Summer 2020

NURS 6412-LAR Psychiatric Mental Health Nurse Practitioner (PMHNP) Diagnosis & Management: Concepts & Theory I

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

COVID-19
Students are expected to follow all policies related to COVID-19 found on the university webpage: https://wp.uthscsa.edu/coronavirus/.

NOTE: Our campus has enabled the CANVAS MOBILE LEARN application. CANVAS tools such as discussions, quizzes or videos May or May NOT function on all mobile devices. This is because mobile devices are available with rapidly changing and different configurations. Hence, students must not depend on only a mobile device to access course materials. Students must have access to a laptop or desktop device to access course materials and complete assignments.

This course is Web Enhanced with 
Please be sure to check the Current Computer Requirements

Link to Graduate Clinical Experiences and Typhon guidelines: http://nursing.uthscsa.edu/gradclinical/

Welcome to the PMHNP Diagnosis and Management: Concepts and Theory I Course. 

This course is web enhanced. 

Classes for summer 2020 will be provided via the Canvas Conference Tool as we will be adhering to social distancing guidelines to maintain the safety of our learning community. Attendance is required for all virtual classes.

Please proceed to Canvas prior to the start of the semester for in-depth information, instructions, required readings, and learning units.  The course begins on the first day of the semester. 

We will meet online almost every Monday with a couple of exceptions.  There are assigned readings and work inside Canvas for every week. The Canvas online component will open prior to the first day of class so you may begin preparing for class. 

Assignments and required readings will be posted inside Canvas. 

In order to prepare for the first day of class, please review the following:

American Nurses Association, American Psychiatric Nurses Association, and the International Society of Psychiatric Mental Health Nurses. Psychiatric-Mental Health Nursing: Scope and Standards of Practice. Review Entire Manuscript

See Canvas for required readings for Week 1

Additional required articles are found inside the learning module

Reading for First Day in Class:

Sadock, BJ, Sadock, VA & Ruiz, P. (2015) Kaplan & Sadock's Synopsis of Psychiatry Behavioral Sciences Clinical Psychiatry 11th Ed. Chapters 1 Neural Science; Chapter 2 Contributions of the Psychosocial Sciences; and Chapter 3 Contributions of the Sociocultural Sciences.

Fitzpatrick, J.J. (2016). Theoretical understandings and evidence base for practice, Chapter 1 in Tusaie, K.R. & Fitzpatrick, J.J. (Eds.) (2016) Advanced Practice Psychiatric Nursing: Integrating Psychotherapy, Psychopharmacology, and Complementary and Alternative Approaches (2nd Edition). New York: Springer Publishing Company

Preliminary Class Calendar (check inside Canvas for updates)

Monday May 11, 2020	5:00 – 8:50 PM
Monday May 18, 2020	5:00 – 8:50 PM
Monday May 25, 2020	No Class – Memorial Day Online Work - week
Monday June 1, 2020	Online Work- week
Monday June 8, 2020	5:00 – 8:50 PM
Monday June 15, 2020	5:00 – 8:50 PM
Monday June 22, 2020	Online Work  - Week
Monday June 29, 2020	5:00 - 8:50 PM
Monday July 6, 2020	5:00 – 8:50 PM
Monday July 13, 2020	5:00 – 8:50 PM
Monday July 20, 2020	Online week & Exam 5:00 - 6:30 PM
Monday July 27, 2020	5:00 – 8:50 PM Psychotherapy Presentations
Monday August 3, 2020	5:00 – 7:50 PM Final Exam

FACULTY CONTACT INFORMATION

Mark Soucy, PhD, RN, APRN, FAANP

Associate Professor - Clinical

Track and Course Coordinator

Room 2.132

UT Health San Antonio School of Nursing

Telephone: 210-567-5893

FAX: 210-567-5822

Office Hours by Appointment (Use Starfish) and Posted OutsideOffice

Email: soucy@uthscsa.edu

Marta Vives, DNP, RN, APRN,FPMHNP-BC
Assistant Professor - Clinical
Course Faculty
Email: vivesm1@uthscsa.edu
Office Phone: 210-450-8194
FAX: 210-567-5822
Office Room: 2.334
Office Hours: By Appointment through Starfish

Benjamin Snellgrove, MSN, RN, APRN, PMHNP-BC
Clinical Assistant Professor
Guest Lecturer
Email: SnellgroveB@uthscsa.edu 
Office Phone: 210-450-0822
FAX: 210-567-5822
UT Health San Antonio School of Nursing
Office Hours by Appointment  (Use Starfish)

COURSE DESCRIPTION

This course provides the theoretical basis for the competencies of the Psychiatric Mental Health Nurse Practitioner (PMHNP). This course lays the scientific foundation for independent practice as the RN transitions to the role of the Nurse Practitioner in health promotion, disease prevention, diagnosis and management of illness in psychiatric patients across the lifespan. Using self-directed learning strategies, disorders of approximately one half of the physiologic/psychological systems are examined. Psychotherapies and theories of psychopathology are surveyed. Additionally, this course emphasizes collaborative, partnership development among patients, families, and interprofessional teams.

