The American Psychiatric Nurses Association The State of Psychiatric Mental Health Nursing in the Recovery to Practice Journey Recovery to Practice The American Psychiatric Nurses Association April 7, 2011

Appreciative Inquiry Thinking, seeing, acting for powerful, purposeful change in organizations Assumption: What you want already exists Define, Discover, Dream, Design, Deliver Year 01: Define & Discover Define: Need for transformation Discover: Situational analysis Year 02: Dream & Design

RTP Structure and Organization RTP Project Staff RTP Steering Committee APNA Consumer Advisory Panel APNA Chapters Education & Administration Councils RTP Undergraduate Educator Workgroup

Process of Discovery Facilitated Discussions Interviews 12 APNA Chapters Consumer Advisory Panel Clinical Psychopharmacology Institute MH Field Advisory Committee - Office of Veteran Affairs, Office of Nursing Service International Society of Psychiatric-Mental Health Nurses Annual Conference APNA Annual Conference Interviews National Mental Health Leaders State Mental Health Director Peer Support Specialists Including Nurses Nursing Administrators Nursing Educators National Behavioral Health Association Leader Psychiatric Rehabilitation Leader Recovery Champions

Process of Discovery Literature Review: Academia Essentials of Undergraduate/Graduate Education (CCNE Accreditation Criteria) Undergraduate/graduate curricula in selected schools Undergraduate primary texts in psychiatric-mental health nursing Resource Review: Nursing Science & Practice Evidence-based literature SAMHSA Recovery Resources DSG Recovery Resources Available recovery-related curricula, i.e., NASMHPD, HRSA, SAMHSA, AACN) Recovery Webinar participation Member Bridge Recovery Dialogue APNA Annual Educational Needs Assessment PMHN Meetings APNA Annual Conference APNA Clinical Psychopharmacology ISPN Annual Conference

Strengths SAMHSA’s 10 Recovery Components Evidence in nursing history, research, practice Congruence with nursing philosophies Cultural competency HRSA –Cultural/Linguistic Competency Curriculum AACN Tool Kits for Undergrad/Graduate Cultural Competence Professional experts of practice Nursing Standards of Practice Participant consumers as full partners - involved at all levels Strong self-care and nursing practice components Strong psychoeducational background Strong holistic background

Strengths Recognition of the role of trauma (need for trauma-informed care) Nursing actively seeking education for trauma -informed care Empathy is a core value of nursing and a core nursing skill Infusion of recovery practice throughout MH organizational systems RN’s in system administrator positions System commitment from administrators to pilot the RTP training curriculum

Challenges SAMHSA’s 10 Recovery Components Need for more recovery knowledge Implement and infuse recovery components into daily nursing practices Increase partnership with consumers Cultural competency Increase use of person -centered language and practice Increasing cultural competency Increase involvement of various cultural & ethnic groups Consumers as full partners - involved at all levels Accessing consumer content experts Securing funding support payment and travel Increase consumer participation in education

Challenges Recognition of the role of trauma (need for trauma-informed care) Enhance PMH nurses knowledge of impact of trauma of lives of those with mental disorders Support the development of skills to implement trauma-informed nursing practice Increase awareness of the role of trauma for the MH service recipient and the nurse Infusion of recovery practice throughout MH organizational systems Increase funding Increasing priorities by administrators for recovery-oriented practices Poor communication among providers Increase nurses ‘trust and comfort of partnerships with consumers Across all areas Limited number of content nurse experts

What Was Discovered Need for Integration of Education Need for Recovery Champions Need for Recovery Experts Need for Consistency in Systems

Dream and Design Plan for Curriculum Development Consumer involvement throughout Recovery resources Financial system incentives Practical skills that work Trauma informed care Collaborative relationships Cultural competence Person-centered communication

Target Audience PMH RN’s practicing in an inpatient setting Best positioned to support persons in their recovery journey Positioned to model recovery practice for nursing students Continuing education is a professional requirement for licensure and/or accreditation

Who Will We Involve Consumers/Peer Specialists Recovery Champions PMH Nursing Leaders PMH Nursing Educators Online Educators RTP Curriculum Partners

Long Term Impact By the end of year 05 behavioral healthcare will be significantly improved as a result of psychiatric mental health nurses integrating recovery care into their practice.

Intermediate Outcomes The revised (2012) Scope and Standards of Psychiatric Mental Health Nursing Practice reflects mental health recovery as fundamental to PMH nursing practice. By the end of year 03 all PMH nurses have access to recovery resources Upon completion of the pilot training, PMH nurses: Begin to apply SAMHSA’s 10 mental health recovery principles to nursing practice. Actively use recovery language Begin to demonstrate shared decision making in partnership with mental health service recipients. Begin to share with consumers community resources that facilitate recovery.

Dreaming Changing the Paradigm Best practice is recovery practice Trauma informed skills for safe and therapeutic environments Person-centered/experiential language Consumer partnerships Culturally sensitive practice

Dreaming Big Changing the Paradigm Recovery within: Scope & Standards of PMH Nursing Practice PMH Nursing Certification Academic Accreditation Standards