1. health and fitness

NOR-MAN
Research into
Innovative Recruitment in
Psychiatric/Mental Health Nursing
Practice
Final Report
Sponsored by the
Workplace Prior Learning Assessment and
Recognition Committee (WPLAR)
Authored by Project Consultant
Marlene Gogal, RPN
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN
PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
Table of Contents
Executive Summary .................................................................................................................... 3
Introduction/Background .......................................................................................................... 4
Definitions ................................................................................................................................... 5
Partners ......................................................................................................................................... 5
Needs/Issues ................................................................................................................................ 6
Objectives ..................................................................................................................................... 8
Assumptions ................................................................................................................................ 9
Consultation................................................................................................................................. 9
Provincial and National Trends ............................................................................................. 11
Assessment ................................................................................................................................. 14
Scope of Practice and the Nursing Act................................................................................ 15
Education Comparative......................................................................................................... 16
Standards of Practice.............................................................................................................. 17
Competency Mapping ........................................................................................................... 18
LPN Survey ............................................................................................................................. 21
Postgraduate Psychiatric/Mental Health Programs for LPNs .......................................... 22
Nursing Articulation Pathways.............................................................................................. 23
Limitations ................................................................................................................................. 25
Results ......................................................................................................................................... 26
References................................................................................................................................... 28
Appendix A: Tables .................................................................................................................. 31
Appendix B: LPN Survey Highlights.................................................................................... 90
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Executive Summary
A labour shortage of health care professionals to provide quality Psychiatric/Mental Health
services in the NOR-MAN Health Region has driven the need for innovative recruitment
research. The primary focus has been the exploration of the potential to establish and deliver an
Advanced Practice Licensed Practical Nurse credential in Psychiatry/Mental Health as part of a
broad recruitment and retention strategy. To this end, research was conducted to ascertain if
Licensed Practical Nurses have the foundation to develop the specialized skills required to
practice in this extended area of practice, as well as to identify gaps and explore solutions and
pathways of delivery to address these gaps. The practices of Prior Learning and Recognition
and career laddering are considered throughout the process. Attention is also drawn to the need
to develop meaningful education and employment opportunities in the North through a
collaborative approach, thereby fostering the growth and optimal utilization of our invaluable
human resources.
There is a decided absence of clearly defined processes of analysis that have limited the
outcomes of this research. Despite these limitations, there is the possibility of establishing and
delivering an Advanced Practice Licensed Practical Nurse credential in Psychiatry/Mental
Health to meet the identified needs. The key recommendation of this research is ongoing
collaboration to explore and develop this potential.
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Introduction/Background
The NOR-MAN Health Region is a vast and diverse area. It has a population of approximately
26,000 residents, encompasses a geographical area of 72,000 square kilometres, and includes the
communities of Flin Flon, Cranberry Portage, Sherridon/Cold Lake, Wanless, The
Pas/Opaskwayak Cree Nation, Snow Lake, Moose Lake/Mosakahiken Cree Nation, Cormorant,
Easterville/Chemawawin First Nation, Grand Rapids/Misipawistik Cree Nation, and
Pukatawagan/Mathias Colomb Cree Nation. (NOR-MAN Regional Health Authority, 2007)
The NOR-MAN Regional Health Authority has the capacity to provide a full continuum of
Psychiatric/Mental Health services to its residents. An eight bed Psychiatric Unit opened in 2001
in The Pas Health Complex. It has a staffing compliment of 1.0 EFT Psychiatrist, 1.0 EFT Nurse
Manager, 8.4 EFT General Duty Nurses, 2.0 EFT Psychiatric Nursing Assistants, 0.6 EFT
Activity Aide and 0.5 EFT Ward Clerk. The Community Mental Health program, under the
umbrella of Primary Health Care Teams, delivers community-based services to adults, children,
adolescents and the elderly. There are five Community Mental Health Clinicians located in The
Pas and seven in Flin Flon, who respectively serve these and the outlying communities. In
addition, there is a Regional 1.0 EFT Psychologist and 1.0 EFT Occupational Therapist who
provide in-patient and community-based services. The Occupational Therapist position is
currently vacant. Community-based psychiatric services are enhanced by the employment of
itinerant Psychiatrists who travel to the Region on a regular basis.
Unfortunately, due to an acute labour shortage, the Region has been restricted in its ability to
deliver the Psychiatric/Mental Health services it is mandated to provide. When this project was
conceived, there were 4.4 EFT General Duty Nurse Positions vacant on the Psychiatric Unit. The
Region was forced to staff on an overtime basis and to draw nursing resources from the
Community Mental Health program to operate the Unit in a minimal capacity. This was
certainly not a sustainable solution, and the Region responded by initiating the practice of
under filling nursing positions that would typically be held by Registered Psychiatric Nurses
(RPNs) and Registered Nurses (RNs) with Licensed Practical Nurses (LPNs). LPNs were hired
on an indefinite term basis and were not able to occupy permanent positions. They were
consistently paired with an experienced RPN or RN. This practice permitted the Region to
maintain a bed availability of five spaces. However, services were curtailed as the LPNs were
not able to be in a charge position and were not left alone on the Unit. This meant that the
demands of the RPN or RN on duty were increased, as they were not able to leave the Unit for
the duration of the 12-hour shift. It also generated a gap in the consultative services available to
other units in The Pas Health Complex. The effects were felt in community-based Mental Health
services as well. Initially, staff were seconded to the Psychiatric Unit to maintain acute services,
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which to a degree disabled the community program’s ability to provide a full scope of services.
The inherent challenges of recruiting experienced staff to the community program were also
compounded by the inability to follow the natural pathway of transitioning experienced staff
from in-patient to community services. In addition, professional opportunities for nursing staff
were limited and had implications for employee satisfaction.
Definitions
For the purpose of this document, the following definitions have been adopted:
Prior Learning and Recognition: a process that recognizes that adults acquire skills, knowledge
and attitudes through formal and informal learning, and evaluates and recognizes this prior
learning as it relates to performance standards.
Scope of Practice: the range of activities on which a Nurse is educated and authorized to
perform.
Standards of Practice: statements that guide Nurses in the delivery of competent, ethical and
safe practice.
Competency: the integrated knowledge, skills, abilities, judgements, attitudes and values
required of an entry-level Nurse.
Entry Level Nurse: a Nurse at the point of registration or licensure following the completion of
an approved nursing education program.
Advanced Practice Licensed Practical Nurse: a Practical Nurse who has gained additional
specialized knowledge, competence and experience through a Board-approved postgraduate
program, and is registered by the College of Licensed Practical Nurses of Manitoba to practice
at an advanced nursing level (CLPNM, 2004).
Collaborative Practice: a cooperative approach used to attain the common goal of providing
quality nursing care that is founded in professional mutual respect and understanding.
Partners
This project is a joint initiative of the Workplace Prior Learning and Recognition Committee
(WPLAR), as funded by the Employment Manitoba Department of Competitiveness, Training
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and Trade and the NOR-MAN Regional Health Authority. It was administered by an Advisory
Committee comprised of representatives from these organizations.
Needs/Issues
Presently, the Psychiatric Unit has a full 8.0EFT Nursing contingent consisting of RPNs and
RNs. This leaves vacant a 0.4EFT which is regularly filled by a casual RPN. The Unit is fully
operational to its eight bed capacity. The community program is fully staffed, but has two
vacant term positions in lieu of maternity leaves (one of which is filled on a short-term basis). It
is, however, recognized that this is not the result of a carefully executed strategic plan as
opposed to a fortunate series of events. Given the trends in nursing in this Region, which are
reflective of the national trends, it is expected that there will be ongoing labour challenges. A
review of the NOR-MAN nursing profile demonstrates that the highest percentage of Nurses
(all designations and areas of practice) fall into the 35 to 49 and over 50 age range. Of the 21%
remaining that are under 35 years, 16% are currently on maternity leave (please refer to
Diagrams 1.1 and 1.2). With a high percentage of Nurses approaching retirement and a
significant contingent being of child-bearing age, labour challenges will continue to impact the
delivery of health care services, including Psychiatry/Mental Health.
Although acute care in-patient services is the area in most critical need of human resource
development at present, there are other areas which fall under the scope of Psychiatric/Mental
Health service delivery which also require attention. The need to provide training opportunities
to better prepare Nurses to deliver comprehensive Psychiatric/Mental Health care to the
geriatric population has been flagged as a priority. There is a rising prevalence of
Psychiatric/Mental Health issues in the elderly demographic, which is concentrated in the
Personal Care Home (PCH) setting, and this is expected to continue to increase. According to the
Manitoba Center for Health Policy (2004), 83% of Personal Care Home residents and 75% of new
admissions had some mental health diagnosis within five years. This is consistent with the
findings reported by The Alliance on Mental Illness and Mental Health (2007), who reported that
83% of Personal Care Home residents in Manitoba are diagnosed with a mental illness. The
cumulative physical and mental health needs of the elderly present unique challenges and
increasing demands for Nurses. Attention has been focused on the delivery of physical care, and
must also be drawn to the provision of training and support for Nurses in order for them to
provide for the holistic needs of the elderly patient.
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Diagram 1.1 NOR-MAN RHA Nursing Profile by Age
Diagram 1.2 % of Nurses on Maternity Leave per Age Group
100
90
80
70
< 35 years
60
35-49 years
50
> 50 years
40
30
20
10
0
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0
0
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Objectives
This project has a multifaceted scope of objectives and desirable outcomes. The primary
objective is to research the possibility of employing an innovative recruitment strategy to
address the need for skilled health care professionals to deliver Psychiatric/Mental Health
services in the NOR-MAN Health Region. The practices of Prior Learning and Recognition
(PLAR) and career laddering are considered throughout the process.
The utilization of LPNs played a critical role in the delivery of acute Psychiatric/Mental Health
services in response to a critical labour shortage. It has been proposed that they may play an
ongoing legitimate role in this area of practice, one that they are not traditionally employed in.
The primary focus of this project has thus been to examine the feasibility of this proposal
through several activities that include, but are not limited to, identifying the competencies
required, identifying gaps, and identifying the gap training solutions and pathways required to
deliver these services. Although acute care, in-patient services is the most immediate area of
need, LPNs are often employed in PCHs. This is a setting where mental health issues are
concentrated, and it is reasonable to extend the project scope to exploring additional training
opportunities for LPNs in this area as part of the process. It is important to qualify that this
solution is not intended to be exclusive, but rather part of a broad health care strategy that aims
to sustain the integrity and optimum delivery of Psychiatric/Mental Health services in the
Region. The delivery of competent and quality services is the foremost guiding principle.
On a broader scope is the recognized need to support and develop regional human resources. It
could also be said that there is a need to facilitate opportunities “in the North for the North.”
This is not isolated to health care, and there are several presenting dynamics that undermine the
stability and growth of our human resources in all sectors. There is an established pattern of
emerging professionals relocating to northern areas to draw from the diverse professional
development opportunities, and then transplanting back to more southern, often urban locales
as experienced professionals. A parallel pattern is the need for individuals who wish to pursue
professional careers to have to relocate to larger, southern centers to obtain their education.
Often individuals who have left the North to pursue an education lose ties with their home
communities and do not return. For many others, the option of relocating for educational
purposes is simply not feasible for a variety of reasons, and hence they are not able to attain the
education or career they desire. The advances in distance education and emerging virtual
classrooms have certainly minimized this gap; however, there is an ongoing need to develop
innovative solutions and opportunities for our residents. Assiniboine Community College’s
Practical Nursing rotating site program is one such example having a direct causal relationship
to this project. The delivery of that program in the Region generated a contingent of LPNs that
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were available to provide the skilled labour required to sustain acute Psychiatric/Mental Health
services. The availability of meaningful training and employment opportunities in the Region
has the capacity to stabilize our human resource pool, while also attending to the unique
cultural and social needs of the area. In addition, it would also provide professionals who are
committed to practicing in the North with professional development opportunities, which may
have an impact on overall professional satisfaction and retention.
Systemically, the development of a collaborative and interdependent partnership between
employment, education and employers – one that is knowledgeable and responsive to the
collective needs and issues of the Region – provides an opportunity to develop meaningful
strategies to foster the growth and optimal utilization of our human resources. Consultation
and collaboration with other stakeholders would serve to define, guide and enhance these
partnerships and broaden their capacities.
Assumptions
The project proceeded based on several assumptions which guided the exploration and
qualification of the research. These included, but were not limited to, the following
assumptions:
•
There are areas of commonality in Entry-Level Competencies and Standards of Practice
between RPNs, RNs and LPNs.
•
LPNs have a foundation in Psychiatry/Mental Health from which to pursue an
Advanced Practice Licensed Practical Nurse in Psychiatry/Mental Health credential.
•
LPNs in the Region have an interest in postgraduate education and to work in an
extended area of practice.
•
The infrastructure required to deliver and support an Advanced Practice Licensed
Practical Nurse in Psychiatry/Mental Health program exists in the Region.
•
There are existing programs that may meet the educational requirements for the
development of an Advanced Practice Licensed Practical Nurse in Psychiatry/Mental
Health credential.
•
There is a need for meaningful education and employment processes in the North to
develop and sustain our human resources.
Consultation
Various stakeholders were consulted throughout the research process, including but not limited
to: Nursing Colleges, Unions, Educational Institutions, and Health Regions in Manitoba and in
other Provinces.
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The College of Licensed Practical Nurses of Manitoba (CLPNM) has supported this preliminary
exploration into an extended area of practice and an advanced practice educational component
in Psychiatry/Mental Health as it relates to their scope of practice. It is notable that the
Competency Profile for Licensed Practical Nurses in Manitoba was released in May 2007 and
entails a comprehensive mental health component (College of Licensed Practical Nurses of
Manitoba and Alberta Health and Wellness, 2007). The profile is responsive to changes in the
Practical Nursing curriculum, which introduced enhanced mental health content in 2006/07
(depending on the delivery site).
The College of Registered Psychiatric Nurses of Manitoba (CRPNM) has expressed some
concern regarding the practice of LPNs in Psychiatry/Mental Health. It is their position that
despite the high quality of the LPN program in Manitoba, that LPNs do not have a solid
foundation in Psychiatry/Mental health from which to build an “Advanced Practice”. They
similarly expressed concern about Diploma-prepared Registered Psychiatric Nurses who
practice in very independent and autonomous community settings. The need for a strong
professional support network for new graduates and even experienced Nurses practicing in
such settings was identified and presented as a valuable recruitment and retention incentive.
The CRPNM suggested that a comprehensive recruitment and retention strategy to draw RPNs
to the Region would be an appropriate short-term approach, with the delivery of the Bachelors
of Science of Psychiatric Nursing program in the North being a long-term objective. They
offered assistance in developing and facilitating a strategic plan of this nature. The CRPNM also
encourages employers to specify their needs for Registered Psychiatric Nurses when advocating
for human resources, as Provincial Departments respond to employer demand when
developing resources.
The College of Registered Nurses of Manitoba (CRNM) likewise expressed concern regarding
an “Advanced Practice” designation for LPNs in the absence of a strong foundation of
theoretical and practical experience in Psychiatry/Mental Health. It was suggested that
practicing LPNs should be consulted in the process to determine if they, as a nursing body, are
interested in employment in an extended practice area.
Preliminary contact with the Manitoba Nurses Union (MNU), Regional Representative,
revealed support for an extended LPN practice in Psychiatry/Mental Health and encouraged
organizational recognition and utilization of LPNs to their full scope of practice. Emphasis was
placed on the development of a sustainable and legitimate employment strategy as opposed to a
stop gap intervention.
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Contact with representation from the Brandon University, Psychiatric Nursing programs,
recollected that efforts had been made to expand the program into the North; however, the
infrastructure to support this initiative was not viable at that time. Presently, the first year is
deliverable through distance education. There is an expressed willingness to respond to the
labour needs by delivering an increased number of psychiatric nursing courses through
distance education. However, the Baccalaureate program is not attainable solely via distance
education, and students would be required to relocate to Brandon or Winnipeg to complete
their degree.
Preliminary contact with University College of the North (UCN) revealed a strong interest in
partnering in this process to deliver postgraduate programming for LPNs. UCN has a
fundamental interest in expanding their delivery of nursing education. Their “Blueprint for
Health Careers Education in Northern Manitoba: A Discussion Paper” (Gregory and Gardiner,
2005) outlined recommendations for the delivery of a broad continuum of health care
programming in the North. The document highlighted among other things the need for
maximum articulation and credit transfer between nursing programs, and proposed the
development of a foundational year from which to deliver a continuum of nursing education.
UCN has expressed a commitment to partnering in subsequent phases of this process.
The Office of Rural and Northern Health (ORNH) was developed in response to the need for
recruitment and retention of health care professionals in the rural and northern areas of the
Province. It represents the interests of the Northern Regional Health Authorities, which include
Parklands, NOR-MAN and Burntwood. Preliminary conversation with this organization
revealed a significant interest in partnering in this initiative as it is in line with their objective of
facilitating training opportunities in the North.
Provincial and National Trends
We need only refer to works such as The Nursing Strategy for Canada (2000) and the Manitoba
Nursing Strategy (2000), and to the establishment of organizations like the Office of Rural and
Northern Health and the Northern Sector Council, to realize that significant national, provincial
and regional concern exists with respect to health human resources. The Health Human
Resources in Collaborative Mental Health Care report (2005) refers to the recruitment and
retention of mental health care professionals as a significant challenge, and identifies the
maldistribution of mental health care providers in rural and remote areas as a compounding
issue.