CREDIT AND TIME ALLOCATION

Credit Hour Allocation: 4 semester credit hours
Clock Hour Allocation: 60 clock hours class

PREREQUISITES

• NURS 5339 Leadership for Quality, Safety, and Health Policy
• NURS 5306 Advanced Theory for the Practice of Nursing
• NURS 5307 Using Research for the Practice of Nursing
• NURS 5356 Financial and Economic Evidence in Healthcare
• NURS 6315 Informatics and Health Care Technologies
• NURS 6250 Health Promotion, Health Protection and Disease Prevention
• NURS 5338 Advanced Pathophysiology
• NURS 6302 Advanced Pharmacotherapeutics
• NURS 6110 Advanced Health Assessment and Clinical Reasoning: Clinical Application
• NURS 6210 Advanced Health Assessment and Clinical Reasoning
• NURS 6312 Advanced Mental Health Concepts

PROGRAM OUTCOMES

Upon completion of the Master of Science in Nursing Program (MSN) students will:

1. Integrate scientific findings from nursing and related sciences, including genetics and genomics, into the delivery of advanced nursing care to populations in diverse settings.
2. Demonstrate organizational and systems leadership to assure ethical and critical decision-making at all systems’ levels for quality and patient safety.
3. Incorporate performance improvement strategies for quality, safety, and patient-centered care delivery.
4. Use improvement science to achieve optimal patient care and care environment outcomes.
5. Integrate meaningful and usable information systems and healthcare technologies to support safe, quality patient care and healthcare systems effectiveness.
6. Advocate for policy changes that influence healthcare at appropriate levels.
7. Lead interprofessional teams using collaborative strategies to effect quality patient care and population health outcomes.
8. Analyze and incorporate broad ecological and social health determinants to design and deliver evidence-based clinical prevention and population healthcare and services to individuals, families, and aggregates/identified populations.
9. Integrate the advanced competencies expected of a master’s prepared nurse to design, deliver, and evaluate outcomes of systems of care for individuals, families, and diverse populations.

COURSE OUTCOMES

1. Apply theoretical concepts of patient-centered care with emphasis on health promotion, disease prevention, health protection, anticipatory guidance, counseling, and disease management of patients and families during developmental transitions and life-style adjustments in psychiatric practice across the lifespan (Essentials I, III, VIII).
2. Demonstrate integrated learning of course concepts by applying knowledge of acute and chronic illness to diagnose and manage patients and their families in psychiatric practice across the lifespan and as health status varies (Essentials I, IX).
3. Integrate history and physical examination data with the knowledge of pathophysiology of acute and chronic diseases to develop appropriate differential diagnoses, and initiate customized interventions in psychiatric practice across the lifespan (Essentials I, IV, VII, IX).
4. Integrate traditional and complementary pharmacological interventions into the treatment and management of psychiatric illnesses (Essentials I, IX).
5. Integrate social, cultural, explanatory models and spiritual components in patient-centered plans of care in psychiatric practice across the lifespan (Essentials I, VIII).
6. Demonstrate core professional values and ethical/legal standards in the implementation of the nurse practitioner role (Essentials I, III, IV, IX).
7. Identify and integrate evidence-based findings to the diagnosis and management of illnesses in psychiatric practice across the lifespan (Essentials I, VIII and IX).
8. Examine, evaluate, and demonstrate professional development in the role of the Nurse Practitioner in the diagnosis and management of health and wellness as well as acute and chronic illnesses in psychiatric practice across the lifespan as a member of an interprofessional team (Essential II, VII, VIII, IX).
9. Analyze patient safety, quality indicators, and outcome improvement in the delivery of quality primary care to patients (Essentials I, III).

GRADING SCALE FOR GRADUATE COURSES

A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)

CRITERIA FOR EVALUATION / GRADES

A = 90 - 100 Points
B = 80 - 89   Points
C = 75 - 79   Points
D = 66 - 74   Points
F =  65 and below Points

Please see Canvas for details of assignments, examinations, discussions, and grading criteria 
 

CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

APA GUIDELINES

The APA Publication Manual 7th edition is required for use in all nursing school programs. 

SCHOLASTIC DISHONESTY

Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.

PROFESSIONAL CODE OF CONDUCT

Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.

http://catalog.uthscsa.edu/schoolofnursing/policiesandprocedures/

School of Nursing Netiquette Guidelines for Online Interaction

Netiquette guidelines provide information for behaving properly online, when using email, tweets or texts so that you may successfully communicate your thoughts in a manner that is respectful and avoids misunderstandings with others.

