NURS 6670 Psychiatric Mental Health

The Psychiatric Mental Health Nurse Practitioner (PMHNP) Doctor of Nursing Practice (DNP) program at Seattle University prepares you for advanced nursing practice and leadership in transforming health care systems that serve individuals with mental health and substance-related problems and their families. Our program’s distinctive lifespan approach focuses on the integration of mental health and addictions treatment in community, primary care, hospital and outpatient settings. NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

Join us as we provide a scientific and compassionate framework for understanding and intervening in complex problems that face populations disproportionately affected by mental health and substance-related problems. Become a leader who drives policies and reduces disparities in access to high-quality, evidence-based mental health and addiction treatment for children, adolescents, adults and older adults in our community.

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Psychiatric Assessment of the Adult and Older Adult

Attach the interview format document you would use for an initial interview of a client. Describe what interview format your preceptor uses for the initial interview of a client.

Describe which element of your interview format is most helpful in your practice For any assignment, it should be written for NURS 6670, Psychiatric Mental Health Nurse Practitioner role for Adults and older adults except otherwise stated. Please, contact me for clarification if more information is needed.

NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Psychiatric Assessment of the Adult and Older Adult

Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true).

Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges.

This week, you will develop your own personal format for initial interviews of mental health clients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam.

Week 1 – Developing skills in interviewing and diagnostic reasoning

As we begin Week 1, the module is focused on developing an interview format that provides you with questions/responses that you will use in your work-ups and diagnostic assessments or some call them Psychiatric H & P. By now, you have seen many different formats and ways that providers conduct interviews.

For this document, I encourage you to think of your personal style as well as assure that all relevant information is collected in the first interview. Do not use a template that you find online or that your preceptor uses in the office. The purpose of this assignment is for you to think through how you interview patients. There are many examples online to use as a guide. The key elements are similar to a medical H &P, HPI, PPH, PMH, FH, SH, ROS (psychiatric), MSE, Clinical Assessment and Formulation, Diagnosis, and Plan. This will be your ‘bread and butter’, so to speak for your entire career. It is worth spending some time and effort on this. If you put in a canned template, I will not accept your work. NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

My personal style is what I would call ‘conversational’. I try to engage in some social conversation to get the visit started and then as the patient talks, I make notes on follow-up questions. I keep a list of the basic things that I need for my write-up: HPI, PPH, PMH, Soc/Dev, Substance use, Medication history, Stressors, coping abilities, therapy history. At the end of what I consider ‘the interview’ I review my list to make sure that I have all the information and I sometimes say to patients, “let me make sure that I got all the information that I need to make an accurate diagnosis and develop a treatment plan”. Then, I will say to the patient, “do you have anything that you’d like to add?”

This conversational style is not for everyone and I know many providers that use more of a ‘checklist’ style. Think about what you want and how you will feel most comfortable. Feel free to provide feedback to your colleagues –there are no right or wrong styles.

Instructions – Week 1:

Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. In fact, there are numerous books written about the various ways of conducting the clinical interview. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client. In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback.

Learning Objectives

Students will:

Develop formats for initial interviews of mental health clients

To prepare for this Discussion:

Review the Learning Resources. Develop an interview format you would use for an initial interview of a client.

ASSIGNMENT

Attach the interview format document you would use for an initial interview of a client. Describe what interview format your preceptor uses for the initial interview of a client. Describe which element of your interview format is most helpful in your practice. NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

Learning Resources Required Readings Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Section 5.1, “Psychiatric Interview, Mental Status Examination” (pp. 192–211) Section 5.2, “The Psychiatric Report and Medical Record” (pp. 211–217) Section 5.3, “Psychiatric Rating Scales” (pp. 217–236) Section 5.5, “Personality Assessment: Adults and Children” (pp. 246–257) Section 5.7, “Medical Assessment and Laboratory Testing in Psychiatry” (pp. 266–275) Chapter 6, “Classification in Psychiatry” (pp. 290–308)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Cautionary Statement for Forensic Use of DSM-5” “Assessment Measures” “Cultural Formulation” “Glossary of Technical Terms” “Glossary of Cultural Concepts of Distress”

Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults.

Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Required Media

Laureate Education (Producer). (2017b). Working with Adults and Older Adults” [Video file]. Baltimore, MD: Author.

Hagen, B. (Producer). (n.d.-a). Conducting a mental status exam [Video file]. Mill Valley, CA: Psychotherapy.net.

Optional Resources

American Psychological Association. (2008). Assessment of older adults with diminished capacity. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf

Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine, 78(4), 489–497. doi:10.1002/msj.20277

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). TIP 59: Improving cultural competence. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders. Psychiatric Nursing essay assignment paper

Learning Objectives for NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Students will:

• Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients
• Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy
• Evaluate efficacy of treatment plans
• Analyze ethical and legal implications related to prescribing antidepressant therapy to adult and geriatric clients.

Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

• At each decision point stop to complete the following:
  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources. Psychiatric Nursing essay assignment paper.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

Review the following medications:

• amitriptyline
• bupropion
• citalopram
• clomipramine
• desipramine
• desvenlafaxine
• doxepin
• duloxetine
• escitalopram
• fluoxetine
• fluvoxamine
• imipramine
• ketamine
• mirtazapine
• nortriptyline
• paroxetine
• selegiline
• sertraline
• trazodone
• venlafaxine
• vilazodone
• vortioxetine

you can edit my work bellow, add more information  , and use same medication therapy. Plagiarism must be less than 15 %

NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Introduction

Improving depression care for depressed older men is a public health priority because older men are less likely than older women to receive depression treatment and are also more likely to commit suicide .Depressive disorder causes a continuous feeling of worthlessness , hopelessness and unhappiness to the victim and loss of interest in what they used to enjoy doing, also call major depressive disorder (MDD) or clinical depression (Unützer & Park, 2012). 3 Depression is one of the most common mental health problem leading to disabling in older men (Unützer & Park, 2012). A Late-life depression (LLD), is referring to depression that recurs in old age (having begun earlier in life) and again late in life; this negatively affect patients cognitive impairment, functional impairment, and development of Alzheimer’s disease and vascular dementia (Diniz & Reynolds, 2014).

3 Late-life depression (LLD is associated with burden of medical illnesses (especially cardiovascular and cerebrovascular) and risk of death. Patients assessment for depression should be using a standard rating scale, and initiate effective treatment such as antidepressant medications or evidence-based psychotherapies and psychiatric follow up. Electroconvulsive therapy (ECT) (Unützer & Park, 2012) can be an alternative for patients who are not improving. Antidepressants reduce the consequences of depression. 3 It is important to note that depressed adults may be at increased risk for antidepressant adverse effects. (Diniz & Reynolds, C. F. (2014). 3 This week paper focuses the identifying and trPsychiatric Nursing essay assignment papereatment of late-life depression of an Elderly Hispanic Man with history of Major Depressive Disorder (MDD).

Decision #1

1 Will start with Zoloft 25 mg orally daily

Reason for the Selection:

3 Assessment tool used is Montgomery–Åsberg Depression Rating Scale (MADRS), patient score 52, which is an indication of severe depression. When choosing an antidepressant my treatment option is based on the best side effect profile and lowest risk of drug-drug interactions Wiese, (2011). Wellbutrin is an antidepressant, but can cause seizures and Effexor may increase blood pressure Wiese, (2011). Zoloft is one of the most effective and safest medication for the treatment of severe depression in adults (Flint & Rifat, 2013. My best option is Zoloft 25mg which is best choice because of harmless to the elder (Flint & Rifat, 2013). Antidepressant use in the elderly are thought to be due to changes in hepatic metabolism with aging, concurrent medical conditions, and drug-drug interactions (Wiese, B. 2011). 3 (Flint & Rifat, 2013).