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In order to develop a grassroots, comprehensive understanding of the labour challenges, needs
and potential solutions as they pertain specifically to Psychiatric/Mental Health nursing,
research comprised of a literature search and personal contacts was completed. What was
confirmed is that the challenges experienced in NOR-MAN are not unique or isolated. Health
regions throughout the Province and across Canada are experiencing difficulty recruiting and
retaining Nurses in all areas of practice, including Psychiatry/Mental Health. The following
information details this exploration.
In Burntwood Health Region, the ten bed Psychiatric Unit has endured similar bed closures as
the result of nursing labour shortages. They have resorted to hiring Agency Nurses in order to
maintain minimal services. This is a costly financial undertaking and has implications for the
consistency of care due to the transitional staffing patterns. Burntwood has not adopted the
practice of hiring LPNs to underfill vacancies. This was presented as not being a considerable
option due to a lack of LPNs to employ in this manner.
The Parklands Regional Health Authority (PRHA) is also in the process of recruiting to their
Psychiatric Unit. It is their practice to employ only RPNs in this area. Although they have
historically had little difficulty recruiting and retaining Nurses, this is not the current
circumstance. An additional challenge encountered is with respect to remuneration, as the
PRHA is not able to offer the Northern Living Allowance. They do offer a bursary for nursing
students, with a work-back agreement to draw Graduates to their area. A similar natural
transitioning process of experienced staff occurs between their in-patient and community-based
Psychiatric/Mental Health programs. To address Psychiatric/Mental Health service delivery
needs for the geriatric population, the PRHA added Mental Health Resource Nurse positions to
support the General Duty Nurses in long-term care to manage mental health issues with their
residents.
The Selkirk Mental Health Center (SMHC) experienced an acute nursing shortage in 2001/02.
SMHC opted to employ LPNs on a permanent basis to a maximum of 10% of their staffing
compliment, or 12 positions. LPNs were subjected to the same hiring process as other Nurses.
Their duties were primarily related to direct care and they did not complete mental health
assessments or assume charge responsibilities. LPNs were encouraged to advance their
education through the provision of an incentive opportunity to work on a part-time basis, with
a work-back agreement, to accommodate part-time study. A number of LPNs did respond to
this opportunity. Currently, SMHC’s contingent of LPNs is to full capacity, and the practice of
recruiting LPNs has declined as there are more RPNs and RNs available.
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According to the College of Licensed Practical Nurses, LPNs are similarly employed in
Psychiatric/Mental Health settings throughout the Province, including the Manitoba
Developmental Center, Rideau Park Personal Care Home, St. Amant Center, and St. Judes
Group Home.
The Saskatchewan Hospital in North Battleford, Saskatchewan, is a Psychiatric facility
comprised of seven in-patient units. They are similarly challenged by a nursing labour shortage,
and in addition to other strategies have adopted the ongoing practice of employing LPNs. LPNs
are subjected to the same interview and orientation process as other Nurses. The extensive
orientation program includes information regarding the continuum of mental illnesses and
employs a “buddy system” that pairs new Nurses to the facility with experienced ones. LPNs
are not tasked with Charge Nurse responsibilities, but instead fulfil all other nursing duties. It is
expected that Saskatchewan Hospital will increase the practice of employing LPNs as the
nursing shortage intensifies.
The practice of employing LPNs in Psychiatry/Mental Health is gaining momentum in Alberta.
According the College of Licensed Practical Nurses of Alberta, LPNs are working to full scope
of practice in a number of Psychiatric/Mental Health settings throughout the Province.
Considerable attention has been focused on a collaborative nursing model and interprofessional
education. The Claresholm Center for Mental Health and Addictions is a 100-bed facility that
employs LPNs to full scope of practice on all units, including their Methadone Clinic. The
Alberta Hospital in Edmonton, a 400-bed psychiatric facility, received funding in 2006/07 to
super numerate their nursing workforce, and commenced the practice of employing LPNs in
Rehabilitation and Psychogeriatric Units to their full scope of practice. Similar initiatives that
utilize the services of LPNs in the delivery of Psychiatric/Mental Health services are underway
in Medicine Hat and Red Deer as well. Enhanced Psychiatry/Mental Health education
programming for LPNs has been developed to support this employment practice.
According to the College of Licensed Practical Nurses of British Columbia, the practice of
employing LPNs in Psychiatry/Mental Health settings is expanding in their Province. This is
thought to be a response to a nursing shortage, as well as a commitment to the better utilization
of nursing resources. It is noted that their LPN training entails a very basic mental health
education, and additional education in this area of practice is encouraged and supported by the
availability of enhanced training opportunities. Considerable emphasis has been placed on the
education of employers regarding the role that LPNs can play and the supports they require to
practice competently and within their legislated scope of practice. Riverside Psychiatric Center
provides acute-tertiary psychiatric care for adults and geriatrics, and also houses a
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Neuropsychiatric Unit. LPNs are employed on the Neuropsychiatric Unit, providing direct care
for patients who are relatively stable and have been oriented to the Unit. Being a new facility (a
product of a decentralization process in the Province), a substantial amount of attention was
attributed in the development phase to the client profile and needs when formulating the
desired nursing mix. It was determined that LPNs had a role to play in the delivery of services.
However, their psychiatric education base was limited. In collaboration with Douglas College,
the Mental Health Certificate for RNs was adapted for LPN delivery. Based on the individual
Nurse’s training and experience at the time of hire, a condition of employment may include the
completion of identified Psychiatric/Mental Health courses. This applies to both LPNs and RNs.
The Center for Nursing Studies located in St. John’s, Newfoundland, delivers a Licensed
Practical Nursing program , a Bachelor of Nursing (Collaborative) program, and the Nurse
Practitioner program, as well as a number of continuing education programs and workshops for
Registered Nurses and Licensed Practical Nurses. Approximately two years ago the nursing
labour shortage demanded an enhanced training program to equip LPNs to practice in the area
of Psychiatry/ Mental Health. The Center for Nursing Studies subsequently developed an LPN
Post-Basic Mental Health program, and has generated approximately 80 graduates, meeting the
need for qualified health care professionals to deliver Psychiatric/Mental Health care.
This exploration revealed some common themes within the Province and Nationally. In the
developmental stages, it is critical to involve stakeholders in the process. It is also important to
consider staff mix in response to client needs. The biggest challenge encountered when LPNs
were introduced to extended practice areas was the reticence of other Nurses to accept their
presence. Issues regarding territorial boundaries and the fear of being displaced prevailed.
Placing the emphasis on serving client needs and teamwork helped to foster acceptance. The
delivery of inter-professional education was instrumental in assisting Nurses to understand the
roles that each designation could play. Well-defined roles and support networks are essential,
and using a collaborative nursing model that considers the client, the Nurse and environmental
factors in nursing utilization assisted in meeting these needs. LPNs employed in
Psychiatric/Mental Health settings were consistently reported to be meeting organizational
expectations.
Assessment
In order to respond to the needs identified in the Region, meet the objectives of this project and
attend to the assumptions, it is necessary to develop a comprehensive understanding of the
existing processes and the opportunities for development through an assessment-focused
approach.
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Scope of Practice and the Nursing Act
The Licensed Practical Nursing Scope of Practice is defined in Part 2 of The Licensed Practical
Nurses Act (2001) as:
“The practice of practical nursing is the provision of nursing services for
the purpose of assessing and treating health conditions, promoting
health, preventing illness, and assisting individuals, families and groups
to achieve an optimal state of health.”
Nursing Acts as legislated in Manitoba give nursing regulatory bodies the authority to define
and regulate the practice of their membership. Neither the Licensed Practical Nurses Act nor
the College of Licensed Practical Nurses clearly identifies any restricted areas of practice for
LPNs.
According to the College of Licensed Practical Nurses Regulatory Bulletin (2005), the
parameters of Scope of Practice are established through basic entry-level, postgraduate and/or
advanced education. Scope of Practice can be a seemingly vague and ambiguous term, but
establishes a basis from which regulatory bodies establish Standards of Practice, educational
institutions develop curriculum, employers develop job descriptions, and consumers know
what to expect of the profession. It sets the outer limits of practice; however, the individual
Nurse’s scope of practice will be influenced by the practice setting, employer requirements and
client needs (Canadian Nurses Association, 1993).
For the purpose of this exercise, it is necessary to understand the process through which an
Advanced Practice Licensed Practical Nurse credential is established. According to Section 7
Part 51(1) of the Licensed Practical Nurses Act (2001), the CLPNM Board may (d) make
regulations defining areas of general or specialized Practical Nursing practice as related to
education, experience or otherwise and (I) with respect to standards for educational programs
including advanced practical nursing education programs. A Licensed Practical Nurse may be
registered as an Advanced Licensed Practical Nurse as per Regulation 14(1) and (2) of the Act
(2002). In essence, if the CLPNM Board approves a training program that meets their criteria for
an Advanced Practice Licensed Practical Nurse credential, the Nurses completing the training
and practicing in these areas would be practicing within the parameters of their licensure. The
CLPNM has to date established Advanced Practice credentials in the specialized areas of
operating room, dialysis and foot care.
It is commonly reported in the literature that Nurses are restricted from practising to full Scope
of Practice. This may be particularly true with respect to LPNs as suggested in the work of
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Besner et al. (2005) on maximizing nursing scopes of practice. According to Bosco (2005), a lack
of understanding regarding Scope of Practice parameters and boundaries is a primary cause of
health care professionals not working to the full extent of their training. This results in
confusion and conflict over roles and responsibilities amongst providers. This work in
collaborative mental health care recommended that strategies be developed to promote the
maximum utilization of the skills and competencies of all mental health care providers.
Building the Future: An integrated strategy for nursing human resources in Canada, Phase I
Final Report (2005), recommended that the ability of Nurses to work to their full Scope of
Practice needs to be maximized. The Phase II Final Report (2006) proceeded to identify that,
“There is a need to move away from the language of “scope of practice” and focus on
developing management policy to facilitate nurses to practice to their level of competency in
various clinical settings.”
Education Comparative
As was previously highlighted, Scope of Practice is defined by basic entry-level preparation and
postgraduate and/or advanced education. Central to this process is an understanding of the
foundational elements upon which an Advanced Practice Licensed Practical Nurse in
Psychiatry/Mental Health could be established. It also begs the question of what the difference
in the preparation of an LPN to other Nurses as it pertains to entry- level practice in
Psychiatry/Mental Health entails.
Appendix A - Table 1.0 provides an overview of curricular elements of the Practical Nursing
program, the Diploma Nursing (Accelerated) program and a Bachelors of Nursing program
specific to Psychiatry/Mental Health. The curriculum content of the Psychiatric Nursing
education was not included in this exercise, given that it is dedicated to this area of practice.
The Practical Nursing curriculum includes the enhanced mental health content introduced in
2006/07.
It is observed that the Practical Nursing and Diploma Nursing (Accelerated) programs are most
relatively comparable and contain an equivalent number of theoretical credit hours dedicated to
Psychiatry/Mental Health. Of course, the challenges of drawing definitive conclusions about
equivalency based on credits is that educational institutions do not necessarily utilize a
standardized system of measurement, and it does not account for how the material is delivered.
Nonetheless, a review of the course objectives/syllabus for each program respectively does
support a reasonable comparison of Psychiatric/Mental Health content. The primary, most
observable difference between the two programs is the lack of emphasis on the elements of skill
development and implementation in the Practical Nursing program. This is noted throughout
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the content delivery and in the critical absence of a Psychiatric/Mental Health specific
practicum, and would suggest a degree of equivalency in the knowledge base of the graduate
PN and DNA, but with a gap in the area of practical skill development. Although Practical
Nurses would have had some exposure to Mental Health processes in their practicum rotations,
it can be expected that this does not provide adequate opportunity to develop the broad range
of skills specific to practice in a Psychiatric/Mental Health setting.
Standards of Practice
Standards of Practice provide direction for professional practice in the delivery of services that
are competent, ethical and safe. Standards provide information regarding what the public can
expect of Nurses in any practice setting or role. Each nursing College in Manitoba has the
legislated authority though their respective Acts to establish Standards of Practice that guide
the practice of their membership. Nurses are accountable to ensure that they are practicing in
accordance with their Standards of Practice.
Diagram 2.0 Standards of Practice – Universally Valued Principles
Appendix A - Table 2.0 outlines the Standards of Practice adopted by each of the Nursing
Colleges in Manitoba, CRPNM (1993), CLPNM (2004) and CRNM (2004). It also includes the
Standards of Practice of the Canadian Federation of Mental Health Nurses (2006). The Canadian
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Standards for Psychiatric-Mental Health Nursing are included as a baseline reference in lieu of
this project’s specific focus on the delivery of Psychiatric/Mental Health nursing care and the
adoption of these standards by the Region, as per their accreditation process, to guide delivery
of Psychiatric/Mental Health services. The CFMHN is a national body and the Canadian
Standards for Psychiatric-Mental Health Nursing 3rd Edition involved consumers of
Psychiatric/Mental health nursing services in the process of improving the standards as part of
their ongoing quality improvement initiatives. Please note that the standards are not
represented in their entirety in Table 2.0, in that qualifying statements that outline the specific
activities of each standard are not included. For a full description of all Nursing Standards
referred to in this document, please refer to their respective websites. A review of these
Standards of Practice reveals that there are central principles that are universally valued
amongst all nursing designations, and that are fundamentally consistent with standards that are
specific to practice in Psychiatry/Mental Health. Diagram 2.0 demonstrates the
interconnectedness of nursing designations based on these principles.
Appendix A - Tables 3.1 and 3.2 demonstrate the correlation between the Psychiatric/Mental
Health curriculum content of the Practical Nursing program and the Canadian Standards for
Psychiatric-Mental Health Nursing. The purpose of this exercise was to determine if this content
provides a basis for the practising LPN to be able meet Standards of Practice specific to this
practice area. The conclusion that a basis exists can be drawn.
Competency Mapping
Competency profiles provide a framework from which it is reasonable to develop expectations
with respect to what an entry-level Nurse can do. They are not, however, static or exhaustive
documents. It is important to recognize that entry-level competencies do not reflect the
additional competencies that the individual Nurse may acquire through postgraduate
education, employment or experience (College of Licensed Practical Nurses of Manitoba, 2002).
It also does not reflect the Nurse’s individual aptitudes, strengths, and informal life learning
and experiences. All competencies may not relate to all areas of practice, and as the Nurse’s
practice evolves, he or she may become more proficient in some competency areas and less in
others (College of Registered Nurses of Manitoba, 2005). Each nursing profession has
expectations around continuing competency that guide the Nurse’s efforts to remain current in
his/her ability to provide quality, competent nursing care.
A task of this project was the identification of skills and abilities commonly shared by nursing
designations. This exercised is aimed at developing a base understanding of the competencies
required by LPNs to practice in Psychiatry/Mental Health by comparing their competencies
with those of nursing designations that typically practice in this area. It may also be utilized to
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determine the commonalities across competencies between professions, and allow for the
analysis of PLAR or credit transfer opportunities against further education and training. As the
practice of nursing is holistic in its orientation, competencies are examined from this
perspective.
It was not possible to directly correlate competency profiles as they currently exist. Competency
profiles are not standardized in their language, construction or delivery. This conclusion was
similarly drawn by Basford (2005) in their work on competency mapping. A mapping process
that groups competency statements in thematic clusters was therefore utilized. This approach
was based on work completed at The University of Lethbridge (Basford, 2005). A “Competency
Clusters Exercise” was completed by a focus group comprised of seven Nurses. These
participants were chosen from each of the nursing designations and represent diversity in
educational preparation, experience and employment roles and settings. A forced choice format
was adopted, and participants were asked to categorize each competency statement into the one
thematic cluster that they thought best represented the intent of the statement. Conversely,
many of the competency statements could be represented by more than one cluster. Based on
the responses, each competency statement was then categorized and inferences drawn with
respect to commonality. Appendix A-Table 4.0 highlights the proposed areas of competency
commonality in each cluster. It is important to note that competencies that are not identified as
being common may be represented in another cluster.
In consideration of the limited number of Graduates who would have received the enhanced
mental health content in the Practical Nursing program and the constitution of the regional
contingent of LPNs, this exercise used the pre-existing, 2001 Scope of Practice Entry-Level
Competencies (College of Licensed Practical Nurses of Manitoba, 2001).
Definitive conclusions with respect to commonality between nursing designations could not be
drawn through this process. The subtle differences in how the information and intent are
presented make it difficult to comprehend the commonality and uniqueness between Nurses.
Competency statements are highly interpretive. This was evidenced by the lack of consensus
between participants as to which cluster best represented the intent of each competency
statement, and through the process of trying to draw reasonable conclusions. Whereas the LPN
and RN competency statements are similarly expressed and organized, they do not provide
clarity around depth or breadth of scope. The RPN competencies are expressed and organized
quite differently and are very specific to Psychiatry/Mental Health. The areas highlighted in the
RPN competencies as being common with the LPN and RN competencies are based on an
interpretation of how it relates to the practice of Nursing. For example, all Nurses are expected
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to chart accordingly. There are competencies that suggested commonality between the RPN and
RN only. These are concentrated in the areas of leadership/supervision of staff and on
community consultation and collaboration.
This exercise was intended to provide a base understanding of the commonality between entrylevel Nurses as defined by their knowledge, skills, abilities, attitudes, judgement, attributes and
values. What it perhaps most effectively demonstrates is that a lack of definition makes it
difficult to develop a clear understanding of roles and responsibilities of Nurses in their
practice. This is particularly the case for the LPN and RN designations, whereas the RPN
competencies are more defined by the nature of their specific practice orientation.