• Be courteous about what you say to or about others in any electronic format. In electronic communication the golden rule is "Remember the Human." Remember there is a real person with real feelings on the receiving end of your email or post.
• Be respectful and open to opinions and ideas that differ from yours. The exchange of diverse thoughts, ideas and opinions are an important part of the scholarly environment. Keep in mind that the people in your classes may come from different backgrounds and have views that may vary significantly from your own.
• Flaming (defined as posting of messages that are deliberately hostile and insulting in an online social context) is never appropriate. While everyone (learners and instructors alike) is encouraged to share ideas and opinions openly, you should never use insults or resort to name-calling even if you disagree strongly with what someone else has written.
• When responding to messages or posts made by others, address the ideas, not the person.
• It’s often best to avoid using sarcasm and humor online. Without social cues, such as facial expressions and body language, a remark meant as humorous could come across hurtful or offensive. Keep in mind that ‘emoticons’ (such as J) may not convey your tone or intent.
• Capitalizing whole words is generally seen as SHOUTING and is difficult for most people to read. Use all capital letters sparingly, such as to highlight an important word or point.
• Think and reread what you’ve written before you post! Make sure that what you’ve written makes sense (is clear and to the point).
• Remember you are responsible for the content you communicate on CANVAS. What you write represents you, so use appropriate language. Remember that all writing should be professional, consisting of complete sentences, and free of grammatical and spelling errors.
• Be aware that distributing copyrighted materials, such as articles and images, is illegal. Most of the materials on the Internet are copyrighted. The only time it’s ok to distribute materials from the Internet is when you are sure those materials are "fair use." To be safe, if you want to share materials with classmates and/or your instructor, share the web link or URL only.
• To avoid plagiarism, make sure you properly cite all source materials. All materials should be cited unless you are the author of the content.
• Protect your privileges in online communication (avoid posting spam or emailing chain letters).

ADA ACCOMMODATIONS

Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.

REQUIRED TEXT / REFERENCE

Required Texts

American Nurses Association. (2015) Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: Nursesbooks.org ISBN: 9781558105997

American Nurses Association (2013) Psychiatric-Mental Health Nursing Scope and Standards of Practice 2nd Ed. Nursebooks.org ISBN: 9781558105553

American Nurses Association (2015). Nursing: Scope and standards of practice, 3^rd Ed. Silver Springs, MD: Nursingbooks.org.ISBN: ISBN: 978-1-55810-619-2

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Paperback (DSM-5). American Psychiatric Association. ISBN 978-0-89042-555-8

Beck, J.S. (2011). Cognitive Behavioral Therapy: Basics and Beyond 2nd Edition. Guilford Press. ISBN: 978-1-60918-504-6

Blazer D.G., Steffens D.G., Busse E.W. (2015) The American Psychiatric Publishing Textbook of Geriatric Psychiatry. 5th ed. Washington, DC: AmericanPsychiatric Publishing; 2015. Use the electronic edition available through the library

Carlat, D.J. (2017). The Psychiatric Interview 4^thEd. Wolters Kluwer  ISBN 978-1496327710

Dunphy, L.M., Windland-Brown, J.E., Porter, B.O., & Thomas, D.J. (2019). Primary Care: Art & Science of Advanced Practice Nursing - An interprofessional approach, 5th Ed. F.A. Davis. ISBN: 9780803667181

First, M.B. (2013) DSM 5 Handbook of Differential Diagnosis. American Psychiatric Publishing, Inc. ISBN: 9781585624621

Neuroscience Education Institute – Membership  Student Rate https://www.neiglobal.com/Members/Become/MBRRates/tabid/192/Default.aspx

Full Time Students Discount membership

Perese, E.F. (2012). Psychiatric advanced practice nursing:A biopsychosocial foundation for practice. Philadelphia, F.A. Davis.ISBN:978-0-8036-2247-0

Sadock, B.J., Sadock, V.A., & Ruiz, P.  (Eds.) (2015).  Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/Clinical psychiatry. 11th Ed. Philadelphia, PA: Lippincott Williams & Wilkins/Wolters Kluwer

Stahl, S. M. (2017). Stahl’s Prescribers Guide, 6^thEd. Cambridge UK: Cambridge University Press. ISBN: 978-1316618134

Stahl, S.(2013) Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications 4th Edition. Paperback Edition.  ISBN:  9781107686465

Tusaie, K.R. & Fitzpatrick, J.J. (Eds.) (2017). Advanced practice psychiatric nursing: Integrating psychotherapy, psychopharmacology, and complementary and alternative approaches across the life span, 2^nd Ed. New York, Springer Publishing Company.ISBN: 978-0-8261-3253-6 

