A running header is not required in a student APA paper. Learning Plan 1 Claire Isha Molion Ryerson University Nursing Practice II CNCL 800 DS0 DT0 W2021 Jennifer Black February 12, 2021 RYERSON UNIVERSITY DAPHNE COCKWELL SCHOOL OF NURSING Learning Plan (C)NCL700/800 Student Name: Claire Isha Molion Date: February 12, 2021 … Continue reading “importance of safety in clinical nurses | My Assignment Tutor”
A running header is not required in a student APA paper. Learning Plan 1 Claire Isha Molion Ryerson University Nursing Practice II CNCL 800 DS0 DT0 W2021 Jennifer Black February 12, 2021 RYERSON UNIVERSITY DAPHNE COCKWELL SCHOOL OF NURSING Learning Plan (C)NCL700/800 Student Name: Claire Isha Molion Date: February 12, 2021 Setting: Schizophrenia Treatment Unit A: Unit 2-2 Preceptor/Mentor’s Name: Tatiana Issatchenko Work Study ☐ Clinical Placement ☐ Learning Goal: The learning goal for the present study is to look at the importance of safety in clinical nurses and patients with schizophrenia. The emphasis is on improving safety measure by using therapeutic communication and techniques. The theory that will be used to support this learning goal is Peplau’s Therapeutic Communication Model. This is a good start. You need to provide a brief rationale for choosing this goal. Why do you want to do this? How will you do this? When will you accomplish this by? You must include ALL SMART goal components. Please have another look at the sample LP in the course materials to see how an overarching goal statement should be constructed. Theoretical Perspective: Schizophrenia is a mental disorder that has a long-term effect on the mental and physical well-being of the individual. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, schizophrenia is a severe psychiatric disorder that requires urgent interventions. Peplau’s Therapeutic Communication Model, is a model that was theorized by Hildegard Peplau. The theory discusses how nurses should approach patients in terms of developing interpersonal relationships, identifying their roles in certain situations as well as assisting the individual in their process of healing and rehabilitation (Senn, 2013). This theory is useful in the present study because the concepts presented in Peplau’s theory can help the mental health nurse effectively communicate with the patient. Building this pathway of effective communication in a patient with schizophrenia is especially important (Loughland et al., 2015). One reason for this being that individuals with schizophrenia have positive symptoms such as delusions and hallucinations that can make them feel disoriented and disassociated from reality (APA, 2013). It is in this case that for the safety of the patient, their family as well as the caregiver, an effective communicative approach should be undertaken. According to the theory, the nursing goals are achieved in a systematic manner where both the nurse as well as the patient participate and exchange knowledge about the disorder in the process (Harris & Panozzo, 2013). In this method, the nurse taken on multiple roles, they are teachers, who impart knowledge to the patient. Mediators who pass on information between their doctors, their families and all other members involved. They also work as safety agents who put the patient’s safety first and work with them to ensure that they do partake in self-destructive or harming behaviors (Stockman, 2005). According to Peplau, there are four stages of building interpersonal relationships between the nurse and their patient. The first stage is Orientation where the client is introduced to the nurse who is a stranger to them and seeks their advice and support with their treatment (McCarthy & Aquino-Russell, 2009). They identify their problems at this stage and convey their questions to the nurse. At this stage, the role of the nurse involves conveying the needs of the client of the rest of the medical team as well interacting with the client directly to make them feel at ease. The second stage is that of Identification. In this stage, the patients feel a certain level of comfort with the nurse simply due to the fact that they know them. This decreases their level of helplessness as they can seek support from the nurse. The third stage is the exploitation stage. In this stage, the patient feels that they have become an integral part of the environment that they are in and may feel comfortable sharing more personal thoughts (D’Antonio, 2014). Patients may also feel more comfortable requesting for things and taking advantage of the resources made available to them. The final stage is the resolution stage. The resolution stage is where the nurse has to terminate their relationship with the patient. This is an integral step as the patient’s needs have been met and the nurse has done what they could do for them. It is also important to terminate the therapeutic relationship as the patients may develop a dependence which can become unhealthy for them. According to the theory purported by Peplau, the four stages that have been mentioned above all interact with one another and cannot be separated. Therefore, to create