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Nursing Workforce Development: Implications for Children’s Mental Health. Nalini Jairath, PhD, RN, Dean Ellen Mahoney, DNSc, CARN, RNCS , Clinical Assistant Professor Sylvia Stevens, MS,RN,CS, Clinical Assistant Professor School of Nursing, The Catholic University of America.

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nursing workforce development implications for children s mental health
Nursing Workforce Development: Implications for Children’s Mental Health

Nalini Jairath, PhD, RN, Dean

Ellen Mahoney, DNSc, CARN, RNCS, Clinical Assistant Professor

Sylvia Stevens, MS,RN,CS, Clinical Assistant Professor

School of Nursing, The Catholic University of America

The Skills to Succeed -The Values that Guide

slide2
Purpose: Describe an educational initiative for nursing personnel caring for adolescents and children in a dedicated psychiatric facility
  • Assumption: The knowledge, skills and attitudes of care providers can be changed through targeted, on-site education

The Skills to Succeed -The Values that Guide

mental illness in childhood
Mental Illness in Childhood
  • Approximately 1 in 5 American children have diagnosable mental illness in any given year (US Surgeon General)
  • Mental illness significantly affects daily life for approximately 5 million American children and adolescents
  • The most severely affected children require some type of acute/longer term intervention in a dedicated psychiatric setting

The Skills to Succeed -The Values that Guide

mental illness in children
Mental Illness in Children
  • Anxiety Disorders
  • Disruptive behavior disorders
  • Developmental disorders
  • Eating & Elimination disorders
  • Learning & communication disorders
  • Affective/mood disorders
  • Schizophrenia
  • “Tic” disorders
  • Dual Diagnoses

The Skills to Succeed -The Values that Guide

treatment
Treatment
  • Medication
  • Psychotherapy (directed counseling)
  • Expressive therapies (music, play, art)
  • Team approach; all care providers are involved in therapy

The Skills to Succeed -The Values that Guide

nursing role
Nursing Role
  • Therapy involves changes in life patterns and responses
  • Therapy is not confined to encounters with psychiatrist, but also occurs in groups and individually
  • Nursing personnel are present 24 hours

The Skills to Succeed -The Values that Guide

the concern
The Concern
  • Massive shortage of nurses
  • Even greater shortage of psychiatric nurses because of need for special skills, stigma of mental illness
  • Balance between RN, LPN and psychiatric technicians
  • The role of culture and education upon knowledge, skills and attitudes of nursing personnel

The Skills to Succeed -The Values that Guide

slide8
Nursing personnel must be present in sufficient numbers and must have the knowledge, attitudes and skills to be therapeutic as opposed to simply being present

The Skills to Succeed -The Values that Guide

grant goals
Grant Goals
  • Develop career advancement program for culturally diverse nursing personnel
  • Augment skills in current child and adolescent psychiatric-mental health care roles across clinical settings
  • Promote entry into nursing and advancement through nursing degree

The Skills to Succeed -The Values that Guide

partners
Partners
  • School of Nursing: The Catholic University of America
  • Adventist Behavioral Health Network
  • (Potomac Ridge)
  • (Crownsville Hospital)
  • (Adventist Healthcare Group Homes)
  • (Runaway Program)
  • Montgomery County Community Mental Health Center/Linkages

The Skills to Succeed -The Values that Guide

potomac ridge adventist behavioral health
Potomac Ridge Adventist Behavioral Health
  • Acute children’s unit
  • Acute adolescent unit
  • Two long term units for girls who have been sexually abused
  • Sexual offender unit for boys

The Skills to Succeed -The Values that Guide

nursing personnel
Nursing Personnel
  • Roughly 30% registered nurses, 20% licensed practical nurses & 50% psychiatric technicians
  • Many of the nurses have been educated outside of the United States, most notably in the Caribbean & African nations
  • Multicultural staff

The Skills to Succeed -The Values that Guide

slide13

Orientation

Unit-based training of nursing staff

REMEDIATION

Pre-nursing transition

Intro to Psych. Nursing

Certificate Offerings

Nursing Degree Programs

Proposed Developmental Pathways Through Career Advancement

The Skills to Succeed -The Values that Guide

strategy
Strategy
  • Non-degree certificate program
  • Articulation into nursing degree program
  • Pre-nursing transition program
  • Computer Labs & Web-Enhanced Learning

The Skills to Succeed -The Values that Guide

certificate programs
Certificate Programs
  • Caring & The Healing Arts of Psychiatric-Mental Health Nursing
  • Human Growth & Development in the Early Years
  • Social Justice & Mental Health Care Ethics for Children & Adolescents
  • Clinical Observations & Assessment of Children & Adolescents

The Skills to Succeed -The Values that Guide

certificate programs cont
Certificate Programs (cont)
  • Clinical Interventions for Children & Adolescents 1
  • Clinical Interventions for Children & Adolescents 2
  • Evidence-Based Clinical Practicum
  • Each module is about 20 hours

The Skills to Succeed -The Values that Guide

outcomes
Outcomes
  • Computer labs/learning centers established at two sites
  • Long distance teleconferencing/telelearning packages in place
  • Courseware for online learning functional
  • Certificate modules available via face to face and online

The Skills to Succeed -The Values that Guide

outcomes18
Outcomes
  • 27 nursing staff employees of the Adventist Behavioral System have taken classes in certificate program (19 nurses and 8 technicians)
  • Approximately 1 on 5 nursing staff employees have taken certificate programs
  • 27% decrease in turnover rates for the combined group

The Skills to Succeed -The Values that Guide

outcomes cont
Outcomes (cont)
  • Pilot of streamlined admission process to MSN program at CUA through elimination of GRE requirement
  • Research project entitled “Hospitalized Psychiatric Patients’ Perceptions of Nurse Caring Behaviors” is under development
  • Poster presentation at American Psychiatric Nurses Association 2005 conference

The Skills to Succeed -The Values that Guide

issues
Issues
  • Computer competence of nursing personnel;in-service education required
  • Poor staffing and inclement weather affect ability to attend face to face classes
  • Different learning needs of ABH nursing personnel and Linkages to Learning personnel
  • Challenges involving nursing staff in research & evidence-based practice opportunities

The Skills to Succeed -The Values that Guide

conclusion
Conclusion
  • Personnel costs of grant offset by retention benefits
  • Nursing workplace program is cost-effective and should ultimately improve patient care

The Skills to Succeed -The Values that Guide

acknowledgement
Acknowledgement
  • The project described in this presentation was supported by a grant (D65HP03108) from the Bureau of Health Professions. Their support and assistance is gratefully acknowledged.

The Skills to Succeed -The Values that Guide