Expected Results

The patient should be able to improve within two weeks. Some signs should might be am improve in his work, exercise, hobbies, intellectual pursuits, as well improve sleep. 3When using Zoloft, the level of awareness should improve. It must be noted that the patient is back on track with motivation to follow his normal activities and relate well with associates (Flint & Rifat, 2013).NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

1 Differences between Expected Results and Actual Results

3 Expected outcome after the use of Zoloft 25mg is the patient will see improvement in his mental capability and importantly that there was no side effect of the medication.The patient revisited after four weeks on his follow up appointment and reported of a decrease in the symptoms, but with a complain of sexual dysfunction and insomnia. The difference in the expected result and the outcome may be reason out that the body of the patient is trying to adjust to the medication while solving the problem of MDD (National Alliance on Mental Illness, 2017).

1 Decision Point Two

Selected Decision: 1 Augmenting agent such as Wellbutrin XL 100 mg in morning

Reason for Selection

3 The added augmenting agent such as Wellbutrin XL150mg in morning was because the patient has some complain of having decrease sex drive, impotence, or difficulty in having an orgasm and sleep problem (insomnia). Bupropion is an antidepressant with excellent tolerability in elderly person improve depression, insomnia, somatic symptoms, work functioning, and certain quality-of-life measures in elderly depressed subjects with medical disorders (American Psychiatric Association, 2013). Though, patient verbalized decrease in the depression symptoms because of using Zoloft, but because of decrease sex drive and insomnia, Zoloft will be decrease to 12.5mg orally every day and continue to watch for side effects, like suicidal tendency in the elderly, and complain about ejaculatory and sexual dysfunction (American Psychiatric Association, 2013).

Expected Results

3 With the combination of using Wellbutrin and Zoloft, it is still expected to see the patient to continue to experience reduction in depression symptom. The therapeutic effect should be observable which will motivate and encourage the patient.

1 Differences between Expected Results and Actual Results

3 The expected outcome after four weeks visitation is that the therapeutic effect of the medication will be clear and no more report of adverse reaction, that shows patient is tolerating the medications as agree. The actual result was that the patient report that there was more reduction in the MDD symptom and improved in the side effect which is insomnia and sexual dysfunction.

Decision Selected. Psychiatric Nursing essay assignment paper

1 Decision Point Three

3 Selected Decision I will discontinue Zoloft 12.5mg orally daily and increase the dosage of Wellbutrin to 150mg XL every morning.

1 Reason for Selection

3 The desire result was not obtained in the second stage though the patient observe reduction in the symptom of MDD, but the resulting side effect is not reducing or eliminated. Wellbutrin XL can help to reduce depression and remove most of the side effect of Zoloft (Mangoni, & Jackson, 2004), also this will help attain therapeutic effect with his symptoms until his next appointment to evaluate response to therapy (Mangoni, & Jackson, 2004). The patient will have to be monitor closely because of the medication adjustment side effect, the suicidal tendency (Mangoni, & Jackson, 2004).

Expected Results

3 At this point the patient is anticipated to experience close to zero symptom of major depressive disorder without any side effect, the sleeping problem or insomnia, sexual dysfunction. He is also expected to have good interaction with neighbor and friends.

1 Differences between Expected Results and Actual Results

Wellbutrin 150mg XL, there is a solution in the treatment of the patient with MDD, (Laureate Education, 2016). 3 When the medication is working well with no side effect, patient will continue with Wellbutrin XL 150mg orally daily dose and will be re-evaluated during the next appointment, medication can be increase if there is a reduction in symptoms to achieved desired maximum therapeutic effect. The actual result from the patient is that the medication is achieving the therapeutic effect that is nePsychiatric Nursing essay assignment papereded by the patient (Mangoni, & Jackson, 2004).

1 Impact of Ethical Considerations on Treatment Plan

3 Ethical Considerations on treatment plan of a psychiatry patients can be complicated which can arise from plan therapy. Addressing the side effects of medications should be the most important in the plan of this therapy which include suicidal tendencies, dosage adjustment and close monitoring for effects (Flint & Rifat, 2013. Some drugs can cause patients to have suicidal tendencies (Flint & Rifat, 2013. Ethically there are sometimes practitioner are being influence by the health insurance of the patient, that is it easier to have a claim for drug treatment than physical therapy, therefore the health professional will choose to go the route of drug treatment. In all consideration the beneficence and no maleficence principles must be observe, the best treatment and best drug that sooth the patient must be administered.

