a. Neuroanatomical and a. Demonstrate competent

Basis of Care neurophysiological basis of and generalist assessment skills with
Practices relationship to observable patient emphasis on mental status and
behaviors and symptoms of neurological functioning.
psychiatric disorders b. Apply neurobiologic knowledge
b. Neurobiological theories of etiology to care practices
of common psychiatric health disorders and patient teaching.
c. Genetics and psychiatric disorders
3. Pharmacothera- a. Neurobiological basis of a. Articulate knowledge of the

peutics & Basic pharmacological and somatic treatments neurobiological mechanism for
Principles of b. Major psychotropic agents for various psychotropic medications.
Pharmacology identified psychiatric disorders that b. Evaluate effects of medications
include: on patient, including symptom
1. Classification abatement, side effects, toxicity,
2. Action and expected effect and potential interactions with
3. Side effects and toxicity other medications/substances.
4. Potential interactions with other c. Identify factors contributing to
medications and diet patient non-adherence.
c. Common alternative medicine d. Teach patients to manage their
approaches used in the treatment of own medications including
psychiatric disorders strategies to increase adherence
1. Herbals, minerals, and vitamins to prescribed therapeutic
2. Other alternative treatments regimen.
e. Apply pharmacotherapeutic
principles to the safe
administration of psychotropic
medications.
4. Communication a. Therapeutic interventions for a. Demonstrate therapeutic use of

Theory and patients, families, and groups self with patients, families and
Interpersonal experiencing, or at risk for, groups.
Relational psychiatric disorders b. Apply therapeutic
Skills b. Therapeutic use of self with patients, communication techniques in
families and groups experiencing, or care practices with patients
at risk for, psychiatric disorders experiencing common
1. Appropriate affective and psychiatric symptoms including
cognitive responses to patients disorganized speech,


2. Concept of professional hallucinations, delusions, and

boundaries with psychiatric decreased production of speech.
patients and appropriate use of self c. Demonstrate group
disclosure participation/leadership skills.
3. Communication with patients d. Develop professional boundaries
experiencing common psychiatric necessary for professional care
symptoms such as disorganized giving relationships.
speech, hallucinations, delusions, e. Discuss strategies for safe
and decreased production of management of crisis situations
speech that occur in various treatment
4. De-escalation of aggressive settings incorporating principles
behavior of therapeutic communication and
5. Suicide assessment techniques patient psychopathology.
5. Clinical a. Taxonomy systems commonly used a. Apply taxonomy structures to

Decision- in care of psychiatric disorders patient specific situations
making 1. NANDA including the development of
2. DSM-IVTR and ICD-10 nursing diagnosis.
3. Omaha System b. Identify signs and symptoms
b. Evidence-based care principles for characteristic of each major
psychiatric disorders disorder.
c. Use of outcome measurements to c. Evaluate the degree of evidence-
evaluate interventions and care strategies base available to support
d. Principles of safety in various common psychiatric nursing
treatment settings actions.
e. Concepts of psychiatric crisis and d. Implement evidenced-based care
common intervention practices with for patients with psychiatric
patients experiencing psychiatric crisis disorders.
f. Violence e. Plan and implement nursing
1. Anger and aggression interventions appropriate to
2. Levels and types of violence patients needs that reflect
expression such as suicide, etiological factors and standards
homicide, domestic violence, child of nursing care.
and elder abuse f. Prioritize crisis intervention care
g. Standard care practices of common practices with patients with
psychiatric disorders including: psychiatric disorders.
1. Psychotic disorders g. Assess patient potential for
2. Mood disorders violence including suicide and
3. Anxiety disorders homicide.
4. Personality disorders h. Develop and implement suicide
5. Substance abuse/dependence disorders prevention strategies.
6. Cognitive disorders
7. Eating disorders
8. Somatoform disorders
9. Family and community violence
h. Use of informatics in psychiatric nursing
6. Patient Care a. Principles of teaching/ a. Demonstrate ability to