In the process of trying to develop an understanding around competency, a considerable
literature search was conducted to determine how this question of competency commonality
has been addressed in other efforts. This produced little by way of work in the area. The
aforementioned work by Basford (2005) was one such example; however, it was concluded in
the study (Besner et al. 2005) that no definitive determinations could be drawn with respect to
the degree of commonality. The only other work unearthed was the National Nursing
Competency Project (Health Canada, 1997). This project in part examined the commonality and
uniqueness of nursing competencies as they existed in 1996 and projected into 2001. It was
concluded that of the entry-level competencies developed through their process (not existing
competency profiles), 57.9% were shared by the three nursing groups in 1996, and that by 2001,
68.8% would be shared.
Despite the limitations of this exercise, it is reasonable to determine that an entry-level LPN
possesses the competencies from which to develop the specialized skills to practice in
Psychiatry/Mental Health. The Theoretical Statement of Nursing Roles contained in the work of
Besner et al. (2005) highlighted that there is a singular discipline of nursing, with distinct
professional groups, that derive nursing knowledge from the same central body of knowledge.
Although there are also differences or uniqueness between Nurses, LPNs possess the
fundamental elements of nursing on which to build their practice.
The matter of LPN competency in Psychiatry/Mental Health is further compounded by the
recent evolution of the Practical Nursing program. In consideration of the enhanced mental
health content and the extended competencies for LPNs, we must consider if there is a
difference between older and new Graduates, with respect to the knowledge and skills required
to deliver Psychiatric/Mental Health nursing care. The 2007 LPN Competency Profile identifies
the LPN as being competent at an entry-level to provide comprehensive mental health nursing.
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Any LPNs graduating prior to 2006/07 would not necessarily meet these competencies based on
educational preparation solely, and would have had to develop them through experience
and/or continuing education. The pre-existing Practical Nurse program did include mental
health components. However, these related primarily to Gerontology. Hence, there is an
obvious theoretical difference in the preparation of LPNs. To address this disparity, a PLAR
process could be utilized to assess the knowledge and skills of an LPN who graduated prior to
2006/07, and if required, a bridging component could be delivered prior to entry into a
Psychiatric/Mental Health postgraduate program. Nonetheless, there would remain a
consistent gap in practical skill development that is facilitated through experiential learning.
The development of leadership skills and the ability to collaborate with the greater communitybased system is also required. A postgraduate program would have to address these needs.
LPN Survey
Instrumental to moving through this process was developing some insight into the perceptions,
experiences and desires of LPNs. To this end, ten LPNs who had been employed by the NORMAN RHA on the Psychiatric Unit were interviewed. Table 5.0 presents a general overview of
the participants. The standardized interview addressed areas related to educational
preparation, Scope of Practice, employment experience, and employment and educational goals.
The resounding result of this exercise was the presentation by LPNs that they did not feel
prepared or confident, based on their training, to practice in Psychiatry/Mental Health.
However, they felt that they had the capacity to develop the skills required through further
education, experience and support. Refer to Appendix B: LPN Survey Highlights.
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38.3
•
•
2 Male
8 Female
1 2001
1 Brandon
5 2003
5 Flin Flon
4 2006
4 The Pas
< 1 Year
8 - 1.0 EFT Perm
6 PCH
1 - 0.6 EFT Perm
1 Med/Peds
1 DNA Student
2 Float
Leave
Maternity
Setting
Practice
Status
Employment
Current
on Psych Unit
Employment
Length of
Average
Location
Year
Graduating
Gender
Median Age
Table 5.0 LPN Survey Participant Overview
2
Average Length of Employment on Psych Unit represents full-time to casual positions with a range
of full-time to part-time hours.
3 LPNs who have permanent positions in long-term care have taken term positions in other
areas, including Medical, Out-Patient Clinic and another PCH.
Postgraduate Psychiatric/Mental Health Programs for LPNs
In the process of exploring the feasibility of establishing an Advanced Practice Licensed
Practical Nurse credential in Psychiatry/Mental Health, it was to be determined if programming
exists or would need to be developed to meet the educational criteria. The research revealed
that there are existing programs that have been developed to address similar needs and
challenges experienced in other Provinces. Each of the Institutions identified through this
process are well established and have worked in collaboration with their respective nursing
regulatory bodies to develop resources to meet the needs of the evolving health care system.
Appendix A- Table 6.0 presents for consideration the components of three programs that would
appear to meet the comprehensive needs of the credentialing process and the Region. These
programs are available through distance education, or have the potential to be brokered for
direct delivery by an appropriate educational provider as deemed by the respective institution
owning the program. As per UCN’s expressed interest in delivering this programming, the
most appropriate option to pursue would be to broker the selected program. This approach
proposes several developmental opportunities. A program delivered by a regionally-based
educational institution provides the opportunity to adapt it, in consultation and with the
consent of the owner, to meet the unique needs of this Region. It may also set the stage for the
development of recognition and transfer components that would foster a natural laddering
process through the continuum of health care programming.
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Each of the Institutions identified through this process also offer a range of postgraduate
programs related to specific mental health consumer populations for LPNs, as well as some
programs for RNs. This speaks to the resources required to also meet the Region’s priority of
providing enhanced training opportunities for LPNs in Geriatric Psychiatric/Mental Health.
PLAR is another feature available through each of these educational facilities. This meets the
needs of this initiative in that there is an assessment process already established that may
address the question surrounding basic educational preparedness, and the additional
knowledge and skills that LPNs acquire through formal and informal learning.
Nursing Articulation Pathways
A broad objective of this project is to be responsive to the need to support and develop regional
human resources. An awareness and appreciation of the structures currently in place is a basis
for meeting this objective, and a necessary starting point. Diagram 3.0 provides a framework for
understanding the articulation pathways that currently exist to support Nurses in advancing
their education.
The processes outlined were found to be cumbersome to navigate in the absence of a
standardized system of measurement and recognition, as well as in the absence of a competency
analysis between the educational institutions. Nurses subsequently receive limited credit for the
knowledge and skills they attained in previous training and through experience. This is not
necessarily conducive to a climate that endorses the need for higher levels of educational
attainment, nor is it responsive to labour needs. The advances made in terms of existing
articulation agreements and Prior Learning and Recognition has addressed the need for a
streamlined articulation process to some extent. There seems, however, to be a pervasive
reticence by nursing faculties and their respective institutions to supplant nursing specific
courses through a recognition/transfer process in order to preserve the integrity of their
programs.
In addition, accessibility is a substantial barrier to educational and professional advancement.
The distance delivery system has ameliorated some of the challenges that exist for individuals
in rural and northern areas, and for those who wish to study on a part-time basis. However,
many challenges remain. Some nursing programs are not fully extended into the North. Others
are available, but the limited availability of required courses at any given time substantially
extends the length of study. In effect, this limits professional advancement opportunities for
Northern residents, and has a direct relationship to recruitment and retention challenges in the
North.
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Diagram 3.0 Nursing Articulation Pathways in Manitoba
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Table 7.0 Articulation Pathways Additional Information
Assiniboine Community
College
Red River College
University of Manitoba
Brandon University
Other
The LPN program consists of 95 credit hours of study as per the
curriculum outline. However, the program is typically measured
in months of study. Credit hours allocation does not necessarily
equate with that of other institutions.
The DNA program consists of 152 credit hours of study as per
the curriculum outline. However, the program is typically
measured in months of study. Credit hours allocation does not
necessarily equate with that of other institutions.
Red River College and University College of the North both offer
the Joint Baccalaureate in Nursing in collaboration with U of M
and resulting in a degree from U of M.
The DNA to BN is in its final year due to low enrolment.
The BScPN is currently in revision which may result in increased
transferability.
Transfer credits from the BScPN to the BN program are
undefined and addressed on an individual basis.
It is expected to take 3-4 years to complete as a second degree.
15 credit hours typically = 1 term
30 credit hours typically = 1 year of study
Nursing-specific courses have a 5-year shelf-life.
Ongoing collaboration between educational institutions presents an opportunity to meet
education and labour needs. Each of the institutions in Manitoba has a variety of PLAR
offerings against selected courses or programs. The potential to develop one exclusively across
the nursing designations seems an undetermined possibility at present. For the purpose of this
research, a PLAR process may be developed by the institution offering additional LPN training
to establish what the individual Nurse’s knowledge and skills are against the competencies of
the proposed credential. Beyond this, the presence of UCN in the North and the ongoing
development of their capacity to deliver a full range of nursing programs may be the vehicle
necessary to deliver a fully articulated nursing education contingent and a meaningful
laddering process for Northerners.
Limitations
This work has significant limitations. The lack of standardization encountered throughout this
process made it difficult to develop meaningful conclusions that are not subject to interpretation
and perspective. A clearly defined and articulated system of assessing prior learning and
providing recognition of knowledge and skills as it applies to all aspects of Nursing, from basic
and advanced education to licensure/registration, would provide a comprehensive framework
for innovative health human resource development.
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Results
The primary objective of this research was to explore the possibility of employing an innovative
recruitment strategy to address the need for skilled health care professionals, resulting from
labour shortages, to deliver Psychiatric/Mental Health services in the NOR-MAN Health
Region. The practices of PLAR and career laddering were considered throughout the process.
The initial research suggests the possibility of establishing and delivering an Advanced Practice
Licensed Practical Nurse credential in the area of Psychiatry/Mental Health to meet the
identified needs. The broader and systemic considerations have been the development and
support of regional human resources, and the formation of partnerships that can foster and
sustain their growth.
The processes engaged through this work would suggest that LPNs have the foundational
elements from which to develop the specialized knowledge and skills required to practice
competently at an entry-level in collaborative Psychiatry/Mental Health practice. These
elements exist in the LPNs’ educational preparation and their established Competencies and
Standards of Practice. The gaps that do exist would be addressed through the delivery of a
comprehensive postgraduate program that includes an experiential component.
The NOR-MAN Regional Health Authority has the capability to develop and implement an
innovative and sustainable recruitment response to the challenges encountered in the delivery
of Psychiatric/Mental Health services resulting from a labour shortage. LPNs in the Region have
expressed an interest in related postgraduate education and employment. Postgraduate
Psychiatric/Mental Health programs exist that meet developmental and credentialing
requirements, and there is a vehicle for delivery in the Region. The catalyst for moving forward
and for success is the consolidation and evolution of the partnerships and networks that have
been developed through this exploratory process.
The reality of the health care labour market demands that innovative practices be employed to
develop, support and effectively utilize our human resources. This is particularly true for rural
and northern regions who assume an even greater burden in recruiting and retaining health
care professionals. This conclusion is supported by other initiatives such as the ORNH’s
activities to nurture sustainable human resource development through educational and
recruitment and retention strategies (Manitoba’s Office of Rural and Northern Health, 2007),
and the Manitoba Nursing Strategy Five-Year Progress Report , which has encouraged RHAs to
utilize LPNs in more acute care settings (Manitoba Health, 2005).
The advanced preparation of LPNs in Psychiatry/Mental Health does not suggest a measure of
equivalency with the RPN or RN with respect to depth and breadth of Scope of Practice, and is
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not intended to displace other health care professionals. LPNs are required to work within the
parameters of their Scope of Practice and according to their individual levels of competency. It
is proposed that LPNs can play a complimentary role within a collaborative nursing
framework. This has been demonstrated in this Region, in organizations across the country, and
in other areas of practice.
Recommendations
This report recommends ongoing collaboration between Employment Manitoba, NOR-MAN
Regional Health Authority and University College of the North for the purpose of further
exploration and development of the structure and processes required to establish and deliver an
Advanced Practice Licensed Practical Nurse in Psychiatric/Mental Health credential.
Consultation with and enrolment of stakeholders is required to support this process.
It is important that this recommendation be viewed as part of a whole. Attention needs to be
drawn to the need for a well articulated and multifaceted strategic plan to meet the challenges
of recruitment and retention specific to Psychiatric/Mental Heath human resources. This may
include, but will not be limited to:
•
Maximum utilization of recruitment and retention resources through creative education
and marketing to draw Students and experienced Nurses to the Region.
•
Consultation and collaboration with the Nursing Colleges to enhance regional
recruitment and retention practices.
•
Attention to enhancing the professional support network for regional health care
providers in Psychiatry/Mental Health (i.e., access to consultation/supervision, a
comprehensive orientation process, continuing competency opportunities, etc.).
•
Establishment of a collaborative framework for the delivery of Psychiatric/Mental
Health Nursing based on well defined roles and expectations, including the provision of
interprofessional education.
•
An ongoing commitment to the proactive identification of labour issues, and the
development of sustainable solutions through the delivery of meaningful training and
employment opportunities for Northerners.
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References
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Basford, L. (2005). Mapping Competencies: LPN; RN; RPN on behalf of Calgary Health Region as part
of their Systematic Approach to Maximizing Nursing Scopes of Practice Research Project. University of
Lethbridge, School of Health Sciences. Calgary: Calgary Health Region.
Besner, J., Doran, D., McGills Hall, L., Giovannetti, P., Girard, F., Hill, W., et al. (2005). A
Systematic Approach to Maximizing Nursing Scopes of Practice. Ottawa: Canadian Institute of
Health Research.
Bosco, C. (2005). Health Human Resources in Collaborative Mental Health Care. Mississauga:
Canadian Collaborative Mental Health Initiative.
Canadian Federation of Mental Health Nurses. (2006). Canadian Standards for Psychiatric-Mental
Health Nursing - Standards of Practice. Toronto : First Stage Enterprises.
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http//:www.cfmhn.ca/standards.html
Canadian Nurses Association. (1993). The Scope of Nursing Practice: A Review of Issues and Trends.
Ottawa: Author.
College of Licensed Practical Nurses of Manitoba and Alberta Health and Wellness. (2007).
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Edmonton: Author.
College of Licensed Practical Nurses of Manitoba. (2005). Regulatory Bulletin Scope of Practice and
Accountability. Retrieved June 2007, from http://www.clpnm.ca/content
College of Licensed Practical Nurses of Manitoba. (2002). Scope of Practice Entry-Level
Competencies. Winnipeg: Author.
College of Licensed Practical Nurses of Manitoba. (2004). Standards of Practice. Retrieved May
2007, from College of Licensed Practical Nurses of Manitoba: http://www.clpnm.ca/content
College of Registered Nurses of Manitoba. (2005). Entry Level Competencies for Registered Nurses
in Manitoba. Retrieved May 2007, from College of Registered Nurses of Manitoba:
http://www.crnm.ca
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College of Registered Nurses of Manitoba. (2004). Standards of Practice. Retrieved May 2007,
from College of Registered Nurses of Manitoba: http://www.crnm.ca
College of Registered Psychiatric Nurses of Manitoba. (1993). Standards of Practice. Retrieved
May 2007, from College of Registered Psychiatric Nurses of Manitoba: http://www.crpnm.ca
College of Registered Psychiatric Nurses of Manitoba. (1993). Psychiatric Nursing Competencies.
Retrieved May 2007, from College of Registered Psychiatric Nurses of Manitoba:
http://www.crpnm.ca
Gregory, D., and Gardiner, L. (2005). Blueprint for Health Careers Education in Northern Manitoba:
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Health Canada. (1997). National Nursing Competency Project: Final Report. Ottawa: Author.
Manitoba Center for Health Policy. (2004). Patterns of Regional Mental Illness Disorder Diagnoses
and Service Use in Manitoba: A Population Based Study. Faculty of Medicine, University of
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Department of Community Health Sciences . Winnipeg: Manitoba Health.
Manitoba Government. (2002). Licensed Practical Nurses Regulation. Retrieved July 2007, from
College of Licensed Practical Nurses of Manitba: http://www.clpnm.ca/reg_regulation2.html
Manitoba Government. (2001). The Licensed Practical Nurses Act. Retrieved June 2007, from
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Canada, Phase II Final Report. Ottawa: The Nursing Sector Study Corporation.
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The Alliance on Mental Illness and Mental Health in Manitoba. (2007). News Release: The Alliance
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Appendix A: Tables
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Table 1.0 Nursing Educational Programs
Psychiatric/Mental Health Content
Assiniboine Community
Red River College
College
Diploma Nursing
Practical Nursing Program
(Accelerated)
Course
Cr Term Course
Cr Year/
Hrs
Hrs Term
Mental
3
4
Psychology
3
1/1
Health
Psychology
3
Additional Information:
MH content integrated
into additional courses as
it relates to Gerontology
and Pediatrics.
Enhanced Mental Health
content introduced in
2006/07.
Nursing
Care in
Mental
Health and
Illness
Clinical
Nursing
Practice –
Mental
Health
Component
3
2/6
2
2/6
Additional Information:
MH content integrated
into all course content as it
relates to the area of study.
University of Manitoba
Baccalaureate of Nursing
Program
Course
Cr Year/
Hrs Term
Intro to
6
1
Psychology
(Elective)
Nursing Care
3
4/A
in Mental
Health and
Illness
Clinical
Nursing
Practice 5 –
MH Specific
144 hrs
4
Additional Information:
NURS 2220 Pharmacology in
Nursing Practice – 2.5 hrs on
Psychotropic meds and drug
classifications.
NURS 2230 Health
Promotion of Older Adults
and Their Families – 6.5
hours on MH concerns of the
Elderly.
The BScPN and BScMH content are not included in this comparison given that it is
geared specifically to Psychiatry/Mental Health.
32 Final Report
4/A
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
Table 2.0 Nursing Standards of Practice
Standard I: Provides Competent Professional Care Through The Development of a Therapeutic Relationship.