a plan that will help better therapeutic communications about safety among nurses and patients with schizophrenia we will be using the Peplau’s therapeutic communication model as the basis. Excellent! You’ve described the theoretical perspective well and you’ve articulated how it will be integrated into your learning plan. Well done. CNO Competency 1 & 2: The Canadian Nursing Practitioner’s Core Competency Framework has a set of conceptual frameworks that guide nurses in their roles. Four main competencies have been identified. The two competencies that are relevant to our plan are as follows. Competency #1: Therapeutic Management Under therapeutic management, the nurse is responsible for collaborating with their clients to come up with interventions that will best suit their recovery. This can includes both pharmacological and non-pharmacological methods. 3.1 The nurse is responsible for creating an environment where the patient can communicate effectively with regards to the interventions taking place. 3.5 The nurse via communication, supports their client and educates them about the progression of the disorder, teaches them how to manage their symptoms as well as provides them support to make long-term changes to their lifestyle to improve overall health. 3.11 The nurse is also responsible for informing the patient of the use and the benefits of the chosen therapeutic model. They should guide the patient by informing them of the necessity of following up with their medications and complying to doctor’s suggestions. Competency #2: Health promotion and prevention of illness and Injury. All nurse are responsible for working towards promotion of health and wellness in patients. Nurses in collaboration with other medical staff have to ensure the overall wellness and safety of the patient to reduce the risk of errors and mistakes, to protect the patient from injury and to cater to their individual needs based on their case. 4.1 The nurse has to look at the existing data to ensure that the interventions and plans that are being applied for patient care have positive long –term effects and do not have negative health implications. 4.2 The nurse must participate in the development of strategies that would best suit the needs of the client and address their concerns. 4.3 The nurse is responsible for designing intervention plans that will cater to the specific requirements of the clients and protect their wellbeing and interests. Good choices. You needed to provide a rationale for these choices and discuss how they are relevant to your LP. RNAO BPG 1 & 2: RNAO BPG Guideline #1: Person and Family Centered Care This guideline suggests that the role of the nurse involves focusing on aspects of patient care and make decisions regarding their treatment on a person-to person basis. The focus must be on the wellbeing of the patient. Recommendation #1: The first recommendation is that nurses have to identify the factors that are important for the patient’s wellbeing and involve the patient as well as the family in the decision making regarding the chosen interventions. Recommendation #2: A second recommendation is that the nurse must focus on educating the patient as well as their family and friends on the disorder, its symptoms, managing the symptoms as well as how to avoid triggering the patient. This will protect the safety of the patient and those around them. Recommendation #3: The third and final recommendation is that the nurses need establish a strong therapeutic relationship with the patient so as to understand verbal and non-verbal cues. This will help them build genuine relationships with the patient, which is essential in patients with schizophrenia. RNAO BPG Guideline #2: Promoting Safety: Alternative Approaches to the Use of Restraints This suggested guidelines looks are the use of restraints in patients that are at risk of harming themselves of others around them. In which case, the guidelines provides nurses with strategies on how they can practice safe restraining practicing with the patients to avoid them getting hurt in the process. Recommendation #1: It is a well-understood fact that nurse play an important role in ensuring the safety of the patients. On way through which they do this is by using alternative restraining methods. Patients with schizophrenia might not respond well to being physically restrained due to their symptoms of paranoia. Therefore, nurses must come up with alternative plans. Recommendation #2: Nurses must work in collaboration with the medical team so that they can de-escalate crises where the patient can endanger the lives of those around them including the nursing and medical staff. Recommendation #3: Lastly, the nurses should use restraints only out of concern for the safety of the patient and their wellbeing. Good. ObjectivesResources & TimelinesIndicators of AchievementThe first objective is to explain the Peplau interpersonal relationship model to nurses to help them get a better understanding on how to build genuine relationships with their patients. (Week 1) The first objective needs to be an assessment. The activity where you conduct a