Roles learning theories as they relate to patients effectively teach patients
with psychiatric disorders including experiencing psychiatric
psychoeducational approaches disorders and their families.
b. Principles of clinical care manage b. Plan and evaluate for a
with psychiatric patients continuum of care that provides
c. Principles of case manager with safety, structure, and support for
psychiatric patients patients with psychiatric
d. Principles of patient advocacy with disorders.
psychiatric patients c. Evaluate the continuum of care
e. Consumer advocacy groups for a patient experiencing a
1. NAMI psychiatric disorder.
2. NMHA d. Refer patients and families to
3. Local resource identification advocacy organizations.

f. Overlap of nursing roles with self- e. Assist patients to access self-

help models of care including 12 step help groups.
models
g. Principles of collaborative
relationships with individuals,
families, consumers and advocacy
groups
7. Health Care a. Principles of inpatient care. a. Describe available treatment

Settings b. Principles of psychiatric care in options and community based
emergency department settings resources.
c. Principles of community mental b. Plan and implement care in
health diverse settings including acute
d. Principles of psychiatric home care inpatient and community based
e. Relationship of acuity of care and settings of care.
patient needs to the setting of care c. Analyze adequacy of care
f. Evolving care settings (e.g. primary settings related to patient acuity
care, telecare and web-based) and needs.
8. Cultural, a. Diversity a. Demonstrate competent

Ethnic, and b. Cultural, religious, and spiritual generalist cultural and spiritual
Spiritual beliefs regarding mental health and assessment.
Concepts illness b. Provide culturally and spiritually
c. Cultural issues and spiritual beliefs competent care within the scope
as they relate to psychiatric symptom of nursing that meets the needs
expression of patients from diverse cultural,
d. Cultural/racial/ethnic diversity and racial and ethnic backgrounds.
impact on mental health care
delivery
e. Resources for
culturally/linguistically sensitive
PMH care
9. Health a. Concepts of mental health promotion a. Describe populations at risk for

Promotion and and illness prevention psychiatric disorders.
Illness b. Known risk factors of common b. Evaluate the need for screening
Prevention psychiatric disorders and referral for populations at
c. Screening and referral for common risk for psychiatric disorders.
psychiatric disorders c. Assess, plan, implement and
d. International and national indicators evaluate interventions related to
on mental health (e.g. World Health mental health
Report and Surgeon General’s promotion and illness prevention
Report on Mental Illness) specific to the
e. Healthy People 2010 goals and needs of diverse communities.
objectives d. Describe standardized screening
f. Standardized screening and symptom tools used to
rating instruments identify at risk groups.
g. IOM Report and National Patient e. Plan, implement, and evaluate
Safety Goals preventive care
practices for patients at risk for, or
experiencing psychiatric disorders.
10. Concepts of a. Common adaptation and coping a. Establish and maintain

Chronic Illness techniques used to deal with severe therapeutic relationships with
and persistent psychiatric disorders individuals who have a severe
b. Symptom management with those and persistent psychiatric
who have serious and persistent disorder.
psychiatric disorders. b. Assess common mechanisms of
c. Concepts of co-morbidity adaptation and coping used by
d. Symptom management with those patients experiencing a severe
who have co-occurring chronic and persistent psychiatric
conditions (e.g. medical conditions disorder.

and psychiatric disorders and/or c. Plan, implement, and evaluate a

substance abuse and psychiatric relapse prevention plan for
disorders). patients experiencing a severe
e. Concepts of relapse, relapse and persistent psychiatric
prevention, recovery and resilience disorder.
d. Prioritize care strategies for
patients experiencing co-morbid
health states.
11. Ethical and a. ANA Code of Ethics and patient a. Clarify personal values
Legal Principles rights legislation concerning working with patients
b. Standards of practice for PMHN experiencing psychiatric disorders.
c. Least restrictive treatment b. Advocate for patients and
approaches families with legal and ethical
d. Legal rights of psychiatric patients concerns.
based on voluntary versus c. Develop plan of care to address
involuntary treatment status ethical and/or legal concerns that
1. Duty to protect promote individual integrity.
2. Duty to report
3. Confidentiality
12. Vulnerable a. Principles and concepts of working a. Recognize the multiple and
Populations with vulnerable populations complex care needs of
b. Access to care vulnerable populations.
c. Health disparities in mental health b. Plan, implement, and evaluate
care and outcomes care strategies that protect the
1. Developmentally disabled rights and dignity of vulnerable
2. Elders and children populations.
3. Special needs of diverse
populations
4. Marginalized populations such as
homeless and jailed
13. Nursing a. Research related to psychiatric a. Critically analyze research reports