CFMHN
Standard II: Performs/Refines Client Assessments Through The Diagnostic and Monitoring Function.
Standard III: Administers and Monitors Therapeutic Function.
Standard IV: Effectively Manages Rapidly Changing Situations.
Standard V: Intervenes Through the Teaching Coaching Function.
Standard VI: Monitors and Ensures the Quality of Health Care Providers.
Standard VII: Practices Within Organizational and Work-Role Structure.
CRPNM
STANDARD I: Collects Data Through Pertinent Clinical Observations Based On A Knowledge Of Nursing And The Behavioural
And Physical Sciences.
STANDARD II: Involves The Individual, Family And Appropriate Others In the Assessment, Planning, Implementation and
Evaluation Of The Individual’s Nursing Care Program.
STANDARD III: Uses Problem-Solving In Developing A Psychiatric Nursing Plan.
STANDARD IV: Promotes The Realization Of Optimal Health In Individuals Through Health Teaching.
STANDARD V: Uses Activities Of daily Living In A Goal-Directed way When Interacting With Individuals.
STANDARD VI: Uses Knowledge Of Somatic Therapies And Related Clinical Skills While Working With Individuals.
STANDARD VII: Modifies The Environment To Establish And Maintain A Therapeutic Milieu.
STANDARD VIII: Participates With Members Of The Multi-Disciplinary Team In Assessing, Planning, Implementing and
Evaluating Selected Programs For The Individual.
STANDARD IX: Uses Psychotherapeutic Interventions To Assist The Individual In Achieving Optimal Health.
STANDARD X: Practices As An Accountable Health Professional In Providing Psychiatric Nursing Care.
STANDARD XI: Participates With Members Of The Multi-Disciplinary Team In Community Health Planning.
STANDARD XII: Contributes To The Leadership Of Personnel In The Provision Of Psychiatric Nursing Care.
STANDARD XIII: Assumes Responsibility For Personal And Professional Development And Contributes To The Professional
Growth Of Others.
STANDARD XIV: Contributes To The Development Of Psychiatric Nursing.
33 Final Report
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
STANDARD XV: Understands the provincially and federally sponsored legal Limitations, Statutes and Acts covering his/her
actions as a Registered Psychiatric Nurse functioning in current health systems in Canada.
CRNM
Standard I: Professional Responsibility and Accountability – Registered Nurses are responsible and accountable for their nursing
practice and conduct.
Standard II: Competent Application of Knowledge – Registered Nurses base their practice on the application of current knowledge
from the sciences, the humanities and other disciplines.
Standard III: Competence in Nursing Practice – Registered Nurses use appropriate knowledge, skills, attitudes and judgment in
the practice of nursing.
Standard IV: Communication and Collaboration – Registered Nurses communicate and collaborate with clients, health care
professionals and others in providing nursing services.
Standard V: Ethical Practice – Registered Nurses promote and uphold the ethical standards of the nursing profession.
CLPNM
Standard I: Knowledge – The Licensed Practical Nurse bases practice on knowledge acquired from nursing science and the
humanities.
Standard II: Application of Knowledge, Skills and Judgment – The Licensed Practical Nurse assesses the clients’ actual or potential
strengths and limitations and plans interventions and evaluates outcomes.
Standard III: Professional Service in the Public Interest – The Licensed Practical Nurse provides nursing service and collaborates
with others in providing health care, while respecting individual beliefs.
Standard IV: Ethical Practice – The Licensed Practical Nurse understands, promotes and adheres to the ethical standards of the
nursing profession.
Standard V: Self-Regulation – The Licensed Practical Nurse maintains current knowledge related to the profession.
Standard VI: Continuing Competence – The Licensed Practical Nurse assumes responsibility for attaining and maintaining
competence relevant to his/her own practice.
Standard VII: Professional Responsibility and Accountability – The Licensed Practical Nurse is responsible and accountable for
his/her own practice and conduct.
Standard VIII: Professional Leadership - The Licensed Practical Nurse demonstrates professional leadership in the delivery of
quality nursing and health care services to the public.
34 Final Report
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
Psychology (Term 1)
X
Mental Health (Term 4)
X
X
X
X
X
X
Canadian Nursing Principles (Term 1)
X
X
X
X
X
X
Pharmacology 1 (Term 2)
X
X
Health Restoration and Reorganization 1 (Term 3)
X
Health Restoration and Reorganization 2 (Term 3)
X
X
Human Growth and Development (Term 1)
X
X
Interpersonal Communication (Term 1)
X
X
X
X
Community Nursing (Term 4)
X
X
X
X
Professional Leadership (Term 4)
35 Final Report
Standard VII: Practices Within
Organizational and Work-Role
Structure
Standard VI: Monitors and
Ensures the Quality of Health
Care Practices
X
Standard V: Intervenes Through
the Teaching Coaching Function
X
Standard IV: Effectively
Manages Rapidly Changing
Situations
Curriculum Containing:
Psychiatric/Mental Health Content
Standard III: Administers and
Monitors Therapeutic Functions
Practical Nursing Program
Standard II: Performs/Refines
Client Assessments Through
The Diagnostic and Monitoring
Function
Assiniboine Community College
Standard I: Provides Competent
professional Care Through The
Development of a Therapeutic
Relationship
Table 3.1 Overview of Assiniboine Community College Practical Nursing Program
Psychiatry/Mental Health Curriculum Content Correlated to CFMHN Standards
X
X
X
X
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
Table 3.2 Assiniboine Community College
Psychiatry/Mental Health Related Curriculum Content
Correlated to Canadian Federation of Mental Health Nursing Standards of Practice
Course
Psychology
PSSY-0026
3 Credits
Course Learning Outcomes
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
36 Final Report
Define the science of psychology
Describe the biological basis of behaviour
Integrate the theory of sensation and perception
in client care
Describe the states of consciousness
Describe the theories of learning
Integrate the theory of memory in client care
Describe and integrate the theories of cognition
and mental abilities in client care
Describe motivation and emotion
Describe the personality theories
Integrate the theories of stress and health
psychology in client care
Describe psychological disorders
Describe and integrate therapies in client care
Describe social psychology
Elements of Performance
1.
The learner will be able to define the science of psychology:
1.1. Identify and discuss the science of psychology
1.2. Define psychology
1.3. Identify and describe the fields of psychology
1.4. Describe the goals of psychology
1.5. Identify and describe research methods
1.6. Identify and describe issues of gender, race, culture, ethics
1.7. Identify and describe the early schools of psychology
1.8. Identify career specialist categories
2.
The learner will be able to describe the biological basis of
behaviour:
2.1. Identify and discuss the biological basis of behaviour
2.2. Identify and describe neurons
2.3. Identify and describe the central nervous system
2.4. Identify and describe the peripheral nervous system
2.5. Identify and describe the endocrine system
3.
The learner will be able to integrate the theory of sensation and
perception in client care:
3.1. Identify and discuss sensation and perception
3.2. Describe sensory processes
3.3. Describe vision
3.4. Describe hearing
3.5. Identify and describe the other senses
3.6. Describe perception
4.
The learner will be able to describe the states of consciousness:
4.1. Identify and discuss the states of consciousness
Standard of
Practice
Standard II
Standard III
Standard V
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
4.2. Describe the natural variations in consciousness such as:
daydreaming and fantasy
sleep and dreaming
4.3. Describe the artificial alterations in consciousness such as:
medication
hypnosis
4.4. Describe drug-altered consciousness such as:
depressants
stimulants
hallucinogens and marijuana
37 Final Report
5.
The learner will be able to describe the theories of learning:
5.1. Identify and discuss different types of learning
5.2. Describe classical conditioning including:
Pavlov
elements of classical conditioning
desensitization
5.3. Describe operant conditioning including: Skinner
positive and negative reinforcement
punishment
5.4. Describe cognitive learning including:
latent learning & cognitive maps
insight and learning sets
learning by observing
6.
The learner will be able to integrate the theory of memory in
client care:
6.1. Identify and discuss the theories of memory
6.2. Describe short-term memory
6.3. Describe long-term memory
6.4. Identify techniques to improving memory
7.
The learner will be able to describe and integrate the theories of
cognition and mental abilities in client care:
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
7.1.
7.2.
7.3.
7.4.
7.5.
7.6.
7.7.
7.8.
Define cognition
Identify common strategies used in problem solving
Identify and describe common styles of decision making
Identify and describe intelligence theories
Identify and describe intelligence tests
Identify and describe the determination of intelligence
Identify and describe extremes of intelligence
Describe creativity
8.
The learner will be able to describe motivation and emotion:
8.1. Define motivation
8.2. Identify and describe primary drives
8.3. Identify and describe stimulus motives
8.4. Identify and describe learned motives
8.5. Identify and describe Maslow’s hierarchy
8.6. Define emotions
9.
The learner will be able to describe the personality theories:
9.1. Define and discuss personality
9.2. Identify and describe Psychodynamics Theories such as
those by:
Sigmund Freud
Carl Jung
Alfred Adler
Karen Horney
Erik Erikson
9.3. Define the Humanistics Theory
9.4. Define the Trait Theory
9.5. Define the Social Learning Theory
9.6. Identify and describe the assessment of personality and its
significance to client care
10. The learner will be able to integrate the theories of stress and
health psychology in client care:
38 Final Report
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
10.1.
10.2.
10.3.
10.4.
10.5.
Discuss stress and health psychology
Identify and describe sources of stress
Describe methods of coping with stress
Define and identify defense mechanisms
Identify and describe the psychological and physiological
effects of stress
10.6. Identify and describe sources of extreme stress
11. The learner will be able to describe psychological disorders:
11.1. Discuss the term psychological disorders
11.2. Identify and describe abnormal behaviour
11.3. Identify and describe mood disorders
11.4. Identify and describe anxiety disorders
11.5. Identify and describe psychosomatic disorders
11.6. Identify and describe somatoform disorders
11.7. Identify and describe dissociative disorders
11.8. Identify and describe sexual disorders
11.9. Identify and describe personality disorders
11.10.
Identify and describe schizophrenic
disorders
12. The learner will be able to describe and integrate therapies in
client care:
12.1. Identify and discuss the following therapies:
Insight therapies
Psychoanalysis
Client-centered therapy
Gestalt therapy
Behaviour therapies
Cognitive therapies
Group therapies
Biological treatment
13. The learner will be able to describe social psychology:
39 Final Report
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Mental Health
HLTH-0182
3 Credits
Course Learning Outcomes
1.
2.
The learner will be able to explain concepts
associated with mental health.
The learner will be able to discuss the following
theories and therapies:
Historical theories
Developmental theories and therapies
Humanistic theories and therapies
Systems theories
Behavioural therapies and theories
Cognitive theories
Psychotherapies
Somatic therapies
3.
The learner will be able to discuss caregiver’s
therapeutic skills
4.
The learner will be able to distinguish Mental
Health Problems Throughout the Lifecycle
5.
The learner will be able to identify
Elements of Performance
1.
Standard of
Practice
Standard I
Standard II
Standard III
Standard IV
2.
3.
40 Final Report
13.1. Discuss the term social psychology
13.2. Describe social cognition including:
13.2.1.1.1.
formation of impressions
13.2.1.1.2.
attributions
13.2.1.1.3.
interpersonal attraction
13.3. Describe attitudes
13.4. Identify and describe prejudice and discrimination
13.5. Describe social influence including:
cultural
conformity
compliance
obedience
13.6. Describe social action
The learner will be able to explain concepts associated with
mental health.
1.1. Compare and contrast the Past and Present
The historical treatment of the mentally ill
1.2. Identify and describe Ethical and legal issues
Manitoba Legislation
1.3. Identify Socio-cultural considerations
July 31, 2007
The learner will be able to discuss the following theories and
therapies:
Historical theories
Developmental theories and therapies
Humanistic theories and therapies
Systems theories
Behavioural therapies and theories
Cognitive theories
Psychotherapies
Somatic therapies
The learner will be able to discuss caregiver’s therapeutic skills
3.1. Identify the skills and principles of mental health care
Standard V
Standard VI
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
3.2. Describe and conduct a mental health assessment
Mental State Exam
Mental health treatment plan
DSM-IV
3.3. Identify and implement therapeutic communication
3.4. Describe the therapeutic relationship
3.5. Describe the therapeutic environment
psychological problems
6.
41 Final Report
The learner will be able to integrate theory to
the care of clients with psychosocial problems
4.
The learner will be able to distinguish Mental Health Problems
Throughout the Lifecycle
4.1. Describe problems of childhood
ADHD
Conduct disorder
Eating disorder
Developmental delay
Learning disorder
Communications disorders/autism
Schizophrenia
4.2. Describe problems of adolescence
Behavioral disorders
Emotional disorders
Eating disorders
Chemical dependency
Personality disorders
Sexual disorders
Psychosis
Suicide
4.3. Describe problems of adulthood
Developmental problems
Environmental problems
5.
The learner will be able to identify the following psychological
problems
5.1. Anxiety
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
5.2.
5.3.
5.4.
5.5.
Panic disorders
Obsessive-compulsive disorder
Post traumatic stress disorder
Depression
Bipolar disease
ECT
5.6. Mind-body link
Role of emotions
Anxiety and stress
Psychophysical disorder
Somatization disorder
Conversion disorder
5.7. Eating and sleeping disorders
Anorexia nervosa
Obesity
Other eating disorders
Dyssomnias
Parasomnias
Other sleep disorders
5.8. Dissociative disorders
6.
42 Final Report
The learner will be able to integrate theory to the care of clients
with psychosocial problems including the following
6.1. Anger and aggression
Theories of anger and aggression
Cycle of assault
Anger control disorders
6.2. Violent behaviour
Social factors
Theories
Abuse within the family
Abuse within the community
Mental health issues related to violence
6.3. Suicide
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
6.4.
6.5.
6.6.
6.7.
Canadian Nursing
Principles
HLTH-0183
3 Credits
1.
2.
3.
4.
5.
Summarize the concepts of health and holistic
wellness, including the components of optimal
health
Demonstrate awareness of issues associated
with Canada’s healthcare system, past and
present
Describe Practical Nursing as a profession
Integrate the nurseʹs perspective into nursing
care
Integrate cultural considerations into practice
1.
2.
43 Final Report
July 31, 2007
Standard of
Practice
Impact
Dynamics
Therapeutic interventions
Substance Abuse
Alcoholism
Other substance disorders
Sexual disorders
Personality disorders
Clusters of personality disorder
Schizophrenia
Subtypes of schizophrenia
Other psychoses
Therapeutic interventions
The learner will be able to summarize the concepts of health,
including the components of optimal health:
1.1. Discuss ways that definitions of health have been
conceptualized
1.2. Describe the key characteristics of medical, behavioural,
and socio-environmental approaches to health
1.3. Discuss key health determinants and their
interrelationships in influencing health
1.4. Discuss factors that influences the following components of
self-concept: identity, body image and role performance
1.5. Identify stressors that affect self-concept and self-esteem
1.6. Describe the components of self-concept as related to
psychological and cognitive developmental stages
1.7. Explore ways in which the nurse’s self-concept and nursing
actions can affect the clients self-concept and self-esteem
The learner will be able to demonstrate awareness of issues
associated with Canada’s healthcare system, past and present:
2.1. Discuss the following topics in association with Canadaʹs
health care system past and present:
Standard I
Standard II
Standard III
Standard IV
Standard V
Standard VI
Standard VII
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
history
structure & functioning
financing of the system
exploring personal view on the existing system
health care in Manitoba
threats to the health care system
recent and proposed changes to the health care
system
2.2. List and explore determinants of health.
44 Final Report
3.
The learner will be able to describe Practical Nursing as a
profession:
3.1. Describe the history of nursing
3.2. Discuss the basis for practice
3.3. Discuss theoretical foundations of nursing practice
3.4. Describe the code of ethics
3.5. Discuss caring in relation to nursing practice
Patientʹs Bill of Rights
Client as partner
Confidentiality
4.
The learner will be able to integrate the nurseʹs perspective into
nursing care:
4.1. Demonstrate reorganizing client data to integrate obtained
information utilizing the following steps of the nursing
process:
assessment
diagnosis
planning
implementation
evaluation
4.2. Discuss and demonstrate problem solving
4.3. Discuss and demonstrate critical thinking
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Pharmacology 1
HLTH-0184
3 Credits
Course Learning Outcomes
1.
2.
3.
4.
5.
45 Final Report
Identify pharmaceutical concepts
Understand the general principles of
pharmacology
Apply principles of drug therapy safely and
appropriately
Differentiate between client individuality and
drug therapy
Discuss the classifications of drugs and clinical
aspects of pharmacology
Elements of Performance
5.
The learner will be able to integrate cultural considerations into
practice:
5.1. Discuss the concept of cultural conflicts
5.2. Discuss the concept of cultural awareness
5.3. Discuss transcultural nursing
1.
The learner will be able to identify pharmaceutical concepts:
1.1. Identify and describe pharmaceutical concepts through an
introduction to pharmacology
1.2. Review and demonstrate mathematical skills and
knowledge of dosage measurement systems
1.3. Define and have knowledge the pharmacology language,
drug labels and packaging, sources of information
1.4. Discuss and apply legal/ethical issues
2.
The learner will be able to understand the general principles of
pharmacology:
2.1. Discuss and demonstrate knowledge of pharmaceutics
2.2. Discuss and demonstrate knowledge of sources of drugs,
drug routes, dosage forms and preparations, drug stability
and storage
2.3. Discuss and demonstrate knowledge of pharmacokinetics
(drug movement through the body)
2.4. Discuss and demonstrate knowledge of
pharmacodynamics (drug actions and effects)
3.