Conclusion

When treating patients, we must understand that some drugs are good for a patient but the side effect on the patient might be grave. A careful treatment and monitoring of patients is important for total healing (NAMI National Alliance on Mental Illness, 2017). Psychiatric Nursing essay assignment paper

References

American Psychiatric Association. (2013). 3 Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Note: 3 Retrieved from Walden Library databases.

Diniz, B. 3 S., & Reynolds, C. F. (2014). 3 Major Depressive Disorder in Older Adults: Benefits and Hazards of Prolonged Treatment. Drugs & Aging, 31(9), 661–669.http://doi.org/10.1007/s40266-014-0196-y

Flint, A. 3 J., & Rifat, S. L. (2013). 5 The effect of sequential antidepressant treatment on geriatric depression. 3 Journal of affective disorders, 36(3), 95-105.

Laureate Education. (2016g). Case study: 1 An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.Psychiatric Nursing essay assignment paper

Mangoni, A. 3 A., & Jackson, S. H. D. (2004). 3 Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. British Journal of Clinical Pharmacology, 57(1), 6–14.

Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884408/

6 National Alliance on Mental Illness. (2017). 3 What Is Sertraline and What Does It Treat? Retrieved from: https://www.nami.org/learn-more/treatment/mental-health-medications/sertraline-(Zoloft)

Unützer, J., & Park, M. (2012). 3 Older Adults with Severe, Treatment-Resistant

According to the Institute of Medicine, more than 20% of the growing older adult population has a mental health disorder (IOM, 2012). In the past, many older adults avoided psychotherapy because of the associated social stigma, but with the growing acceptance of therapy and awareness of mental health issues, more of this population is seeking the help they need. In your role, as the psychiatric mental health nurse practitioner, you have the opportunity to help these older adult clients overcome challenges that may have plagued them for a lifetime. Psychotherapy With Older Adults.

This week, as you explore psychotherapy with older adults, you assess clients and consider the appropriateness of various therapeutic approaches. You also examine the theories, goals, and objectives that guided your practicum experience throughout this course. Psychotherapy With Older Adults.

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Learning Resources for NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter 18, “Psychotherapy With Older Adults” (pp. 625–660)
• Chapter 20, “Termination and Outcome Evaluation” (pp. 693–712)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Note: You will access this text from the Walden Library databases.

McGuire, J. (2009). Ethical considerations when working with older adults in psychology. Ethics & Behavior, 19(2), 112–128. doi:10.1080/10508420902772702. Psychotherapy With Older Adults Note: You will access this article from the Walden Library databases.

Swift, J. K., & Greenberg, R. P. (2015). What is premature termination, and why does it occur? In Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes (pp. 11–31). Washington, DC: American Psychological Association. doi:10.1037/14469-002 Note: You will access this resource from the Walden Library databases.

Discussion: Clinical Supervision

Personal reflection and discussion with colleagues is essential to your development as a psychiatric mental health nurse practitioner. In Week 8, you collaborated with colleagues as you participated in your first Clinical Supervision. This week, you have the opportunity to continue your collaboration as you reflect on and discuss your experiences with counseling older adults. Keep in mind that although there may be challenges to counseling this population, these clients offer unique learning opportunities. For this Clinical Supervision, consider an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Learning Objectives

Students will:

• Assess clients presenting for psychotherapy
• Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy

To prepare:

• Review this week’s media and consider the insights provided.
• Reflect on the clients you are currently counseling at your practicum site.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit! Psychotherapy With Older Adults

By Day 3

Post a 3- to 5-minute Kaltura video that addresses the following:

• Describe an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Note: Do not use the client’s actual name.

• Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
• Identify any additional information about this client that may potentially impact expected outcomes.

Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

View a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by sharing additional insights or alternative perspectives. Support your feedback with evidence-based literature and/or your own experiences with clients.