Research health nursing and care delivery as a research consumer.
concepts b. Assist patients and families in
b. Concepts of evidence based practice interpreting and evaluating
research findings.
c. Utilize research findings in
planning and evaluating care
practices.
**DEFINITIONS OF COLUMN HEADINGS

1. CORE NURSING CONTENT – Evident in general baccalaureate nursing curricular content
2. ESSENTIAL MHPN CONTENT – Specific elements and core content for PMHN. For example, under pharmacology; it is assumed that
the psychotropic medications are essential
3. CLINICAL COMPETENCIES OPERATIONALIZED AS LEARNING OUTCOMES – Measurable student behaviors that reflect mastery
of the essential content and reflect the PMHN skills expected of a newly graduated baccalaureate prepared nurse.
references Barrera, C., Machanga, M., Connolly, P. M., & Yoder, M.

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APPendiX ii
mental health competencies -- ohsu ocne Pmh competency task group 6/15/05
Donna Markle, RN, PMHNP (Oregon Health & Science University, Ashland Campus)
Carol Dodson, RN, PMHNP (Clackamas Community College, Clackamas, Oregon)
Beverly Johnson, RN, MS (Umpqua Community College, Roseberg, Oregon)
Kris Crusoe, RN, MS (Bay Area Hospital, Coos Bay, Oregon)
Elizabeth LeCuyer, PhD, PMHNP (Oregon Health & Science University, Portland Oregon)
what every rn should be able to do/handle

1. Communicate with cognitively impaired persons, including the potentially violent person.
2. Establish therapeutic communication and relationships with individuals across the lifespan
a. With individuals who are experiencing acute and/or chronic illnesses
b. With anxious individuals
c. With depressed individuals
d. With psychotic individuals
3. Assess an individual for suicide risk
4. Teach individuals across lifespan about ways in which to maintain mental health
5. Differentiate between major depressive disorder and grief/loss, and respond/or refer appropriately.
6. Differentiate depression, delirium, dementia, psychoses; collect relevant collateral information in
order to make decisions about appropriate action and/ or to make a case for appropriate medical
treatment.
7. Recognize limitations and assure safety for self and others
8. Recognize consequences and signs (“red flags”) of substance abuse in individuals hospitalized for
these problems; notice and respond appropriately to withdrawal from abused substances.
9. Participate in interventions directed toward prevention of substance abuse relapse.
10. Explain to clients and families the potential for various therapeutic treatment modalities ; commu-
nicate with client in a way that supports whatever treatment modality the patient is receiving.
11. Recognize signs and symptoms of methamphetamine abuse
12. Assess individuals & families about sensitive topics/issues including substance abuse, child and
elder abuse, sexuality, suicide thoughts, other safety issues, domestic violence, eating habits/obesity.
Second year: Recognize cultural issues related to this assessment, and handle appropriately. Interpret
& respond appropriately, within the limits of their abilities, policies of clinical agency & resources
available.
13. Recognize stigma and its impact on vulnerable clients.
second year:
14. Every RN should be able to handle patients with psychiatric disorders –
15. Assess individuals and their families as in # 12; respond therapeutically with minimal cuing to persons
with psychiatric diagnoses including
a. Psychotic disorders
b. Anxiety disorders: including PTSD
c. Mood disorders.
16. Communicate therapeutically (including with those who are potentially violent) and establish
and establish relationships with persons with psychiatric diagnoses.
17. Intervene in mental health/psychiatric emotional crisis situations.
18. Recognize the value and role of groups, community-based treatment approaches, self-help groups
such as AA.
19. Recognize the role of psychopharmaceuticals in the treatment of mental disorders and under-
stand the indications, target symptoms, and potential side and adverse effects of these drugs.
20. Recognize the impact of culture on presentation of mental health and illness, and in choosing
appropriate information to gather (assessments) and choosing interventions.
21. Understand legal issues in working with mental health clients: pt rights, commitment laws, duty
warn.
22. See # 12 above; Second year: Recognize cultural issues related to this assessment, and handle
appropriately. Interpret & respond appropriately, within the limits of their abilities, policies of
clinical agency & resources available.
other, regarding implementation of learning

teching approaches for psych-mental health:
1. Relationship with faculty is important for student acquisition of knowledge, skills.