survey to assess opinions about communication issues is a good place to start. Conduct a 2-hour seminar with nurses about the role of interpersonal relationships and their importance in patients with schizophrenia. – this sounds like something you’d do in the Implementation phase of the LP. Why would you be doing a seminar in the assessment phase? Do you think that staff would participate? It might be easier to simply ask staff about their thoughts or ask them to complete a survey instead of asking them to attend a 2-hour session that they may not have time for. Conduct a small survey on where they think communication lacks with said patient group.Give them handouts of a compilation of studies and literature available on PubMed, Medline as well as NIMHS, which can be access through their university login. Bring in a licensed psychiatrist to talk about symptoms of schizophrenia and how to be safe.Is this really possible? What purpose would this serve? The handout will comprise of literature that is relevant to the patient group. The nurses feel less ambiguity about treating patients with schizophrenia. The nurses have the symptoms and their associated behaviors memorized. The interview must be completed and transcribed to note the initial understandings of the nurses.The second objective involves planning a session with the nurses to speak to them about safety in patients with schizophrenia and the role that delusions will play. (Week 2) This seems to be something you’d do in the assessment phase. You need to ensure that your objectives align closely with your overarching goal, which is to improve safety measures by using therapeutic communication and techniques. So, how will you accomplish this? To provide them with examples of delusional beliefs that patients might have via role-play. To give them a guideline on how to respond in various scenarios on recommendation from the psychiatrist. To learn grounding techniques from psychologists. To end the second week of the program with a “granny pitch” session.The granny pitch encapsulates what are the main points that need to be kept in mind in simple language that can be understood by a nonprofessional. The nurse is able to practice the grounding techniques for themselves. The nurse respond without fear and in a positive manner during the role-play. The nurses having memorized the guidelines of the psychiatrist by the end of this week.The third stage involves giving the nurses tools such as proper pamphlets and readings on how to ensure their own safety as well as the safety of patients with schizophrenia in agitated scenarios. (Week 3) Where will the pamphlets come from? Are you developing them or do they already exist? The implementation phase should include rolling out a planned information session to provide new or updated information. Coordinating with a content creator to make the content more succinct, appealing and informative to the nurses. What’s a content creator??? Performing one on one interactions with the nurses and testing them on how they handle agitated scenarios.The pamphlets are informative yet not too text heavy that the nurses cast them aside. The nurses are able to handle the one on one sessions and respond appropriately. The last stage of the plan involves evaluating the plan. To evaluate the plan there will a test and a real time simulation activity that will be conducted to see at the end of the four-week program how the nurse responds to an aggravated patient. (Week 4) This objective seems like it should be an implementation, not an evaluation. The real time role-play simulation activity will involve the nurse having to manage an agitated patient without any guidance or help. The test will include the material that was covered in the pamphlets as well as in the sessions by the psychologist and psychiatrist.The nurses are able to score at least 65% on the test that they are taking. The nurses are able to calm the patient down within the time limit of 6 minutes. Claire, this is a very good start. You have a lot of great ideas, but they need to be more streamlined and focused on your overarching goal. There is a lot going on in your learning objectives, and they seem a bit disconnected from your overarching goal. Think about what it is that you really want to accomplish this term. Are you hoping to help the nurses revise their communication skills? Are you hoping to do this for yourself? I think that you might be trying to do a bit too much. The activities and resources are good, but some of them seem to be a bit unrealistic and perhaps superfluous for the learning plan. Please keep things as simple as possible because of the limited time that you will be in this placement. Your goal and objectives need to be realistic and achievable. You should also revisit the LP sample that is posted in the course material section on D2L. The sample shows how a goal statement and objective statements should be written. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 College of Nurses of Ontario (2014). Competencies for Entry-level Registered Nurse Practice. Retrieved from, http://www.cno.org/globalassets/docs/reg/41037_entrytopracitic_final.pdf D’Antonio, P., Beeber, L., Sills, G., & Naegle, M. (2014). The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nursing Inquiry, 21(4), 311-317. A URL should be included here. Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?.[JB1] Nursing science Quarterly, 30(2), 160–167. https://doi.org/10.1177/0894318417693286 Harris, B. A., & Panozzo, G. (2019). Therapeutic alliance, relationship building, and communication strategies-for the schizophrenia population: An integrative review. Archives of Psychiatric Nursing, 33(1), 104-111. Loughland, C., Kelly, B., Ditton-Phare, P., Sandhu, H., Vamos, M., Outram, S., & ComPsych Investigators. (2015). Improving clinician competency in communication about schizophrenia: a pilot educational program for psychiatry trainees. Academic Psychiatry, 39(2), 160-164. A URL should be included here. McCarthy, C. T., & Aquino-Russell, C. (2009). A comparison of two nursing theories in practice: Peplau and Parse. Nursing Science Quarterly, 22(1), 34-40. URL?? Papageorgiou, A., Loke, Y. K., & Fromage, M. (2017). Communication skills training for mental health professionals working with people with severe mental illness. The Cochrane Database of Systematic Reviews, 6(6), CD010006. https://doi.org/10.1002/14651858.CD010006.pub2 RNAO. (2012). Person and Family Centered Care[JB2] . Retrieved 10 February 2021, from https://rnao ca/bpg/guidelines. RNAO. (2012). Promoting Safety: Alternative Approaches to the Use of Restraints[JB3] . Retrieved 10 February 2021, from https://rnao.ca/bpg/guidelines. Senn, J. F. (2013). Peplau’s theory of interpersonal relations: application in emergency and rural nursing. Nursing Science Quarterly, 26(1), 31-35. Stockmann, C. (2005). [JB4] A literature review of the progress of the psychiatric nurse-patient relationship as described by Peplau. Issues in Mental Health Nursing, 26(9), 911-919. Zarea, K., Maghsoudi, S., Dashtebozorgi, B., Hghighizadeh, M. H., & Javadi, M. (2014). The Impact of Peplau’s Therapeutic Communication Model on Anxiety and Depression in Patients Candidate for Coronary Artery Bypass. [JB5] Clinical Practice and Epidemiology in Mental Health: CP & EMH, 10, 159–165. https://doi.org/10.2174/1745017901410010159 Good list of resources! There are quite a few formatting errors in this reference list. C/NCL700/800: Learning Plan Part 1 Grading Criteria Rubric Student Name: Claire M. Grade: 10/15 (C) Grading CriteriaCommentsTheoretical Perspective: describes the theory and provides a rationale for the chosen theorydiscusses how the theory was integrated throughout the learning planExcellent choice. You’ve described it well and included a rationale for its use.One Overarching Goal: clearly statedSMART formatbrief rationale relates to the chosen themeapplicable to current practice placementrelevant to learning needs as a senior studentreflects course outcome and course objectives Your goal statement is good, but additional clarity is needed. Why have you chosen this goal? What is it that you hope to accomplish?Identifies 2 CNO competency categories and a minimum of 3 CNO competencies for each of the 2 categories and briefly explains connections between: learning goal and objectivesCNO standards Good choices. Rationale not included.Identifies two RNAO BPGs guidelines: implements threerecommendations per guideline describes the individual points under each recommendation discusses how the guidelines and recommendations inform the learning goal and objectives Good.Four objectives: align with overarching goal and informed nursing process (APIE)clearly stated brief rationale SMART formatrelevant to placementcongruent with learning goal Your objective statements need revision. They must be aligned directly with your overarching goal. As mentioned earlier, there seems to be a lot going on in your learning plan. You will need to decide what your priorities are with respect to what you want to accomplish, and revise your objectives accordingly. Keep it simple!Minimum 2 resources identified for each objective: support and are relevant to the overarching goal and objectivestimelines achievable within course dates Good resources, although some seem to be a bit unrealistic.Minimum of 2 indicators of achievement identified for each objective: support and are relevant to the overarching goal and objectivesare varied and address different learning domains: knowledge, psychomotor skills, and/or decision-makingare achievable in a timely manner with the resources available Good. You may need to revise these to align better with your objective statements once they’ve been simplified and aligned with your overarching goal.Format: Title page, references and scholarly literature – presented in current APA formatwithin 3-4 page limitwriting is clear, coherent, and succinct APA is okay. There are quite a few formatting errors in the reference list. Watch your spelling and grammar! [JB1]Do not capitalize all words in the title. [JB2]Do not capitalize each word in the title. [JB3]Do not capitalize each word in the title. [JB4]This is an outdated resource. [JB5]Do not capitalize each word in the title.