Note about uploading media: Refer to the Kaltura Media Uploader instructions document, which provides guidance on how to upload media for the Clinical Supervision Discussions.

Submission and Grading Information for NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Grading Criteria

To access your rubric: Week 10 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion: Week 10 Discussion Psychotherapy With Older Adults

Assignment 1: Practicum – Client Termination Summary

Learning Objectives

Students will:

• Develop client termination summaries

To prepare:

• For guidance on writing a Client Termination Summary, review pages 693–712 of the Wheeler text in this week’s Learning Resources.
• Identify a client who may be ready to complete therapy.

The Assignment

With the client you selected in mind, address the following in a client termination summary (without violating HIPAA regulations):

• Identifying information of client (i.e., hypothetical name, age, etc.)
• Date initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
• Total number of sessions, including number of missed sessions
• Termination planned or unplanned
• Presenting problem
• Major psychosocial issues
• Types of services rendered (i.e., individual, couple/family therapy, group therapy, etc.)
• Overview of treatment process
• Goal status (goals met, partially met, unmet)
• Treatment limitations (if any)
• Remaining difficulties and/or concerns
• Recommendations
• Follow-up plan (if indicated)
• Instructions for future contact
• Signatures

By Day 7

Submit your Assignment. NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

Submission

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the following naming convention: “WK10Assgn1+lastname+first initial”.
• Click the Week 10 Assignment 1 link.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn1+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric: Week 10 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity: Submit your Week 10 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment: Week 10 Assignment

Assignment 2: Practicum – Week 8 Journal Entry

Learning Objectives

Students will:

• Develop diagnoses for clients receiving psychotherapy
• Evaluate the efficacy of existential-humanistic therapy for clients
• Analyze legal and ethical implications of counseling clients with psychiatric disorders
• Analyze clinical supervision experiences
• Analyze how nursing and counseling theories guided personal practice in psychotherapy
• Analyze goals and objectives for personal practicum experiences
• Analyze the impact of psychotherapy on social change

The Learning Objectives are related to the Practicum Journal Assignments presented in Weeks 8, 9, and 10.

Week 10 Journal Entry – NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Reflect on your overall practicum experience in this course. Then, address the following in your Practicum Journal:

• Explain whether your therapeutic theory has changed as a result of your practicum experiences. Recall the theories you selected in Week 1.
• Explain how you integrated the therapeutic approaches from this course in your clinical practice. Include how this helped you achieve the goals and objectives you developed in Week 1.
• Explain how you might impact social change through your work with clients who have mental health issues.
• Support your approach with evidence-based literature.

Note: Be sure to use the Practicum Journal Template, located in the Learning Resources.

By Day 7

Submit your Practicum Journal entries for Weeks 8, 9, and 10. Refer to the weekly instructions for additional guidance.

Submission

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignments using the following naming convention: “WK10Journal1+lastname+first initial,” “WK10Journal2+lastname+first initial,” and “WK10Journal3+lastname+first initial.”
• Click the Week 10 Assignment 2 link.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Journal1+last name+first initial.(extension)” and click Open. Repeat for each of the Practicum Journal submissions.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric: Week 10 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity: Submit your Week 10 Assignment draft and review the originality report. Psychotherapy With Older Adults

Submit Your Assignment by Day 7

To submit your Assignment: Week 10 Assignment 2.

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. Psychotherapy With Older Adults.

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Practicum Reminder

NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers – Time Logs

You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term. Psychotherapy With Older Adults.

Week in Review

Now that you have:

• Assessed clients presenting for psychotherapy
• Evaluated the effectiveness of therapeutic approaches for clients receiving psychotherapy
• Developed client termination summaries
• Analyzed how nursing and counseling theories guided personal practice in psychotherapy
• Evaluated goals and objectives for personal practicum experiences
• Analyzed the impact of psychotherapy on social change

Next week, you will:

• Analyze therapeutic approaches to treating clients with personality disorders
• Assess knowledge of concepts, principles, and theories. Psychotherapy With Older Adults.