2. Discussion about own responses and self-awareness when working with mental health issues
3. Students need experience in establishing a relationship with persons with psychiatric diagnoses
(as in competency 16).
4. Intense, consolidated experience with people with psychiatric diagnoses is needed, not to be
replaced by role play, or sim-lab experiences.
5. Practice in a setting where mental health issues are predominant is necessary in the 3rd year of
program (2nd year of nursing program)
6. Psych faculty needed to teach psych-mental health concepts and clinical.
7. Modular approach can be used in second yr for content (first year of nursing program)
Pathophysiology: (should be in those courses)

--Relationship between alcohol abuse and physiological consequences
--Neurobiological basis for psychiatric disorders
other considerations/recommendations:
1. We would like to approach all of these topics from a lifespan approach.
2. We would like to approach all of these topics along the care continuum including in health promo-
tion, acute care, chronic care, and population-based care.
3. We suggest a basic curriculum thread of including human sexuality as a component in wellness,
as well as acute and chronic illness.
4. We would like to recommend that assessment/intervention re: pediatric and gero abuse be included
in other specialty groups such as community/public health.

APPendiX iii
substance use websites
• National Center for Chronic Disease Prevention and Health Promotion
http://www.cdc.gov/nccdphp/
• National Institute on Drug Abuse
http://www.nida.nih.gov/
• Substance Abuse and Mental Health Services Administration
http://www.samhsa.gov/
• National Clearinghouse for Alcohol and Drug Information
http://www.health.org/
• National Center on Addiction and Substance Abuse (CASA)
http://www.casacolumbia.org/
• National Institute on Alcoholism (NIAAA)
http://www.niaaa.nih.gov/
APPendiX iv
mental health websites
• National Institute of Mental Health http://www.nimh.nih.gov/
• Mental Health Data and Statistics http://www.cdc.gov/mentalhealth/data.htm
• Substance Abuse and Mental Health Services Agency, http://www.samhsa.gov
• Substance Abuse and Mental Health Data Archive (SAMHDA), supported by the Substance
Abuse and Mental Health Services Agency, provides free, ready access to comprehensive research
data, http://www.icpsr.umich.edu/icpsrweb/SAMHDA/
• Mental Health: A Report of the Surgeon General, http://www.surgeongeneral.gov/library/
mentalhealth/
• Fact Sheets from Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the
Surgeon General, http://www.surgeongeneral.gov/library/mental-health/cre/
• The Global Burden of Disease study, conducted by the World Health Organization, the World
Bank, and Harvard University, http://www.idpas.org/pdf/155TheGlobalBurdenofDisease.pdf
• Access to statistics and reports on children and families, http://www.ChildStats.gov
• Healthcare Cost and Utilization Project (HCUP) - sponsored by the Agency for Healthcare
Research and Quality (AHRQ); includes HCUPnet, a free, on-line query system with instant access
to the largest set of publicity available all-payer hospital care databases. http://www. ahrq.gov/data
hcup/
• Mental Health America, http://www.nmha.org
• National Alliance on Mental Illness, http://www.nami.org
• National Association for Rural Mental Health, http://www.narmh.org
• Center for Disease Control and Prevention: Mental health work group, http://www.cdc.gov/
mentalhealth/
• The Carter Center, http://www.cartercenter.org/
• State mental health agency profiling system. http://www.nri-inc.org/Profiles.cfm
PSYCHIATRIC MENTAL HEALTH SUBSTANCE ABUSE