The learner will be able to apply principles of drug therapy
safely and appropriately
3.1. Discuss and demonstrate knowledge of the nursing
process
3.2. Discuss and demonstrate knowledge of drug preparation
and administration
Oral Medications
Respiratory medications (inhalers nebulizers)
July 31, 2007
Standard of
Practice
Standard I
Standard II
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
GI medications (suppositories, enemas)
Parental medications (subcutaneous [intermittent]
injection sites} intramuscular, intradermal)
46 Final Report
4.
The learner will be able to differentiates between client
individuality and drug therapy by demonstrating an application
of knowledge of the following:
4.1. Cultural influences
4.2. Psychosocial factors
4.3. Self-treatment
4.4. Substance abuse/addiction
Narcotics
Sedatives
Laxatives
4.5. Elderly
4.6. Drug therapy in home
5.
The learner will be able to discuss the classification of drugs and
apply clinical aspects of pharmacology to:
5.1. Drugs that affect the central nervous system
Antipsychotics
Antiparkinsonism agents
Sedatives
NSAID’s
5.2. Drugs that affect the cardiovascular system
Cardiac glycosides (Digoxin)
Anitarrhythmic drugs
Antihypertensive drugs
Drugs affecting plasma lipids and coagulation
factors
5.3. Drugs that affect the respiratory system
Inhalers, nebulizers, aerochambers
All drug categories
5.4. Drugs that affect the renal system
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Health
Restoration and
Reorganization 1
HLTH- 0133
Course Learning Outcomes
1.
Discuss and identify Immune, Infection and
Cancer
2. Discuss and identify Respiratory Conditions
3. Discuss and identify Cardiovascular Conditions
4. Discuss gastrointestinal Conditions
5. Describe Metabolic/Endocrine Conditions
6. Describe Genitourinary/Reproductive
Conditions
7. Describe Integumentary Conditions
8. Recognize Musculoskeletal Conditions
9. Describe Neurological Conditions
10. Describe Sensorineural Conditions
11. Describe Psychosocial Conditions
Elements of Performance
1.
2.
47 Final Report
Diuretics (lasix HCTZ)
5.5. Drugs that affect the endocrine system
Brief over view of Diabetes Mellitis
Hyperglycemia and hypoglycaemia
Insulin, hypoglycemic agents
Emergency care for DM
Subcutaneous injections of insulin
5.6. Drugs that affect the gastrointestinal system
Laxatives (theory)
Suppositories, enemas
NG medication administration
5.7. Drugs that affect the sensory system
Eye, ear nose medications
Instillation of eye drops ear drops, nasal sprays
The learner will discuss aspects of immunity, infection, and
cancer. Identify and explain the signs and symptoms of the
identified areas.
Autoimmune Disease
Chronic Fatigue
Fibromyalgia
Systemic Lupus Erythmatosis
Lymphatic System Disturbance
Infection
Super-infections
Antibiotic Resistant Infections
HIV/AIDS
Cancer
Pathophysiology
Management
Radiation
Surgery
Chemotherapy
The learner will discuss aspects of respiratory, identify the
July 31, 2007
Standard of
Practice
Standard II
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
appropriate conditions properly and assess the condition for
each stated area.
2.1. Upper Airway Obstruction
Tracheostomy
2.2. Chest Trauma
Hemothorax
Pneumothorax
2.3. Atelectasis and Pleural Effusion
2.4. Pulmonary Edema
2.5. Thoracic Surgery
2.6. Acute Respiratory Failure
2.7. Adult Respiratory Distress Syndrome
Blood Gases
2.8. Upper and Lower Airway Infections
Bronchitis
Pneumonia
2.9. Tuberculosis
2.10. Chronic Obstructive Pulmonary Disease
Chronic Bronchitis
Emphysema
3.
48 Final Report
The learner will discuss aspects of the cardiovascular system,
identify the differences and similarities in the following stated
conditions and describe the interactions of the disease
conditions.
3.1. Coronary Artery Disease
3.2. Peripheral Vascular Disease
Vascular Surgery
3.3. Deep Vein Thrombosis
3.4. Embolism
3.5. Hypertension
3.6. Angina
3.7. Myocardial Infarction
3.8. Congestive Heart Failure
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
3.9.
3.10.
3.11.
3.12.
3.13.
49 Final Report
Carditis
Anemia
Cerebral Vascular Accident
Aneurysm
Shock
Hypovolemic
Obstructive
Distributive
Cardiogenic
4.
The learner will describe the actions of the gastrointestinal
system and its role in proper digestion and identify implications
of alternatives to this system as it pertains to the stated topics.
4.1. Obesity
4.2. Hiatus Hernia
4.3. Gastritis
4.4. Ulcer
4.5. Diverticulosis
4.6. Irritable Bowel
4.7. Inflammatory Bowel Disease
Crohn’s
Colitis
4.8. Intestinal Obstruction
4.9. Abdominal Surgery
Gastric
Laparotomy
Colostomy/Ileostomy
Hernia Repair
Peritonitis
4.10. Hemorrhoids
5.
The learner will describe the functions of the
metabolic/endocrine system and its interactions with total body
systems.
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
5.1. Thyroid Conditions
Hypothyroid
Hyperthyroid
Thyroid Storm
5.2. Pancreatitis
5.3. Diabetes in Adults
5.4. Cholecystitis
5.5. Hepatitis
Viral
Other
6.
50 Final Report
The learner will describe the functions of the
genitourinary/reproductive systems, interactions in body
systems and be able to implement care based on this knowledge.
6.1. Cystitis
6.2. Nephritis
Cystostomy
Acute glomerulonephritis
6.3. Renal Calculi
6.4. Renal Failure
6.5. Dialysis
6.6. Fluid and Electrolytes
6.7. Prostate
Prostatitis
Benign Prostatic Hypertrophy
Prostate surgery
6.8. Gynecologic Conditions
Endometriosis
Pelvic Inflammatory Disease
Ovarian cysts
Hysterectomy and Oophorectomy
Bladder repair
Breast Surgery
Mastectomy
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
Reduction/Augmentation
Menopause
51 Final Report
7.
The learner will describe the integumentary system and the
effects of disease on this system.
7.1. Psoriasis
7.2. Herpes Zoster
7.3. Skin Cancer
Basal cell and Squamous cell cancer
Malignant Melanoma
7.4. Burns
Describe the effect of burns and the implications of body
system failures as the result of same.
8.
The learner will recognize the organizational structure of the
musculoskeletal system and the effects of disease as it relates to
this system.
8.1. Gout
8.2. Degenerative conditions
Osteoporosis
Degenerative Disc
8.3. Musculoskeletal Injury
Fractures
Types
Treatment
Traction
Casts
8.3.1.
Soft Tissue
8.3.2.
Dislocations
8.4. Orthopedic Surgery
Disc Surgery
Amputation
Joint Replacement
8.5. Musculoskeletal Infections
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
Osteomyelitis
Necrotizing fascititis
8.6. Arthritic Conditions
Osteoarthritis
Rheumatoid Arthritis
Psoriatic Arthritic
9.
The learner will describe the neurological system and the effects
altered brain function as it relates to thought process and body
function.
9.1. increased Intracranial Pressure
Crani checks
Shunts
9.2. Headaches
Migraine
9.3. Spinal Cord Injuries
Whiplash
Hemi-, para-, quadriplegia
9.4. Neurological Conditions
Bell’s palsy
Multiple Sclerosis
Huntington’s Chorea
Amyotrophic Lateral Sclerosis
Parkinson’s Disease
10. The learner will describe the effects of sensorineural alterations
as it relates to physical interactions and body function.
Glaucoma
Cataracts
Meniere’s Disease
11. Describe the psychosocial system and its effect on wellness. The
learner will also have an understanding of altered mental states
on the healing process.
52 Final Report
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Health
Restoration and
Reorganization 2
HLTH- 0134
53 Final Report
Course Learning Outcomes
1.
Describe and integrate the principles of
Maternity in conditions Musculoskeletal client
care including:
Normal antepartum complications
Intrapartum complications
Normal postpartum complications:
maternal and infant
2.
Describe and integrate the principles of
Newborn nursing in client care including;
2.1. Assessment
2.2. Infant feeding
3.
Describe and integrate the principles of nursing
children in client care including;
3.1. Immune, Infection and Cancer
3.2. Respiratory Conditions
3.3. Cardiovascular Conditions
3.4. Gastrointestinal Conditions
3.5. Metabolic/Endocrine Conditions
3.6. Genitourinary/Reproductive Conditions
3.7. Integumentary Conditions
Elements of Performance
1.
11.1. Sick role
Patient compliance
11.2. Pain
Acute and Chronic
Management
11.3. Rehabilitation
Physiotherapy
Occupational Therapy
Speech Therapy
Diversional Therapy
11.4. Drug and Alcohol Abuse
Management of Withdrawal
The learner will be able to describe and integrate the principles
of Maternity in client care including:
1.1. Identify and describe the signs and symptoms, assessment,
and treatments associated with normal antepartum care
including;
Childbirth preparation
Preparation for breastfeeding
Tests in pregnancy - ultrasound, HCG, AFP,
amniocentesis, chorionic villi sampling, genetic
testing
Common medications
Complications
Pregnancy-induced hypertension
Gestational diabetes
Placenta previa
Abruptio placenta
Ectopic pregnancy
Abortion
Hydatidiform mole
Group B Streptococcus
1.2. Identify and describe the signs and symptoms, assessment,
and treatments associated with normal Intrapartum care
July 31, 2007
Standard of
Practice
Standard II
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
3.8.
3.9.
3.10.
3.11.
Elements of Performance
Neurological Conditions
Musculoskeletal Conditions
Sensorineural Conditions
Psychosocial Conditions
including;
Stages of labour
Birthing positions
Vaginal delivery
Breech delivery
Cesarean delivery
Pain relief
Medications
Complications
Episiotomy
Forceps
Vacuum extractor
Fetal heart monitoring
Intermittent Auscultation
Continuous Electronic Fetal Monitoring
1.3. Identify and describe the signs and symptoms, assessment,
and treatments associated with Normal post partum care
including;
Maternal changes- uterus, breasts, fluid balance,
lochia
Normal infant- appearance, behavior, tests, PKU
Other- bonding, rooming-in, family relationships
BUBBLEHEV assessment (Breast, Uterus, Bowel,
Bladder, Lochia, Episiotomy, Homans sign,
Emotional, Vital signs)
Complications: maternal and infant
Maternal- postpartum hemorrhage, postpartum
thrombophlebitis, anemia, postpartum depression
Infant- jaundice, sleepy baby, circumcision, colic,
ankyloglossia (tongue tie), withdrawal
2.
54 Final Report
The learner will identify and describe the signs and symptoms,
assessment, and treatments involved in family centered newborn
care including;
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
2.1. Assessment. initial assessment, ongoing assessments
2.2. Infant feeding
Breastfeeding- latching on, positioning, feeding
patterns, intake/output, challenges: poor latch,
sleepy baby, overactive letdown, .Breast pump,
finger feeding, supplemental nursing system
Formula feeding- types, methods, challenges:
overfeeding, milk intolerance, etc.
3.
55 Final Report
The learner will be able to describe and integrate the principles
of nursing children in client care:
Identify and describe the signs and symptoms, assessment,
and treatments associated with the following common
childhood ailments:
3.1. immune, infection and cancer
communicable diseases- diphtheria, invasive
haemophilus influenzae type b infections, hepatitis
b, measles, mumps, pertussis, poliomyelitis,
rubella, tetanus, chicken pox
leukemia
mononucleosis
allergies- allergic rhinitis, food allergies,
environmental allergies
3.2. respiratory conditions:
croup(acute tracheobronchitis)
epiglottitis
tonsillitis
asthma
respiratory syncytial virus
sudden infant death syndrome
3.3. cardiovascular conditions:
congenital heart disease
hemophilia
3.4. gastrointestinal conditions:
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
3.5.
3.6.
3.7.
3.8.
3.9.
3.10.
3.11.
56 Final Report
pyloric stenosis
gastroenteritis
appendicitis
metabolic/endocrine conditions:
diabetes- ketoacidosis, hyperglycemia,
hypoglycemia, diet/exercise
cystic fibrosis
CPT-1, Gluterc Acidemia, PKU
genitourinary/reproductive conditions:
sexually transmitted infections
adolescent pregnancy
hypospadias
epispadias
umbilical hernia
inguinal hernia
hydrocele
testicular torsion
integumentary conditions:
warts
dermatitis- acne vulgaris, eczema, impetigo,
ringworm, scabies
musculoskeletal conditions:
cleft lip/palate
congenital hip dislocation
club foot
neurological conditions:
acute head injuries- concussion, skull fracture
Seizure disorders
neural tube defects- spina bifida
cerebral palsy
meningitis
sensorineural conditions:
otitis media
psychosocial conditions:
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
July 31, 2007
Standard of
Practice
fetal alcohol syndrome
failure to thrive
child with special needs- ADD and ADHD
child abuse/ neglect – shaken baby syndrome
hospitalized child – play therapy, separation
anxiety, family involvement in care, child life
specialists
eating disorders- obesity, undernourished
adolescent depression/ suicide
Human Growth
and Development
HLTH-0007
3 Credits
57 Final Report
1.
Relate the impact that heredity and
environment had on human development
2. Identify and discuss the stages and events
associated with prenatal development and birth
3. Identify and discuss the stages and events
associated with the first two years
4. Identify and discuss the stages and events
associated with toddlers and pre-schoolers: two
to five years
5. Identify and discuss the stages and events
associated with middle childhood: six to the
years
6. Identify and discuss the stages and events
associated with adolescence
7. Identify and discuss the stages and events
associated with early adulthood
8. Identify and discuss the stages and events
associated with middle adulthood
9. Identify and discuss the stages and events
associated with late adulthood
10. Describe family structure and development
1.
The learner will be able to relate the impact that heredity and
environment has on human development:
1.1. Describe sex determination
1.2. Describe monozygotic and dizygotic twins
1.3. Describe genotype and phenotype
1.4. Describe mendellian, polygenic, and multifactoral traits
1.5. Identify and describe environmental influences on
development
1.6. Identify and describe hereditary influences on
development
1.7. Identify and describe chromosomal, genetic, and
teratogenic disorders
2.
The learner will be able to identify and discuss the stages and
events associated with prenatal development and birth:
2.1. Describe the fetal period of development
2.2. Identify and describe potential complications in
development
2.3. Describe and demonstrate the assessment of the newborn
2.4. Describe birth as a family event
3.
The learner will be able to identify and discuss the stages and
events associated with the first two years:
3.1. Identify and describe the size and shape of the newborn
Standard I
Standard II
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
and changes in the first two years
Describe brain development
Describe sensory and motor development
Describe nutrition
Describe piaget’s stages of sensorimotor development
Describe language development
Describe emotional development
Describe Erikson’s origins of personality: trust vs. mistrust
and autonomy vs. shame and doubt
3.9. Identify and describe attachment, neglect, and abuse
3.2.
3.3.
3.4.
3.5.
3.6.
3.7.
3.8.
58 Final Report
4.
The learner will be able to identify and discuss the stages and
events associated with toddlers and pre-schoolers: two to five
years:
4.1. Identify and describe physical changes to size and shape
4.2. Describe brain maturation
4.3. Identify and describe play and gender influences on motor
development
4.4. Describe preoperational thinking
4.5. Describe language development
4.6. Describe initiative vs. guilt in social development
4.7. Identify and describe parenting styles
5.
The learner will be able to identify and discuss the stages and
events associated with middle childhood: six to ten years:
5.1. Identify and describe physical changes in size and shape
5.2. Describe motor skill development
5.3. Describe concrete operational thinking
5.4. Identify and describe peer group influence on social
development
6.
The learner will be able to identify and discuss the stages and
events associated with adolescence:
6.1. Identify and describe physical changes at puberty
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
6.2. Describe timing of puberty and its effects
6.3. Describe formal operational thinking
6.4. Describe adolescent egocentrism, invincibility, imaginary
audience, and personal fable
6.5. Describe sexual decision making
6.6. Describe identity development
6.7. Describe family and friends influence on development
6.8. Describe drug abuse, suicide, delinquency, sexual abuse
59 Final Report
7.
The learner will be able to identify and discuss the stages and
events associated with early adulthood:
7.1. Identify and describe physical changes in growth, strength,
endurance, health
7.2. Identify and describe sexual issues
7.3. Describe dieting
7.4. Describe adult thinking
7.5. Describe adult moral reasoning
7.6. Describe social development: intimacy vs. isolation and
generativity vs. stagnation
8.
The learner will be able to identify and discuss the stages and
events associated with middle adulthood:
8.1. Identify and describe physical changes
8.2. Describe mortality, morbidity and vitality
8.3. Describe stress and other health risks
8.4. Describe menopause and andropause
8.5. Describe changes in cognitive skills
8.6. Describe midlife changes
8.7. Describe family changes
9.
The learner will be able to identify and discuss the stages and
events associated with late adulthood:
9.1. Describe ageism
9.2. Describe the aging process
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
9.3.
9.4.
9.5.
9.6.
9.7.
9.8.
July 31, 2007
Standard of
Practice
Identify and discuss theories on aging
Discuss extending life
Describe changes in cognitive skills
Describe generativity in late adulthood
Describe affiliation
Identify and describe elder abuse
10. The learner will be able to describe family structure and
development:
10.1. Identify and describe theories of families
10.2. Describe the assessment of family dynamics
Functional
dysfunctional
Interpersonal
Communication
COMM-0038
3 Credits
60 Final Report
1.