Nursing is one of the fastest growing careers in the United States. According to the Bureau of Labor Statistics (BLS), nursing careers are projected to grow 15% by 2026 — more than twice the average. One of the advantages of working in a booming field like nursing is that there are so many directions for career growth and specialization.

One increasingly popular nursing specialty is psychiatric mental health nursing. While many mental health patients seek treatment from a psychologist, psychiatrist, or mental health counselor, nurses often play a vital role in the psychiatric care process.

There are two common types of nurses in this specialty: psychiatric nurses and mental health nurses. On this page, you can learn about what each specialist does.

Psychiatric Nurses

According to the American Psychiatric Nurses Association (APNA), psychiatric nurses are experts in crisis intervention, mental health assessment, medication and therapy, and patient assistance. Psychiatric nurses work closely with patients to help them manage their mental illnesses and live productive, fulfilling lives.

How They Work

When working with a new patient, psychiatric nurses start by interviewing and assessing them to learn about their history, symptoms, other ailments, and daily habits. A psychiatric nurse will usually work with people who have

• anxiety disorders, like panic attacks and phobias;
• mood disorders, including bipolar disorder and depression;
• issues with substance abuse, such as drugs and alcohol; or,
• Alzheimer’s disease and other forms of dementia.

Psychiatric nurses work closely with treatment teams to develop individualized patient plans, aiming to maximize care and help patients live productive lives. They also provide individual counseling to patients and families to help them understand the illness. Depending on the situation, nurses may also help patients dress, groom, and take their medications.

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Where They Work

Psychiatric nurses work in many environments. A few common ones are

• Hospitals
• Psychiatric hospitals
• Home healthcare organizations
• Prisons
• Outpatient mental health organizations
• Schools that serve people with emotional and mental issues

Hospital-based psychiatric nurses typically work 12-hour shifts, which is standard practice for nurses. Psychiatric nurses mostly work in inpatient centers and correctional facilities.

How to Become One

Becoming a psychiatric nurse requires at least a two-year associate degree in nursing, but most employers prefer a bachelor of science in nursing (BSN). Once you complete your nursing degree, you must first pass the National Council Licensure Exam (NCLEX-RN), then complete a PMHNP-BC certification through the American Nurses Credentialing Center (ACNN) to become a psychiatric mental health nurse.

Certification requires an active RN license, two years of clinical experience, 2,000 hours in a psychiatric nursing practice, and 30 hours of continuing education in psychiatric nursing. The certification is valid for five years, and renewal requires 75 hours of continuing education and one or more of the following: a presentation or lecture, publication or research, preceptorship, volunteer hours, a minimum of 1,000 practice hours, or a professional assessment.

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Mental Health Nurse

Like psychiatric nurses, mental health nurses work closely with patients who have mental health issues. They are experts in assessing, diagnosing, and treating psychiatric problems. Mental health nurses work as part of a team to provide total medical care for patients. Some common duties for mental health nurses include

• Evaluating mental health needs of patients
• Developing treatment plans
• Providing psychotherapy services
• Providing personal care
• Coordinating with families, doctors, and other health professionals
• Administering medications.

Nursing responsibilities grow with education and experience. As an LPN with a two-year degree, you will mostly provide personal care for patients and give them medications. But when you earn your BSN and become a full RN, you will have the training to assess and counsel patients.

Mental health nurse practitioners with an MSN perform many of the same tasks as psychiatrists. These duties can include diagnosing complex mental health problems, conducting psychotherapy sessions, and prescribing psychiatric drugs, all under the supervision of a physician or RN.