Van Leeuwen, A.M. & Bladh, M.L. (2019). Davis'comprehensive manual of laboratory and diagnostic tests with nursingimplications. FA Davis. ISBN 978-0803674950

Wheeler, K. (2013). Psychotherapy for the advanced practice psychiatric nurse: A how to guide for evidence-based practice. 2nd Edition Springer Publishing. ISBN: 9780826110008

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Recommended Texts:

Kreisman, J.J. & Straus, H. (2010)  I Hate You - Don't Leave Me: Understanding the Borderline Personality.   Check inside Canvas course

Strongly Recommended:

Shea, S.C. (2017) Psychiatric Interviewing: The Art of Understanding: A Practical Guide for Psychiatrists, Psychologists, Counselors,Social Workers, Nurses, and Other Mental Health Professionals, with online video modules 3rd Edition.  Elsevier.ISBN: 978-1437716986

Recommended:

Townsend, M.C. & Morgan, K.I. (2018) Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice 9th Edition. FA Davis.  ISBN: 978-0803660540

CONTENT OUTLINE

Foundational Concepts

A. The role of the Psychiatric/Mental Health Nurse Practitioner
    1.The Nurse Practitioner role
    2.Role definition, expansion, and culture
    3.Evidence-Based Nursing Practice
    4.Information Technology in Advanced Practice Nursing

B. Historical and Theoretical Background of Advanced Practice Psychiatric Mental Health Nursing
    1. Psychoanalytic Theory
    2. Developmental Theory
    3. Behavior Theory
    4. Client Centered Theory
    5. Cognitive Theory
    6. Biological Models
    7. Peplau: Interpersonal Relations

C. The Psychiatric Interview & Differential Diagnosis Using DSM-5
    1.Basic Components of the Psychiatric Interview
    2.Practical Issues in Interviewing
    3.Mental Status Examination

D. Legal & Ethical Issues in Psychiatric Care
    1.Confidentiality
    2.Privilege
    3.Involuntary Treatment
    4.Capacity and Sanity

E. Psychobiology
    1. Neuroanatomy
    2. The Neuron
    3. Neurotransmitters

F. Psychoneurobiology of Mental Diseases
    1.Fear, Reward, and Motor Action
    2.Memory
    3.Medical Disorders of Concern in Psychiatry 
    4.Aggression and Antisocial Behavior
    5.Substance Abuse
    6.Depression
    7.Anxiety Disorders
    8.Adjustment Disorders
    

G. Antidepressants and Mood Stabilizers
    1. Monoamine Oxidase Inhibitors
    2. Tricyclic Antidepressants
    3. The Serotonin Reuptake Inhibitors
    4. The Atypical Antidepressants
    5. Lithium
    6. The Anticonvulsants

H. Mood Disorders Across the Life Span
    1.The Depressive Disorders
    2.The Bipolar Disorders
    3.Other Mood Disorders

I. Mental Health Promotion
    1.Health Promotion Models
    2.Suicide Prevention

J. Individual Therapies theory
    1. Cognitive Behavioral Therapy
    2. Brief Psychotherapy
    3. Dialectical Behavior Therapy
    4. Psychodynamic Psychotherapy
    5. Humanistic Existential 

K. Substance Use Disorders
    1. Alcohol
    2. Cocaine
    3. Opioids
    4. Marijuana
    5. Prescription Drug Abuse (Benzodiazepines)
    6. Other abused substances
    7. Management of Substance Use Disorders

L. Personality Disorders
    1.Theories of Personality Development and Pathology
    2. Odd & Eccentric
    3. Erratic & Dramatic
    4. Anxious & Avoidant
    5. Treatment Strategies
    6. Self Injury

*(or 6416)

CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.

This course opens inside Canvas just prior to May 11, 2020.  The course officially begins on May 11, 2020.  Please check Canvas for online assignments.

Instructions to prepare for first day of class:

Complete Web Learning Unit 1 on Foundational Concepts for Psychiatric Mental Health Advanced Practice as soon as the course opens.

Complete Web Learning Units II on Psychiatric Assessment, Clinical Interviewing, Case Formulation & Unit III on Therapeutic Communication & Introduction to Psychotherapy.


The first day of online class is scheduled for May 11, 2020:

5:00 - 5:50 Introductions & Course Orientation

5:50 - 6:00 Break

6:00 - 6:50 Foundational Concepts Part I

6:50 - 7:00 Break 

7:00 - 7:50 Foundational Concepts Part II - Psychiatric Diagnostic Interview

7:50 - 8:00 Break

8:00 - 8:50 Assessment, Differential Diagnosis, Clinical Interviewing, and Introduction to Psychotherapy

Exam dates and times will be listed inside Canvas

For full calendar information and details, please refer to the information posted inside Canvas.

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