2.
Apply the communication process
Demonstrate self awareness with regard to
verbal/nonverbal communication
3. Utilize basic communication and interviewing
skills by using effective communication
strategies
4. Apply skills necessary for interaction with a
client who has special communication needs
5. Utilize Watson’s Carative Communication
Behaviours
6. Communicate professionally
7. Integrate cultural considerations in
communication
8. Recognize the phases of the helping relationship
9. Discuss and distinguish assertive and
aggressive behaviours in nursing
10. Discuss the impact of group dynamics on
communication
1.
2.
The learner will be able to apply the communication process:
1.1. Describe the communication process.
1.2. Define communication
1.3. Describe levels of communication
Identify and describe intrapersonal communication
Identify and describe interpersonal communication
Identify and describe public communication
1.4. Define elements of the communication process in regards
to the following:referent/stimulus
sender/encoder
message
channels
receiver/decoder
feedback
The learner will be able to demonstrate self awareness with
regard to verbal/nonverbal communication:
2.1. Describe and demonstrate self awareness with regard to
verbal/nonverbal communication.
2.2. Describe the concept of nonverbal communication
Standard I
Standard II
Standard III
Standard IV
Standard V
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
2.3. Describe the concept of verbal communication
2.4. Describe and demonstrate heightened self-awareness using
verbal and nonverbal skills
61 Final Report
3.
The learner will be able to utilize basic communication and
interviewing skills by using effective communication strategies:
3.1. Describe and demonstrate basic communication and
interviewing skills by using effective communication
strategies.
3.2. Describe and demonstrate the following effective
communication strategies:
therapeutic communication strategies
attentive listening
conveying acceptance
asking related questions
paraphrasing
clarifying
focusing
offering information
maintaining silence
using assertiveness
summarizing
3.3. Identify and describe the following barriers to effective
communication:
identifying barriers to effective communication
giving an opinion
offering false reassurance
being defensive
showing approval or disapproval
stereotyping
asking why
changing the subject inappropriately
4.
The learner will be able to apply skills necessary for interaction
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
with a client who has special communication needs:
4.1. Describe and demonstrate methods of communicating with
a client who has special communication needs.
62 Final Report
5.
The learner will be able to utilize Watson’s Carative
Communication Behaviours:
5.1. Identify and describe Watson’s Carative Communication
Behaviours
5.2. Discuss caring and the significance of
warmth
respect
genuineness
empathy
6.
The learner will be able to communicate professionally:
6.1. Identify, describe and demonstrate professional
communication as it relates to the following:
documentation
presentations
reporting
written
telephone
computer
7.
The learner will be able to integrate cultural considerations in
communication:
7.1. Describe cultural considerations relating to
communications
7.2. Describe personal experiences with cultural difficulties
8.
The learner will be able to recognize the phases of the helping
relationship:
8.1. Describe the following phases of the helping relationship:
preorientation phase
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
July 31, 2007
Standard of
Practice
orientation phase
working phase
termination
9.
The learner will be able to discuss and distinguish assertive and
aggressive behaviours in nursing:
9.1. Identify and describe the following behaviours in nursing:
assertive
non-assertive
aggressive
10. The learner will be able to discuss the impact of group dynamics
on communication:
10.1. Describe the impact of group dynamics on communication.
10.2. Describe the concept of group processes
10.3. Verbalize the importance of group dynamics in the field of
nursing
10.4. Identify the advantages and disadvantages of working in
groups
Community
Nursing
HLTH- 0019
3 Credits
1.
2.
3.
4.
5.
Integrate theory of nursing in the community
into client care
Judge the determinants of health in a
community perspective
Manage case management during the client
transition from facility to community and in the
community
Manage communicable disease prevention in
the community
Integrate alternative approaches to health in
client care
1.
2.
63 Final Report
The learner will be able to integrate theory of nursing in the
community into client care:
1.1. Compare and describe nursing in the community to
nursing in a facility
1.2. Identify and describe the scope of practice: roles &
responsibilities of community nursing
1.3. Identify and discuss available community resources
1.4. Describe client advocacy
1.5. Identify and describe legal and ethical considerations
1.6. Describe and demonstrate effective communication
1.7. Describe appreciation of cultural diversity
The learner will be able to judge the determinants of health in a
community perspective:
Standard I
Standard II
Standard III
Standard V
Standard VI
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Course Learning Outcomes
Elements of Performance
2.1. Assess a community as “client” at a beginning level
focusing on those factors, beyond health services, which
impact on health and affect a community’s development
including:
Factors which determine our health
Strategies for action: individual, family,
community
64 Final Report
3.
The learner will be able to manage case management during the
client transition from facility to community and in the
community:
3.1. Describe the transition between facility and community
and the role of coordination including:
Definitions, roles of community nursing
Discharge planning and case management
Coordinating care in the community
4.
The learner will be able to manage communicable disease
prevention in the community:
4.1. Identify and describe the prevention of communicable
diseases in the community including the following topics:
Common diseases and modes of transmission
Reportable vs. non-reportable diseases
Communication
Legal and ethical considerations
Care planning, roles & responsibilities
Prevention strategies in the community i.e.
immunization
5.
The learner will be able to integrate alternative approaches to
health in client care
5.1. Identify and describe complementary therapies and
cultural approaches and beliefs about health maintenance
including the following topics:
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
Professional
Leadership
PEDV- 0011
3 Credits
Course Learning Outcomes
1.
2.
3.
4.
5.
6.
65 Final Report
Integrate the elements of career management
into future nursing profession.
Integrate the responsibilities associated with the
profession of practical nursing
Employ leadership skills in nursing profession
Apply criminal and civil laws as they apply to
nursing in nursing career
Integrate a legal and political awareness in
nursing career.
Reflect and integrate ethical considerations into
practice.
Elements of Performance
1.
Advocacy
Cultural diversity
Legal and ethical considerations
The learner will be able to integrate the elements of career
management into future nursing profession:
1.1. Identify and describe personal career goals and strategies
for job search
1.2. Describe and demonstrate resume writing, cover letter,
interview strategies
1.3. Describe a performance appraisal
2.
The learner will be able to integrate the responsibilities
associated with the profession of practical nursing:
2.1. Describe the responsibilities associated with the profession
of practical nursing
2.2. Identify and describe the role of the practical nurse
2.3. Define and describe contractual agreements
2.4. Describe the role of the individual in policy & procedure
development
2.5. Relate the significance of the professional association and
interest groups
2.6. Describe the political process within the professional
association
3.
The learner will be able to employ leadership skills in nursing
profession:
3.1. Discuss responsibilities in taking charge of a health care
unit – the use of power; development and maintenance of
teams, perception of fairness
3.2. Describe delegating/coaching employees
3.3. Identify and describe conflict management.
3.4. Describe care planning
3.5. Describe the responsibilities of LPN charge nurse
July 31, 2007
Standard of
Practice
Standard VI
Standard VII
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Course
66 Final Report
Course Learning Outcomes
Elements of Performance
4.
The learner will be able to apply criminal and civil laws as they
apply to nursing in nursing career:
4.1. Describe the implications of the criminal & civil law
4.2. Identify and describe employee rights; nurse abuse
4.3. Define and describe negligence, misconduct & malpractice
4.4. Discuss labour relations – unionization issues.
5.
The learner will be able to integrate a legal and political
awareness in nursing career:
5.1. Discuss the implications of legal and political awareness
5.2. Discuss the public perception of the nursing profession
5.3. Describe public policy
6.
The learner will be able to integrate ethical considerations into
practice.
6.1.
Describe ethics and law
6.2. Examine ethical principles
6.3. Discuss current issues
End of Life Decisions/Choices
6.4. Discuss gender perspective
July 31, 2007
Standard of
Practice
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
Table 4.1 Overview of Competency Profiles
CLPNM (2001)
CRNM (2005)
Competency Area A – Provides
Competent, Professional Care
COMPETENCY No. 1: DEMONSTRATES
PROFESSIONAL CHARACTERISTICS
Competency Area A – Provides
Competent, Professional Care
COMPETENCY No. 2: CONTRIBUTES TO
THE HEALTH OF MANITOBANS AND
THE DEVELOPMENT OF THE
PROVISION OF NURSING SERVICES
Competency Area – C Recognizes
Responsibility in Continuous Learning
Competency Area – D Performs and
Refines Client Assessments
Competency Area – E Develops ClientFocused Care
Competency Area – F Intervention:
Implementation
Competency Area – G Intervention:
Communication
Competency Area – H Intervention:
Teaches and Verifies Learning
Competency Area – I Evaluates Client
Progress
67 Final Report
COMPETENCY No. 3: PERFORMS AND
REFINES CLIENT ASSESSMENTS
COMPETENCY No. 4: DEVELOPS CLIENTFOCUSED PLANS OF CARE
COMPETENCY No. 5: INTERVENES –
APPLIES
PROFESSIONAL KNOWLEDGE
COMPETENCY No. 6: INTERVENES –
COMMUNICATES WITH INDIVIDUALS,
FAMILIES, GROUPS AND COMMUNITIES
COMPETENCY No. 7: INTERVENES –
TEACHES AND VERIFIES LEARNING
COMPETENCY No. 8: EVALUATES CLIENT
CRPNM (1993)
1. Psychiatric Nursing Interventions
Psychiatric Nursing, as a distinct profession,
provides service to individuals whose primary care
needs relate to mental and developmental health. The
RPN seeks to develop a unique client-centered
therapeutic relationship through application of
knowledge of psychiatric nursing, physical health
and psycho-social well-being.
2. Therapeutic Use of Self
The RPN is aware of his/her self and any positive or
negative attitudes engendered towards the client and
acts appropriately. The R.P.N. uses communication
skills to establish and promote the therapeutic
relationship, teach appropriate health care and
promote maximum health with the client.
3. Modification of the Environment
The RPN, using a theoretical and experiential base,
evaluates, plans and modifies the client’s
environment to promote self responsibility and
optimal health.
4. Self-Care Activities
The RPN promotes client responsibility and
independence to the maximum of his/her potential,
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
CLPNM (2001)
CRNM (2005)
PROGRESS AND OUTCOMES OF CARE
Competency Area – J Organizes Care
Delivery
Competency Area – K Partnerships
COMPETENCY No. 9: ORGANIZES CARE
DELIVERY FOR SELF AND TEAM
MEMBERS
COMPETENCY No. 10: PRACTICES
COLLABORATIVELY IN THE HEALTH
CARE SYSTEM
July 31, 2007
CRPNM (1993)
while respecting the client’s right to selfdetermination, privacy and safety.
5. Physiological Nursing Interventions
The RPN utilizes knowledge of physical and related
sciences when assessing, planning, implementing
and evaluating care relating to the client’s physical
needs.
6. Promotion of Health and Prevention of Illness
The RPN utilizes health teaching in all components of
care for clients, families and groups to build on
existing strengths and to achieve productive patterns
of living.
7. Utilization of Health Care Systems and
Community Resources
The RPN participates in and provides leadership in
order to establish community resources for the
promotion of mental health.
8. Professional Practice
The RPN practices in accordance with the Standards
of Practice and Code of Ethics of the R.P.N.A.M. and
the legislation in effect in Canada.
68 Final Report
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Table 4.2 Competency Clusters – Commonality Between Nursing Designations
Competency
CLPNM (2001)
CRNM (2005)
CRPNM (1993)
A-1 Identifies effects of own values and
assumptions on interactions with client by:
a) Providing client care in a non-judgemental
manner.
b) Respecting clients’ rights to selfdetermination, informed decisions and
directives.
1.1 Identifies the effects of own values and
assumptions on interactions with clients.
A-2 Understands the ethical framework
behind the nurse-client relationship by:
a) Demonstrating respect, empathy, trust and
honesty in interactions with client.
b) Listening to, understanding and respecting
clients’ values, opinions, needs and ethnocultural beliefs.
c) Providing care that demonstrates
sensitivity to client diversity.
d) Seeking to broaden understanding of
cultural concepts and issues.
e) Maintaining the therapeutic nurse-client
relationship from initiation to conclusion of
care.
f) Understanding the difference between
personal and professional relationships and
behaviours.
1.3 Provides care that demonstrates
sensitivity to clientsʹ diversity.
1.11 Demonstrates receptiveness to
suggestions and new information.
1.6 Promotes rights and responsibilities
regarding the health of individuals,
families, groups, populations and
communities.
1.12 Discusses observations, insights, and
data with client and colleagues.
Professional Practice
Ethical/Legal
Practice
Cultural Awareness
Documentation
Collaboration /
Teamwork
Leadership
Continuing
Competence
Research
Organizational
Expectations
A-4 Promotes client’s rights, and
responsibilities by:
a) Affirming consent prior to initiating care.
b) Practising within the code of ethics.
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1.2 Demonstrates personal attributes
which contribute to effective partnerships
with clients (e.g., respect, empathy,
honesty and caring).
1.7 Advocates for clients or clients’
designated representatives regarding
health care needs when the client is
unable to advocate for self (collaboration).
1.8 Practices in a manner consistent with
provincial and federal legislation and the:
a) College of Registered Nurses of
Manitoba Standards of Practice for
Registered Nurses
b) College of Registered Nurses of
Manitoba Professional Boundaries for
Therapeutic Relationships
c) Canadian Nurses Association Code of
1.01 Maintains personal and professional
integrity in a therapeutic, client-centered
relationship to promote goal directed
change.
1.07 Documents the results of evaluations of
psychiatric nursing interventions.
1.13 Demonstrates understanding of cause
and effect.
1.14 Charts psychiatric nursing actions
performed.
1.15 Charts evidence of changes in client’s
behaviour, skills and knowledge.
2.02 Advocates needs of client regarding
therapies when client is unable to do so.
2.03 Identifies effect of client on self.
2.04 Facilitates constructive problem
solving.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
c) Including confidentiality, privacy, dignity
and self-determination as part of the care
plan.
Ethics for Registered Nurses
d) Scope of practice as documented in the
Registered Nurses Act
A-5 Practices in a manner consistent with:
a) Professional standards of the College
b) Professional ethics
c) Values and obligations to take action
d) Scope of practice of Licensed Practical
Nurse
e) Provincial and federal legislation.
1.9 Functions independently within
legislated scope of practice and own level
of competence.
A-6 Applies critical thinking skills in all
practice activities
A-7 Recognizes limitations of own
competence and seeks guidance or assistance
when necessary, including making the
decision not to provide care when the
condition of personal competence is not met
A-8 Ensures that the person with who the
Licensed Practical Nurse consults with or
seeks advice from is competent to provide
that advice in a given situation.
A-9 Integrates research findings from
nursing, health sciences and related
disciplines into own nursing practice.
A-10 Identifies how own values and
assumptions affect the interactions between
practical nursing and other health team
members.
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1.10 Accepts accountability for own
actions and decisions.
1.11 Takes action, individually or
collaboratively, to address unsafe
situations (e.g., “near miss”, error, failure,
adverse events).
1.12 Uses the CRNM Standards of Practice
for Registered Nurses to meet the CRNM
Continuing Competence Program
requirements. Seeks opportunities for
professional growth to facilitate
continuing competence.
July 31, 2007
CRPNM (1993)
2.05 Recognizes and describes interactions
and transactions.
5.05 Maintains currency in knowledge of
pharmacology (with an emphasis on
psychopharmacology), the positive and
negative
effects of drugs on a person, and the
administration of drugs.
7.02 Demonstrates knowledge of the
structure and function of community
systems.
7.03 Demonstrates knowledge of available
community resources.
7.04 Participates in assessing, planning,
implementing and evaluating mental health
services in the community system at the
primary, secondary and tertiary levels.
1.13 Recognizes limitations of own
competence and seeks direction and/or
consultation when necessary.
7.05 Consults (participates) with
community agencies to ensure continuity of
services for clients.
1.14 Demonstrates critical thinking and
openness to new ideas that change,
enhance or support nursing practice.
7.12 Identifies when the need for service
requires consultation outside the
community.
1.15 Engages in health or nursing research
by identifying researchable issues and
reading and critiquing research reports.
8.01 Recognizes legal issues in the treatment
of clients.
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Competency
CLPNM (2001)
B-1 Demonstrates openness to new ideas,
which may change, enhance or support
practical nursing practice
B-2 Participates in analyzing, developing,
implementing and evaluating practical
nursing and nursing service practices and
policy in the workplace.
B-3 Provides care that demonstrates
sensitivity to client diversity (i.e. culture, race
age, gender, beliefs and values).
B-4 Adapts to the needs of the health care
system by:
a) Recognizing changes that affect own
practice and client care
b) Analyzing changes that affect practice and
client care
c) Collaborating in health or nursing research
activities
d) Implementing changes developed by
others
e) Developing strategies to meet changes that
impact on own practice and client care.
B-5 “Role models” professional behaviour
with nursing students and others.
B-6 Mentors practical nursing students and
others.
B-7 Commits to the principle that the primary
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CRNM (2005)
CRPNM (1993)
Collaborates with others as appropriate in
conducting research and implementing
research findings.
8.02 Demonstrates a working knowledge of
the mental health care delivery system in
Manitoba, relevant legislation and policies.
1.16 Models professional behaviour with
students and other disciplines.
8.03 Practises within Psychiatric Nurses
Association of Canada’s Code of Ethics.