Where They Work

A mental health nurse may work in:

• General hospitals
• Psychiatric hospitals
• Home healthcare organizations
• Community health organizations
• Private medical practices

How to Become One

You can work in mental health as a nurse whether you have an LPN degree, which is a two-year degree, or a BSN degree, which takes four years to complete. You could also earn a general BSN and then get your master’s degree in nursing with a speciality in mental health nursing. Below, we examine the different types of nursing programs for those considering careers as psychiatric or mental health nurses. NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

The Educational Paths to Becoming a Psychiatric or Mental Health Nurse

Associate Degree in Nursing (ADN)

The ADN is the most common degree among RNs. It’s a 60-credit hour program and takes 18-24 months to complete. Students can choose between on-campus and online programs. Programs include core classes and a clinical rotation, which teach the basic skills necessary for entry-level positions in the nursing field.

Requirements vary by program, but some common core nursing courses are foundations in nursing, nursing care of adults, behavioral health, pharmacology, and maternal and child nursing care. After graduation, you need to pass the NCLEX-RN to receive your RN certification before you’re eligible to work as a nurse.

The ADN prepares you for entry-level positions in hospitals, nursing homes, physician offices, and home healthcare. As an entry-level RN, you perform basic tasks including operating medical equipment, checking patient vitals, wound care, diagnostic testing, and tracking patient charts.

A benefit of the ADN is that it only takes two years to complete, which allows you to begin earning income and work experience. A drawback is that career advancement is limited because a growing number of employers prefer higher-level degrees. However, the ADN builds a foundation from which you can pursue specialties like psychiatric nursing. Also, associate degree coursework fulfills necessary prerequisites for other degree programs. This makes an associate degree a practical way to start your nursing career.

NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Bachelor of Science in Nursing (BSN)

The BSN is a four-year, 120-123 credit hour degree. It is typically completed on-campus at a college or university, but online programs are becoming more popular. If you are already an RN, you should consider an RN-to-BSN degree. This is an accelerated program that accounts for work experience, which allows you to graduate sooner.

The program consists of core courses and a clinical rotation. Some common courses include nursing basics, pharmacology, research in nursing, and statistics. Minimum required clinical hours vary by program, but the average is three clinical hours for every one classroom hour. Upon graduation, you will be eligible for entry-level nursing positions.

A few advantages of a BSN over an associate degree is that you gain more in-depth education, command a higher salary, and are better positioned for career advancement. Also, a growing number of employers prefer applicants with a BSN, sometimes implementing deadlines by which associate degree employees must earn a BSN. If you are interested in pursuing a specialty like psychiatric nursing, a BSN helps you apply to higher level degrees. Additionally, some certifications require a BSN to apply.

Master of Science in Nursing (MSN)

The MSN is an advanced degree for RNs interested in pursuing a specialty. Common specialities are nurse practitioner, certified nurse anesthesiologist, clinical nurse specialist, and certified nurse midwife. Programs require 60-75 credit hours and take 18-24 months to complete. There are both on-campus and online options available. Coursework varies depending on specialty, but most MSN programs require a minimum of 600 hours in a clinical rotation to graduate. Admission requirements vary by school and specialty, but typically you need at least a bachelor’s degree, a GRE test score, and letters of recommendation to apply.

The key benefit of an MSN is specialization, which opens up advanced clinical positions. For instance, earning an MSN with a psychiatric concentration allows you to earn an APRN certification and practice as a psychiatric or mental health nurse practitioner. This is a high-level clinician role that offers higher pay, increased autonomy and responsibility, and opportunity for career growth. In some cases, an MSN is required for retaining a nursing license. The main drawbacks to earning an MSN are cost, difficulty, and time commitment.

Deciding whether an MSN is the right path for you comes down to your career goals. An MSN is geared toward those who seek higher clinical positions or want to teach. If that isn’t your career goal, an MSN might not be right for you.

Psychiatric mental health nurse practitioners (PMHNPs) are advanced practice registered nurse specialists who assess and diagnose mental health issues, and who offer treatment by means of pharmacotherapeutic and psychotherapeutic interventions.

PMHNPs work in clinical settings that include private, state or Veterans Administration in-patient or outpatient psychiatric facilities, private psychiatric practices, and community mental health centers. PMHMPs also provide services in settings such as correctional facilities, domestic violence shelters, residential substance abuse facilities, and schools.