ESSENTIAL COMPETENCIES TASKFORCE MEMBERS
Catherine Kane, PhD, RN, FAAN, Co-Chair Madeline A. Naegle, PhD, RN, CNS-PMH, BC,
Associate Professor, University of Virginia FAAN
[email protected] Professor, New York University
[email protected]
Margaret Brackley, PhD, RN, FAAN, Co-Chair
Professor, University of Texas Health Science Marian Newton, PhD, RN, CS, PMHNP
Center at San Antonio Professor, Shenandoah University
[email protected] [email protected]
Jeanne Clement, PhD, RN, FAAN Geraldine Pearson, PhD, RN, APRN, FAAN
Associate Professor, University of Connecticut
Associate Professor, Ohio State University
[email protected]
[email protected]
Elizabeth Poster, PhD, RN, FAAN
Patricia D’Antonio, PhD, RN, FAAN
Dean and Professor, University of Texas Arlington
Professor, University of Pennsylvania [email protected]
[email protected]
Mona Shattell, PhD, RN
Judith Haber, PhD, RN, APRN, BC, FAAN Associate Professor, DePaul University
Professor & Interim Dean, New York University [email protected]
[email protected]
Theodora Sirota , PhD, RN, CNL, PMHCNS-BC
Edna Hamera, PhD, RN, ARNP, CS Associate Professor, Seton Hall University
Associate Professor, University of Kansas [email protected]
[email protected]
Sandra Talley, PhD, RN, APRN, BC, FAAN
Rebecca Harmon, PhD, RN, PMH CNS, BC Associate Professor, Yale University
Assistant Professor, University of Virginia [email protected]
[email protected]
Elizabeth LeCuyer, PhD, RN, PMHNP-BC
Assistant Professor, University of Rochester
[email protected]

Essential Psychiatric Mental Health and

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Essential PMH Competencies

Essential Psychiatric, Mental Health and

of professional organizations who reviewed and provided feedback to this

American Nurses Credentialing Center. (2003). American Essential I: Integration of Liberal

dynamics pacities of these vulnerable populations in order to

Sample Content it is during the transitions (or “hand offs”) between

mental health, addictions treatment, behavioral and evaluating mental health/substance

sults of quality improvement activities to individual and family members.

Sample Strategies for Learning Sample Content

Sample Content Sample

• Principles of person-centered teaching • Standardized measurement instruments

Sample Content Sample Content

tion, evaluation, and documentation on a 17.0 Develop an awareness of complementary

care. level of risk (ANA) involved in experi-

tionship • Learning theory

1. Growth & a. Principles of cognitive, emotional, a. Demonstrate competent

2. Neurobiological a. Neuroanatomical and a. Demonstrate competent

3. Pharmacothera- a. Neurobiological basis of a. Articulate knowledge of the

4. Communication a. Therapeutic interventions for a. Demonstrate therapeutic use of

Core Nursing Learning Outcomes Defined as

2. Concept of professional hallucinations, delusions, and

5. Clinical a. Taxonomy systems commonly used a. Apply taxonomy structures to

6. Patient Care a. Principles of teaching/ a. Demonstrate ability to

Core Nursing Learning Outcomes Defined as

f. Overlap of nursing roles with self- e. Assist patients to access self-

7. Health Care a. Principles of inpatient care. a. Describe available treatment

8. Cultural, a. Diversity a. Demonstrate competent

9. Health a. Concepts of mental health promotion a. Describe populations at risk for

10. Concepts of a. Common adaptation and coping a. Establish and maintain

Core Nursing Learning Outcomes Defined as

and psychiatric disorders and/or c. Plan, implement, and evaluate a

13. Nursing a. Research related to psychiatric a. Critically analyze research reports

**DEFINITIONS OF COLUMN HEADINGS

references Barrera, C., Machanga, M., Connolly, P. M., & Yoder, M.

what every rn should be able to do/handle

other, regarding implementation of learning

1. Relationship with faculty is important for student acquisition of knowledge, skills.

Pathophysiology: (should be in those courses)

PSYCHIATRIC MENTAL HEALTH SUBSTANCE ABUSE

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• Principles of person-centered teaching • Standardized measurement instruments

tion, evaluation, and documentation on a 17.0 Develop an awareness of complementary