2.1 Commits to the principle that the
primary role and function of a Registered
Nurse is the public interest. Demonstrates
knowledge of professional self-regulation,
including own accountabilities as a selfregulating professional.
8.04 Practises within established legislation
and standards of psychiatric nursing
practice.
2.3 Applies the principles of primary
health care to promote health and
wellness.
c) Uses best practices of teaching and learning
in health promotion.
d) Identifies and participates with key
stakeholders in health promotion
activities.
e) Employs culturally appropriate
approaches to foster building of
community capacity (consultation).
i) Coordinates activities with the client
and others to facilitate continuity of care.
2.4 Applies the principles of primary
health care to restore health, promote
rehabilitation and to meet palliative care
needs
g) Communicates significant information
about the clientʹs health problems or
8.05 Demonstrates accountability to his/her
client, his/her employer, his/her
professional association and the public.
8.06 Functions within his/her existing
knowledge and skills.
8.07 Assumes responsibility for the
maintenance of currency in knowledge and
practice through an ongoing program of self
education and formal and informal learning
programs related to his/her area of practice.
8.08 Assumes responsibility for care and
service to clients.
8.09 Assumes responsibility for supervision
of staff.
8.10 Demonstrates leadership ability by
establishing priorities and organizing
personal workload.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
purpose of the profession and college is to
serve the public in a safe and effective
manner.
B-8 Identifies and analyzes trends in practical
nursing and health care delivery, which may
result in changes to practice. Identifies and
analyzes trends in practical nursing and
health care delivery, which may result in
changes to practice
B-9 Develops and implements strategies to
meet changes in practical nursing practice
and health care delivery.
B-10 Supports professional efforts in nursing
to achieve a healthier society.
B-11 Promotes and participates in the
continuing development of the discipline of
practical nursing.
B-12 Identifies policies and protocols, which
impedes the profession from meeting client
needs.
B-13 Promotes and supports practical nursing
and other health team members to practice to
their full scope of practice.
C-1 Uses the professions’ Standards of
Practice and Competency documents to
highlight own learning needs by:
a) Identifying gaps in knowledge and skills.
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CRNM (2005)
issues to appropriate health care team
members.
n) Follows best practices in medication
therapy.
2.7 Demonstrates understanding of
organizational responses and appropriate
nursing roles in disaster situations.
2.8 Demonstrates a beginning level of
understanding of the overall organization
of health care in Manitoba and Canada.
2.9 Acts as a change agent by participating
in monitoring, analyzing, implementing
and evaluating nursing practice and
policy in the workplace at the unit, agency
or facility level.
2.10 Promotes the continuing
development of the discipline of nursing
(e.g., participating in professional
regulatory and health-related community
activities; contributing to health,
community, or nursing publications;
participating in research; participating in
professional interest groups).
4.10 Provides rationale for nursing care
actions and decisions based on theoretical
and evidence based knowledge from
nursing, health sciences, and related
disciplines.
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CRPNM (1993)
8.11 Assumes a leadership role for other
health care providers in the development of
effective health care plans.
8.12 Collaborates and coordinates with
client and other health care providers to
assess needs, plan, organize, implement and
evaluate health care plans and the
therapeutic milieu.
8.13 Maintains a cooperative and
collaborative relationship with other health
care providers to evaluate the care plan and
standards of care provided to the client by
the health care team.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
b) Evaluating own practice
c) Taking action to update competencies.
C-2 Assesses on a continual basis, own
competencies related to:
a) Knowledge
b) Skills
c) Judgment
d) Attitudes
C-3 Actively seeks opportunities for
professional growth, which enhance
competence.
F-9 Consults appropriately with other
members of the health care team.
F-10 Responds appropriately to rapidly
changing situations, which affect client health
or safety.
G-1 Maintains a distinction between social
interaction and professional communication
G-4 Shares appropriate information about
client’s care while respecting confidentiality.
J-1 Comprehends the impact of the health
systems organizational culture on nursing
practice.
J-2 Organizes own workload using effective
time management skills to carry out nursing
responsibilities.
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5.9 Consults with and refers to other members
of the health care team and other health related
sectors.
5.10 Applies safety principles, best
practices and appropriate protective
devices (e.g., handling of hazardous
products, encouraging the use of seat
belts, ʺsafe gradʺ programs, needle
exchanges).
5.11 Follows agency policy and legal
requirements by reporting situations that
are potentially unsafe for individuals,
families, groups, populations and
communities (e.g., the Registered Nurses
Act, the Persons in Care Act, and reports
to supervisor as appropriate).
6.1 Establishes therapeutic relationships
and maintains appropriate professional
boundaries.
6.5 Follows the CNA Code of Ethics for
Registered
Nurses and relevant legislation when sharing
information about clients while respecting
confidentiality.
9.1 Identifies the impact of an agencyʹs
organizational culture on nursing practice
(consultation).
9.2 Organizes own workload.
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CRPNM (1993)
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
J-3 Maintains clear, concise, accurate and
timely records of clients’ care, using
computerized (if relevant) and other health
and nursing information systems.
J-4 Adheres to the legal requirements
regarding practice, client care and
documentation.
J-5 Manages physical resources in order to
provide effective and efficient care.
J-6 Recognizes and reports situations which
are potentially unsafe for health team
members.
J-7 Assumes responsibility for supervising
other health team members as designated.
J-8 Exercises accountability for decisions,
which are delegated to others.
J-9 Directs and coordinates actions of other in
emergency situations.
J-10 Participates in quality assurance and
improvement activities to enhance client care
and nursing practice.
K-1 Collaborates as a member of the health
care team.
K-2 Respects unique and shared
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9.3 Develops time-management skills for
meeting nursing responsibilities.
9.4 Uses computer and technological skills
to plan client care, document and
coordinate care, and to transmit and
obtain information.
9.5 Documents client information
according to best practices.
9.6 Manages resources in order to provide
effective and efficient care (consultation).
9.7 Coordinates health team members to
ensure continuity of health services for
individuals, families, groups and
communities.
9.8 Delegates health care activities to other
health care providers consistent with
levels of expertise, education, job
description/agency, policy, legislation,
and clientʹs needs. Follows best practices
when delegating care.
9.9 Provides effective supervision of
others as appropriate.
9.10 Participates in quality assurance and
improvement activities to enhance client
care and nursing practice.
July 31, 2007
CRPNM (1993)
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
competencies of members of the health care
team.
K-3 Participates with the client and the health
care team in the revision of the goals,
priorities, and nursing interventions
required.
K-4 Promotes team problem-solving,
decision-making and collaboration by:
a) Planning collaborative interventions.
b) Presenting nursing knowledge regarding
the client.
c) Providing constructive feedback to
colleagues about client care.
d) Developing new and innovative working
relationships.
e) Using conflict resolution skills.
f) Using established communication protocol
K-5 Collaborates with other health-related
sectors to achieve client health outcomes.
K-6 Displays professional characteristics and
attributes by showing:
a) Respect for clients
b) Quality nursing care
c) Respect for nursing colleagues and other
members of the health care team
K-7 Evaluates effectiveness of own
communication with clients, nursing
colleagues, member of the health care team
and others.
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10.1 Demonstrates personal attributes,
which enhance the ability to participate as
an effective member of an
interdisciplinary health care team.
10.2 Develops partnerships with nursing,
intersectoral, and health care team
members.
10.3 Understands the basic scope of
practice of other health care team
members.
10.4 Identifies how own values and
assumptions affect the interactions
between nursing and the interdisciplinary
health care team members.
10.5 Recognizes the impact of system
changes on self and other health care team
members.
10.6 Promotes team problem solving,
decision making and interdisciplinary
collaboration by jointly assessing
outcomes of care, planning collaborative
interventions, implementing new
interdisciplinary strategies, evaluating
impact on clients and team members, and
developing new and innovative working
relationships.
10.8 Presents nursing knowledge
regarding clients in interdisciplinary team
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CRPNM (1993)
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
July 31, 2007
CRPNM (1993)
interactions. Clarifies the Registered
Nurse’s role and responsibility to other
health care team members.
10.10 Uses established communication
protocols within the practitionerʹs practice
setting and across practice settings within
the health care system.
Clinical Practice – Nursing Process
Assessment
D-1 Performs comprehensive and holistic
nursing assessment on clients of all age
groups:
a) Neonates
b) Infants
c) Children
d) Adolescents
e) Adults
f) Elderly adults
D-2 Uses assessment tools to guide data
collection for assessing clients.
D-3 Customizes standardized assessment
tools to individualize them to meet the
client’s needs.
D-4 Employs additional assessment tools and
techniques for finer detail and discrimination.
D-5 Uses various techniques of data
collection:
a) Observation
b) Interviewing
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2.2 Applies the principles of primary
health care to prevent illness and injury:
a) Identifies actual or potential health
problems/risk factors.
2.4 Applies the principles of primary
health care to restore health, promote
rehabilitation and to meet palliative care
needs.
o) Determines when a PRN medication is
indicated.
3.1 Uses agency/standard assessment
tools to guide data collection.
3.2 Adapts agency/standardized
assessment tools to meet clientʹs
individual needs (consultation).
3.3 Employs additional assessment tools
and techniques for finer detail and
discrimination (consultation).
3.5 Performs comprehensive nursing
1.02 Collects and analyses data relative to
physical, psychological, cultural, spiritual
and social aspects of the client’s health and,
using the data, assists the client to
formulate an individualized health care
plan.
1.10 Identifies health needs and strengths of
client.
3.04 Observes, analyzes, interprets, discusses
with the client, and records the effects of the
environment upon the client.
3.05 Assesses and develops the potential of
the therapeutic environment through
consideration of physical, social and
cultural features of the setting.
5.07 Assesses the effects of medication on the
client and documents and reports same.
7.06 Identifies client’s need for assistance
from community resources.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
c) Inspection
d) Auscultation
e) Palpation
D-6 Refines and extends client assessment
information by:
a) Collecting data from a variety of sources
(client, family, other health team members
and documentation)
b) Using initial assessment findings to focus
on additional and more detailed assessments.
c) Incorporating the determinants of health
income, social status, education, and
employment and work conditions
d) Analyzing and interpreting data from
client assessments.
D-7 Collaborates with clients, through all
stages of the life cycle, to identify their health
problems and issues.
D-8 Collaborates with clients to performs
holistic assessment of the following needs:
a) Physical
b) Emotional
c) Psychological
d) Cognitive
e) Social
f) Spiritual
g) Cultural
D-9 Anticipates potential health problems or
issues and their resultant effects for the client.
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assessments for non-complex individuals,
families, groups, and communities.
Performs comprehensive nursing
assessments for complex individuals,
families, groups, populations, and
communities (consultation).
3.6 Uses various techniques of data
collection with clients, families, groups,
and communities.
3.7 Refines and extends assessment
information by collecting data from a
variety of sources. Use initial assessment
findings to focus on additional and more
detailed assessments (consultation).
Analyzes and interprets data from client
assessments.
3.8 Incorporates the determinants of
health in assessment process.
3.9 Collaborates with individuals, families,
groups and communities to identify their
health needs, strengths, capacities, and/or
problems.
3.10 Anticipates actual and potential health
care needs.
4.1 Uses critical thinking skills to make
clinical judgments about individuals,
families, groups, and communities.
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CRPNM (1993)
7.11 Assesses strengths and coping skills of
individuals, families and groups within the
community to promote and improve mental
health.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
July 31, 2007
CRPNM (1993)
4.2 Clusters issues and problems into
manageable components.
Diagnosis
Planning
E-4 Participates in the formulation of nursing
diagnoses by identifying need that require
nursing interventions.
E-1 Makes clinical judgments about clients:
a) Respond appropriately to rapidly changing
situations that affect client health and safety.
b) Use evidence-based knowledge from
nursing, health sciences, and related
disciplines to select
individualized nursing interventions in
consultation with other members of the
health care team.
c) Apply critical thinking skills in practice
activities.
E-2 Identifies the range of acceptable health
outcomes for clients.
E-3 Collaborates with clients to develop a
plan of care by:
a) Involving the client in setting the objectives
and goals;
b) Identifying expected outcomes;
c) Questioning and offering suggestions
regarding approaches to care;
d) Reducing complex health problems into
manageable components;
e) Developing a range of possible alternative
and approaches to care;
f) Establishing priorities of nursing care;
g) Seeking information from relevant nursing
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1.03 Identifies problems and maladaptive
behaviour patterns.
2.2 Applies the principles of primary
health care to prevent illness and injury:
b) Collaborates with clients to promote
healthy environments.
2.3 Applies the principles of primary
health care to promote health and
wellness.
a) Assists the client to understand the link
between health promotion strategies and
health outcomes.
f) Collaborates with the client to prioritize
needs and develop risk prevention
strategies (consultation).
2.4 Applies the principles of primary health
care to restore health, promote rehabilitation
and to meet palliative care needs
s) Collaborates with the client and others to
prepare for discharge. Supports the client in
accessing community resources, arranges for
adaptations in the clientʹs environment which
promote independence, facilitates social
integration of the client, and facilitates the
clientʹs reintegration into family and
community networks.
3.4 Consults with the literature,
1.04 Collaborates with other members of the
multidisciplinary team in the development
and implementation of activities specific to
the client’s physical and mental health
needs.
1.09 Identifies data base, psychiatric nursing
diagnoses, psychiatric nursing care plan
objectives, and goals as part of each psychiatric
nursing care plan.
4.03 Collaborates with the client in the
development of a self-care plan.
7.08 Incorporates information from other
resources in assessment and treatment
planning.
7.09 Assists clients in planning treatment
programs involving community resources
where appropriate.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
research, literature, experts and other
relevant health team members.
CRNM (2005)
July 31, 2007
CRPNM (1993)
colleagues, and other sources in selecting
appropriate assessment tools and
techniques.
E-5 Selects appropriate technology in
accordance with available resources and
client needs.
4.4 Establishes priorities of care in
consultation with the client.
E-6 Develops plan to ensure continuity of
care for clients.
4.5 Identifies the range of acceptable
health outcomes.
E-7 Establishes priorities that reflect
individual needs.
4.6 Develops plans to ensure continuity of
care for clients as they move through the
health care system. Coordinates activities
with the client and others to facilitate
continuity of care in the community.
4.7 Uses evidence based knowledge and
critical thinking skills to select and
individualize nursing interventions and
approaches.
4.8 Selects and implements nursing
interventions and approaches, which are
supported by a theoretical perspective
(e.g., nursing theories, family theories,
system theories, communication theories,
and health transitions).
F-1 Performs nursing interventions with
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4.9 Selects technology and resources in
accordance with available resources and client
needs (consultation). Critically evaluates
information provided by technology. Ensures
safe functioning of technology.
2.2 Applies the principles of primary
1.05 Employs psychiatric nursing
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
Implementation
CLPNM (2001)
clients of all age groups, throughout the life
cycle:
a) Neonates
b) Infants
c) Children
d) Adolescents
e) Adults
f) Elderly adults
F-2 Uses evidence-based knowledge from
nursing, health sciences and related
disciplines to select and individualized
nursing interventions
F-3 Selects and implements nursing
interventions, which reflect the needs of the
client.
F-4 Performs individualized nursing
interventions for the client as established
and/or directed by the care plan.
F-5 Deviates from the plan of care according
to professional judgment.
F-6 Manages multiple nursing interventions
simultaneously.
a) Using effective management skills to carry
out nursing interventions.
b) Including the family in the client’s care
delivery when appropriate.
F-7 Uses appropriate technology to perform
safe, effective and efficient nursing
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health care to prevent illness and injury:
c) Encourages the use of safety measures
to prevent injury.
d) Collaborates in implementing
immunization strategies to prevent
communicable disease.
e) Collaborates in implementing
strategies to prevent violence, abuse, and
neglect.
f) Collaborates in implementing strategies
related to the prevention and early
detection of prevalent diseases.
g) Collaborates in implementing
strategies related to the prevention of
addictive behaviours.
h) Collaborates in implementing
strategies to minimize the risk of mental
health problems.
i) Implements preventive strategies
related to the safe and appropriate use of
medication.
j) Implements preventive strategies
related to workplace safety
2.3 Applies the principles of primary
health care to promote health and
wellness.
g) Facilitates the clientʹs ownership of the
health promotion plan.
j) Minimizes sensory overload.
k) Supports the client through
developmental transitions.
l) Supports the client in role change.
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CRPNM (1993)
interventions based on knowledge of
behaviour patterns to assist the client to
modify his/her thought, affect, behaviour
and motivation (see Appendix A).
4.01 Utilizes the activities of daily living in a
goal-directed manner to foster physical and
mental well-being of the client and enhance
Psychiatric Nurse/client relationships.
4.02 Promotes independence in activities of
daily living.
4.04 Performs necessary activities on client’s
behalf when the client is unable to do so on
his/her own.
5.01 Utilizes knowledge of somatic
therapies and applies related clinical skills
in working with the client (see Appendix B).
5.04 Provides basic physical care
appropriate to the needs and capabilities of
the client.
5.06 Administers medications by a variety
of routes including:
• oral
• topical
• rectal
• ocular
• intramuscular
• otic
• subcutaneous
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
interventions.
F-8 Applies safety principles and protective
devices consistently in client interactions by:
a) Implementing Universal/Standard
precautions.
b) Maintaining a safe work environment.
c) Applying the principles of asepsis.
d) Reporting situations, which are potentially
unsafe for clients.
e) Providing support and protection to
clients experiencing difficulty protecting self.