PMHNPs may work with a wide range of people, including:

• Children who have or are at risk for emotional and behavioral disorders
• Adults dealing with stressful and emotional situations, including people dealing with chronic medical conditions and older adults at risk for emotional and cognitive decline
• People with a serious, chronic mental illness or who have mental health problems that lead to criminal behavior
• People with substance-related problems
• People who are in prison, homeless, victims of violence and abuse, and similar circumstances. NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Essay

Increasingly, PMHNPs are also involved in mental health care in primary care settings. Although primary care generalists often treat common mental disorders through psychotropic drug interventions, they don’t typically have specific training in psychiatric conditions, and often have limited time to spend with patients. Psychiatric mental health nurse practitioners serving in a primary care capacity are more often in a position to devote the time needed to provide specialized intensive mental health services.

PMHNP Education Programs – NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

A registered nurse interested in becoming a PMHNP must complete a master’s degree, post-master’s program, or Doctor of Nursing degree program with a concentration in psychiatric mental health. Post-master’s programs are typically pursued by nurses who already have a master’s degree in nursing (MSN) and later decide to specialize in psychiatric mental health. NURS 6670 Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Papers

Highly specialized programs are available that focus specifically on either adult or family (including children’s) mental health. Programs typically offer both theoretical and clinical practice courses that teach a broad range of skills, such as:

• Psychosocial and physical assessment and differential diagnosis of mental health conditions
• Managing the care of a patient, including managing symptoms and behavioral change using education, therapy, and medication
• Promoting mental health
• Understanding cultural differences in providing mental health care
• Using data to evaluate patient outcomes
• Working with families, other healthcare practitioners, and communities

PMHNP Certification and Licensure

National certification is a necessary part of being licensed or recognized by state Boards of Nursing as an advanced practice registered nurse (APRN) serving the psychiatric mental health patient population. Each state has its own licensing laws and requirements and also defines the scope of practice for nurse practitioners.

Certification offered through the American Nurses Credentialing Center results in the designation credential PMHNP-BC. Two exam options are available:

• Adult Psychiatric & Mental Health Nurse Practitioner — requires master’s, post-graduate, or doctorate degree from an adult psychiatric and mental health nurse practitioner program
• Family Psychiatric & Mental Health Nurse Practitioner — requires master’s, post-graduate, or doctorate degree from a family psychiatric and mental health nurse practitioner program

The educational program must have accreditation from the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC). The program must also have included all of the following:

• A minimum of 500 faculty-supervised clinical hours
• Three separate courses in advanced physical/health assessment, advanced pathophysiology, and advanced pharmacology
• Content in promoting health and preventing disease and in differential diagnosis and disease management
• Clinical training in at least two modalities of psychotherapeutic treatment

To be eligible to take a certification exam, nurses must have a current, active RN license in the United States or the equivalent in another country.

These computer-based exams are administered through Prometric Testing Centers, and applicants have 90 days after acceptance of their application to take an exam. Renewal of certification takes place every five years and requires professional development.

Specialty Certification

Psychiatric mental health nurse practitioners that complete educational programs specific to family psychiatric health and hold certification as Family Psychiatric and Mental Health Nurse Practitioners can also become certified as a Pediatric Primary Care Mental Health Specialist (PMHS) through the Pediatric Nurse Certification Board (PNCB).

This certification is for nurse practitioners who want to specialize in working with children who have mental health and psychiatric issues. PNCB recommends, but does not require, that candidates for this certification exam have professional experience that includes the following:

• At least 1,000 hours of nurse practitioner experience within the past two to three years in clinical practice related to primary care or behavioral and mental health issues
• Nurse practitioner continuing education in pediatric behavioral mental health
• Continuing education in pediatric psychopharmacology for nurse practitioners
• Continuing education in a variety of advanced practice nursing mental health content

The computer-based exam is administered through Prometric Testing Centers. Recertification takes place every three years and requires meeting all the following requirements:

• 30 contact hours of pediatric psychopharmacology within the past three years
• 30 contact hours of continuing education and/or professional practice learning activities within the past three years
• Having an active primary certification that is in good standing