1. Toolkits and Standardized Patient Experiences: Developing Core Psychiatric Mental Health Nursing Skills Debra Webster Ed.D, RNBC, CNE NSP II Grant 2014-2016

2. Background Student Anxiety Stigma of Mental Illness Traditional Methods of Instruction Limited Clinical Placements Random Patient Encounters Core Skills

3. Toolkits Year 1 Professional Boundaries and Therapeutic Communication Managing Hallucinations and Delusions Assessing Suicidal Behavior

4. Tool Kit 1 – Student Assignment Title – Therapeutic Communication and Professional Boundaries Objectives At the completion of this clinical experience, the student will be able to: 1. Discuss how empathy, genuineness, and positive regard impact the nurse-patient relationship 2. Compare and contrast therapeutic versus social relationships 3. Define transference and countertransference 4. Identify factors that affect communication 5. Identify and discuss therapeutic and non-therapeutic communication techniques 6. Demonstrate effective therapeutic communication techniques Pre-Assignment activities Read Chapters 8 and 9 in Halter, M. J. (2014). Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach. Elsevier St. Louis: Missouri. (Or selected psychiatric nursing textbook).

5. Video Vignette Client Description 25 year- old Miss Jones currently shares an apartment with two female roommates. She completed two years of college but dropped out due to issues of anxiety. She continues to struggle with anxiety daily and has difficulty in social situations. This has led to difficulty in maintaining a job. She currently works part- time for an online company taking orders for products. She has been hospitalized once in the past for mental health issues. Her psychiatrist prescribed anti-anxiety medication and she has been in outpatient treatment for the past year. Miss P has one older sister and there is a family history of both anxiety and depression. Her maternal aunt committed suicide at the age of 40 and her maternal grandmother was hospitalized with depression in her early 30s. Miss P. presents to the outpatient clinic this morning with complaints of increased anxiety, worry, and difficulty sleeping. She appears jittery and is having difficulty focusing.

6. Directions - Watch video vignette and complete the following written assignment. Submit to clinical faculty. 1. Write a one to two page reflection about your feelings about working with an individual with mental illness. 2. Answer the following questions: a. What is transference? b. What is countertransference? c. Did you observe any issues of transference or countertransference in the video? Discuss in detail what you observed. d. Identify at least three therapeutic communication techniques used by nurse in video. Be specific as to naming the technique and what the nurse said. e. Identify two non-therapeutic communication techniques used by nurse in video. Be specific naming the technique and what the nurse said. Provide a modification as to what the nurse could have said to make the interaction therapeutic in these examples.

7. Suggested Post-Clinical Activities Role Play SPE Case Study

8. Toolkits Year 2 Setting Limits with Manic Patients Managing Addiction and Withdrawal Symptoms Communicating with Individuals with Dementia

9. The Standardized Patient Experience Video Recorded Live Viewing with Feedback Group Debriefing

10. Where From Here Refinement of Feedback Rubrics Web Access of Toolkits Development of Additional Toolkits Presentations and Publications Research Studies

11. Questions? Thanks for your participation.