81 Final Report
CRNM (2005)
2.4 Applies the principles of primary
health care to restore health, promote
rehabilitation and to meet palliative care
needs.
a) Begins rehabilitative measures at the
earliest opportunity.
b) Facilitates the clientʹs participation in
the implementation of the plan of care.
c) Supports the clientʹs use of personal
strengths and resources in meeting selfcare needs.
e) Provides nursing care to prevent the
development of complications.
f) Intervenes in a timely and appropriate
manner to changes observed in the clientʹs
health problem/issue.
k) Prepares the client for diagnostic
procedures and treatments.
l) Provides preoperative and
postoperative care.
m) Provides for physiological needs (e.g.,
optimal ventilation and respiration,
circulation, fluid & electrolyte balance,
nutrition, urinary elimination, bowel
elimination, body alignment, mobility,
tissue integrity, comfort, sensory
stimulation).
p) Assists the client to manage pain with
pharmacological and nonpharmacological measures.
q) Safely manages therapeutic
interventions (e.g., intravenous therapies,
drainage tubes, collection devices).
r) Intervenes in rapidly changing health
July 31, 2007
CRPNM (1993)
• vaginal
7.07 Initiates referrals to community
resources.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
problems (e.g., myocardial infarction,
acute neurological event, shock, acute
respiratory event, cardiopulmonary
arrest, perinatal crisis, diabetes crisis,
mental health crisis, and trauma).
2.5 Performs nursing interventions to
meet the needs of clients receiving
palliative care.
2.6 Provides supportive care to clients
with chronic health issues, provides
supportive care throughout the dying
process.
5.2 Performs a range of nursing
interventions. Initially seeks consultation
with complex nursing interventions.
5.3 Performs nursing interventions which
promote health, prevent disease and
injury, maintain and restore health,
promote rehabilitation, provide palliative
care.
5.4 Responds appropriately to changes in
the health status of individuals, families,
groups, populations, and communities.
5.5 Uses appropriate technology to
provide safe, effective nursing care.
Demonstrates competence with a number
of technical skills. Applies best practices
when learning to manage new technical
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CRPNM (1993)
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
July 31, 2007
CRPNM (1993)
skills.
Evaluation
I-1 Monitors the client’s status in relation to
anticipated outcomes.
I-2 Evaluates the effectiveness of nursing
interventions, including learning plans, by
comparing actual outcomes to anticipated
outcomes.
I-3 Verifies evaluation findings with the client and
other members of the health team.
I-4 Modifies and individualizes the learning
plan, according to evaluation finding, in
collaboration with the client and other
members of the health care team.
5.6 Assists clients to select choices or
modify practices that will support
positive change in their health.
2.4 Applies the principles of primary
health care to restore health, promote
rehabilitation and to meet palliative care
needs.
h) Evaluates and responds appropriately
to the clientʹs health status in relation to
anticipated outcomes.
i) Evaluates the effectiveness of nursing
interventions in collaboration with the
client.
j) Modifies the plan of care consistent with
the emerging priorities of the health
situation.
1.08 Performs ongoing evaluation of care
concurrently with revision.
1.16 Assesses effectiveness of psychiatric
nursing care by comparing expected
outcome of psychiatric nursing care with
actual outcome.
5.1 Uses professional judgment when
modifying established plan of care.
5.02 Observes and interprets pertinent
responses to somatic therapies.
8.1 Monitors status of individuals,
families, groups, and communities in
relation to anticipated outcomes.
5.03 Recommends changes in somatic therapies
as appropriate.
8.2 Evaluates the effectiveness of nursing
interventions by comparing actual
outcomes to anticipated outcomes.
8.3 Verifies evaluation findings with
clients and members of the health care
team.
83 Final Report
1.06 Evaluates, validates and, if necessary,
modifies the dynamics of the therapeutic
relationship and psychiatric nursing
interventions against an established
knowledge base.
6.07 Evaluates the effectiveness of learning
strategies with the client so that the client
may modify activities to promote
functional,
productive, patterns of living.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
July 31, 2007
CRPNM (1993)
8.4 Modifies and individualizes plans in
collaboration with clients and members of
the health care team.
Facilitates Learning
H-1 Provides relevant health related
information to clients to meet specialized
needs by:
a) Providing relevant health information.
b) Planning teaching strategies to enhance
client learning.
c) Selecting appropriate media and learning
strategies to meet client learning.
d) Implementing teaching strategies to
enhance client learning.
e) Verifies whether clients have grasped
essential information and skill.
f) Evaluating client learning
H-2 Encourages client self-care and health
promotion by:
a) Suggesting modification to promote client
independence.
b) Encouraging client-interdisciplinary health
care team participating in the implementation
of the care plan.
c) Encouraging clients to assume
responsibility for their own health.
d) Providing information on support services
that assist clients in the promotion and
maintenance of health.
84 Final Report
1.4 Informs and supports clients while
they are making decisions about their
health care, and supports those decisions.
2.3 Applies the principles of primary
health care to promote health and
wellness.
a) Assists the client to understand the link
between health promotion strategies and
health outcomes.
m) Teaches about family planning.
n) Promotes healthy habits related to
physical activity and exercise.
o) Promotes healthy habits related to
nutrition.
p) Promotes balance between rest or sleep
and activity.
q) Promotes stress management strategies.
r) Promotes healthy practices related to
hygiene.
s) Promotes sexual health and safe sexual
practices
2.4 Applies the principles of primary
health care to restore health, promote
rehabilitation and to meet palliative care
needs.
d) Uses evidence-based information to
assist the client to understand the link
6.01 Understands principles of teaching and
learning, and accompanying rationale.
6.02 Identifies appropriate teaching
methods to prepare, implement and
evaluate a teaching plan.
6.03 Implements appropriate teaching
strategies.
6.04 Teaches coping mechanisms to deal
with deviations from health and strengthen
adaptation skills.
6.06 Identifies resources to maintain gains
achieved in the therapeutic setting (community,
home, facility).
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
July 31, 2007
CRPNM (1993)
between interventions and expected
outcomes.
5.7 Supports clients to draw on own assets
and resources for self-care and health
promotion.
7.1 Addresses the health related learning
needs of individuals, families, groups,
(independent), and communities
(consultation). Assesses learning needs,
develops learning plans, implements
learning plans, and verifies that clients
have understood essential information
and skills.
7.2 Provides general health related
information to clients, families, groups,
and communities.
7.3 Facilitates lifestyle behaviour change.
Interpersonal Skills
A-3 Forms partnership with clients to achieve
mutually agreed health outcomes.
G-2 Establishes and maintains a caring
environment to foster partnerships with
clients to achieve mutually agreed health
outcomes by:
a) Establishing a positive professional
relation with the client.
b) Promoting client safety and comfort.
c) Reinforcing directions given to clients by
85 Final Report
1.5 Forms partnerships with individuals,
families, groups, populations, and
communities, to achieve mutually agreed
upon health
outcomes (consultation).
2.3 Applies the principles of primary
health care to promote health and
wellness.
h) Supports the client to seek out
appropriate groups for mutual aid,
2.01 Encourages client and significant
others to voice concerns and ventilate
feelings regarding therapies and/or
treatment
2.06 Explores alternative lifestyles,
behaviour, etc. with client.
3.01 Creates and maintains a therapeutic
environment.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
other health team members.
d) Encouraging client participation in the
implementation of the care plan.
e) Encouraging clients to assume
responsibility for their own health.
f) Providing clients and significant others
with emotional support.
g) Encouraging and creating opportunities
for clients to interact socially.
G-3 Employs a range and variety of
communication skills appropriate to various
clients by:
a) Providing relevant health information and
client education.
b) Gathering and providing appropriate
information from/to significant others.
c) Communicating with clients to facilitate
their understanding using a variety of
question methods as appropriate for the
individual situation.
d) Providing effective interpersonal
interaction through active listening, nonverbal and verbal communication.
e) Providing an environment that encourages
and supports the opportunity for the client to
express feelings.
f) Using touch in a therapeutic manner to
communicate care and concern to the client.
g) Using conflict resolution skills when
necessary.
CRNM (2005)
support, and community action.
4.3 Facilitates the appropriate
involvement of individuals, families and
groups to identify expected health
outcomes, to facilitate the clientʹs
ownership of the plan, and to identify
client concerns and priorities.
5.8 Assists individuals, families, groups,
and communities to identify and access
health resources in their communities
(e.g., other health disciplines, community
health services, support groups, home
care, and information resources).
5.12 Assists clients to establish and
maintain satisfying and healthy
relationships within their families and
communities.
6.2 Establishes and maintains a caring
environment that supports clients,
families, groups, and communities in
achieving health
outcomes.
6.3 Selects methods of communication
which are appropriate to the client
circumstances.
6.4 Employs a range and variety of
communication skills appropriate to
specific individuals, families, groups,
86 Final Report
July 31, 2007
CRPNM (1993)
3.02 Orients client to the therapeutic
environment.
3.03 Indicates available activities operative
within the environment.
6.05 Assists the client to identify and access
the appropriate community resources in
order to maintain the client-focused goals
achieved in the therapeutic setting.
7.01 Maintains current knowledge of
community resources and interprets these
resources to the client and his/her family as
appropriate. When necessary the R.P.N.
facilitates client access to these resources.
7.10 Encourages active client participation
in assessing and planning programs to meet
the identified mental health needs of the
community.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Competency
CLPNM (2001)
CRNM (2005)
July 31, 2007
CRPNM (1993)
populations, and communities. Applies
basic communication skills. Applies
complex communication skills in
consultation.
10.7 Uses negotiation and conflict
resolution skills to facilitate
interdisciplinary team interactions.
10.9 Provides constructive feedback to
colleagues about client care.
Italicized competencies are those for which there was no consensus regarding the most appropriate cluster by the exercise participants. The author made a determination, taking
into consideration the participant responses, as to the most appropriate cluster in which to place the competency.
Competencies highlighted in * signify those found common to the RN and RPN designations only.
87 Final Report
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
Table 6.0 Post-Graduate Psychiatry/Mental Health Programs for LPNs
Program Name
Course Content
Learning
Objectives
Available
Practicum
Component
Distance
Delivery
Credit
Transfer
PLAR
Cost
Time to
Complet
e
Also Offers:
RN Qualifying
Certificate in
Psychiatric
Nursing
Therapeutic Relationships in
Mental Health
Douglas
College
British
Columbia
Assessment and Promotion of
Mental Health
Licensed
Practical
Nurses Mental
Health Nursing
– Certificates
Professional Practice in Mental
Health Nursing
Additional
Information
Yes
Disorders of Mental Health
Yes
Application of Knowledge to
Nursing Practice (under
development)
Workplace
Knowledge
Transfer
Course –
10 hrs
Instructor
Contact
Approx.
$2760.00/
per
student
Yes
No
Yes
RN Mental
Health Nursing
Certificate
2 years
Includes
all fees
and
texts.
Professional
Development
Certificate
Courses in
Mental Health
Nursing
Child and
Adolescent and
Geriatric MH
Courses
Mt Royal
College/Bow
Valley College
Calgary,
Alberta
Adult Mental
Health
Certificate of
Achievement
for Licensed
Practical Nurse
88 Final Report
The Nature of Adult Mental
Health Nursing Practice
Competencies for Mental Health
Nursing Practice
Yes
Mental Health Concerns,
Disorders and Interventions
Leadership for Licensed Practical
Nurses
No
Yes
No
Yes
Approx.
$1554.45/
per
Student
+ Bow
Valley
tuition.
Does not
include
texts.
5 years
Also Offers:
Gerontology
Certificate of
Achievement
Children’s
Mental Health
Certificate
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Program Name
Course Content
Learning
Objectives
Available
Practicum
Component
Distance
Delivery
Credit
Transfer
PLAR
Cost
July 31, 2007
Time to
Complet
e
Additional
Information
Module One: Overview of Mental
Health, Mental Illness and Trends
in Mental Health Care
Module Two: Application of the
Nursing Process to Mental Health
Nursing
Center for
Nursing
Studies
St John’s,
Newfoundland
Postbasic
Mental Health
Program for
Licensed
Practical
Nurses
Module Three: Therapeutic
Interventions
Module Four: Developmental
Issues Across the Lifespan and
Care of Clients with Specific
Mental Health Problems
Module Five: Application of the
Nursing Process to Disorder
Behaviours
Module Six: Addictions Concepts
Module Seven: Homelessness,
Developmental Delays, and
Forensic Psychiatric Nursing
Module Eight: Crisis Including
Rape, Family Violence and
Suicide
Module Nine: Community Based
Care and Rehabilitation
89 Final Report
Also Offers:
Gerontology
programs for
both LPNs and
RNs
Yes
Yes
Flexible
delivery
based on
learner’s
experience
and needs,
practicum
opportunities
available, and
the needs of
the facility
Yes
To be
determined
with local
Educational
Institutions
$800.00/
per
Student
Yes
Includes
course
materials
and
texts.
1year
Developing a
RN Post Basic
MH program.
Accredited and
approved by all
governing
bodies.
NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN
PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
Appendix B: LPN Survey Highlights
90 Final Report
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NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN
PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
July 31, 2007
LPN Survey Highlights
•
The Practical Nursing program Psychiatric/Mental content was very basic. There was no
mental health specific theoretical component, but some related content was dispersed
through the Pharmacology and Gerontology programs.
•
A Psychiatric/Mental Health practicum was not available. All would have been
interested in this option.
•
LPNs did not feel that they were equipped at an entry level to competently practice in
Psychiatry/Mental Health. A need for increased theory and practical experience was
consistently identified.
•
The need to learn how to relate effectively to mental health patients was repeatedly
highlighted.
•
LPNs were approached by the Region to work in Psychiatry/Mental Health on a term or
casual basis.
•
The mentorship of RPNs on the Unit was the most significant occurrence in assisting
LPNs to develop their skills on the job.
•
With the exception of charge responsibilities, most LPNs performed the same duties as
RPNs and RNs on the Unit. Some found that the range of duties assigned were
dependent upon the Nurse in charge.
•
Roles and responsibilities were ill-defined, and there was no clear leadership.
•
Most LPNs felt that they were able to practice to full scope without restrictions.
•
The biggest challenges identified included: adapting to a different model of delivering
care, not having a solid foundation of knowledge or skills, diffuse role definition, lack of
clear and accessible leadership, learning how to relate to individuals with mental illness,
and poor acceptance by the other health care providers.
•
Most LPNs had a positive experience working with the other health care providers.
Those who did not were the first LPNs to work on the Unit, and found that staff came to
accept them in time.
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•
July 31, 2007
Most LPNs thought that practice in Psychiatry/Mental Health falls within their Scope of
Practice.
•
Identified barriers to working to full Scope of Practice included limitations imposed by
regulatory and employing organizations and other staff, as well as lack of training.
•
LPNs feel they have a role in the delivery of Psychiatric/Mental Health services.
•
The majority of the LPNs would be interested in further employment in
Psychiatry/Mental Health, depending on how the terms of employment fit with their
personal employment needs (i.e., full-time permanent)
•
LPNs felt reasonably well prepared to deliver psychiatric/mental health care to a
geriatric population based on their training and experience.
•
Additional training in the full range of mental illnesses as they pertain to the Elderly
would be beneficial.
•
Resources required to support mental health service delivery for geriatric patients
included more staff to provide the opportunity to spend the time required with PCH
residents to meet their mental health needs, and organizational support for ongoing
training (time and funding to attend workshops).
•
All of the LPNs surveyed expressed an interest in additional Psychiatric/Mental Health
education and training for both the adult and geriatric populations. It was recognized
that it is relative to all practice settings.
•
All of the LPNs expressed a desire to advance their nursing education. Most were
interested in pursing their RN-Diploma and a BScPN.
•
Identified barriers to achieving this goal included accessibility, financial resources, and
age and limited transferability into other programs (which meant a longer period of
study to obtain a diploma or degree).
•
Identified supports required to achieve this goal included access to programs in the
Region and financial support.
•
Additional Comments:
•
Emphasized need for exposure to Psychiatric/Mental Health practice and
experiential learning in the Practical Nursing program.
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NOR-MAN – RESEARCH INTO INNOVATIVE RECRUITMENT IN
PSYCHIATRIC/MENTAL HEALTH NURSING PRACTICE
•
July 31, 2007
LPNs should have three years postgraduate experience to work in
Psychiatry/Mental Health.
•
Need for greater distinction between, or a joining of, LPNs and RNs (diploma
prepared) as there is little difference in actual practice.
•
LPNs can do the same work as RNs in most practice settings, including
Psychiatry/Mental Health.
•
The LPN program should be expanded to include Psychiatry/Mental Health.
•
The RHA must be committed to continuing education for all staff.
•
Nursing programs in the North require the same degree of professionalism as
those delivered elsewhere in the Province.
•
Need for all RHA staff to be educated in Addictions.
•
Need for clear guidance and policies/procedures for practice on the Psychiatric
Unit.
•
Need for increased financial sponsorship for nursing education.
•
Need for nursing programs in the North.
•
There is a gap in services for geriatric patients with mental health problems who
need long-term care but who do not fit in a PCH.
•
Beneficial for nursing students to have experience in a hospital setting before
entering a program.
•
Beneficial for nursing students to get employment/practice experience between
nursing programs to develop their skills (i.e., LPN to RN).
•
There is little understanding amongst Nurses about what LPNs can do, and this
creates resentment about territory. The labour shortage is good in that other
Nurses are learning about the LPNs’ skills.
•
Education about Psychiatry/Mental Health would be helpful in all areas of
practice and for all health care providers.
•
93 Final Report
Need for the LPN and RN (diploma) programs to be expanded.