Teaching psych, what is most important/valuable?

NPAlby · Nov 28, 2008

Safety and the roles that other staff have in it. As in security, social work, techs. I had a new grad go into a patient who was in seclusion with just the security guys. Granted they were big guys but she had no clue what she was doing and security didnt know anything about the patient. At our facility security waits for nursing to instruct them on what to do with a patient. No hands on til nursing says its necessary kinda thing. Talked to the new grad afterwards and realized she didnt understand securitys role in the whole process. Just my two pennies!

RnAlby

medsurgrnco, BSN, RN · Nov 29, 2008

Students in my BSN program were scared of psych patients and uncomfortable with the subject. So somehow that barrier needs to be addressed.

I personally don't like many of the movies you have on your list. Unfortunately, Hollywood tends to take the liberty of creatively depicting psychiatric illnesses and glamorizing them instead of portraying them accurately.

PMHNP10 · Nov 29, 2008

Hi,
I am teaching the psych component for an ASN nursing program as well as taking them to clinical. I did this last year and it went well but am interested in what other nurses think is important and/or ideas for learning experiences.
I have looked a bit through the older threads and found some good ideas, and I have some of my own.
- So as a new psych nurse what do you wish your instructor would have gone over better?
- As experienced psych nurses, what would you like new nurses to know more about?
- And as current psych nurses what do you think would be valuable for student nurses to learn?
The final project I will do (did last year) will be putting the students into groups (4-5) and they pick a movie from a list (A Beautiful Mind - schizophrenia; As Good As It Gets - OCD; Sling Blade - mental retardation, anti-social PD; Reign Over Me - PTSD; Girl Interrupted - several personality disorders; Rain Man - Autism; The Aviator - Paranoid personality disorder; Mr. Jones - bipolar disorder; The Taxi Driver - Paranoid personality disorder; 28 Days - alcoholism; Born on the 4th of July - PTSD; Leaving Las Vegas - alcoholism). Then the group will do a presentation, either a skit, Powerpoint, poster, etc. on the diagnosis. It went really well the last time.
Any thoughts?

I really like the idea of your group project it could be really fun (but agree with medsurgrnco about liberties hollywood takes); are the students required to get together and watch the movie or do it on their own?

as for what they need to know...the absolutely, positively most important thing students must know about psych patients is that they get sick and end up in their ICU, m/s, l&d, ortho, neuro, and GI units as patients; in fact, one could contend that just about every hospitalized patient has a concurrent psych Dx and it must not be overlooked because without a healthy mind, acheiving a healthy body is much more challenging (and vice versa)

ruralnurs · Nov 29, 2008

Thanks for the ideas so far. Yes I agree about the movies. That is one reason one of the criteria they must meet is to elaborate on the movies and show what was or was not realistic.

For instance I tell them (after they have done their presentation) that in A Beautiful Mind, John Nash is portrayed as being able to be off all meds and have an almost perfect life. I tell the that it does not show it in the movie but he left his beloved wife for a awhile and had a son with another woman and that son is severely mentally ill with schizophrenia. And that today he does take meds, the newer atypicals. And that he was incredibly intelligent, had a long term doctor that knew him well and very supportive friends and family.

So part of the assignment is for them to decide if it is all "Hollywood" or if there is some realism in it. They are to watch the movie as a group. and they have an anonymous evaluation of each other to show how much each put into the project. They have to discuss meds that are commonly used, therapeutic treatments, statistics related to the illness, etc.

So thanks again for the ideas and keep them coming.

PMHNP10 · Nov 29, 2008

way cool; something you can add is that he had audio, not audio/visual hcn's, but of course visual hcn's translate much better on the big screen

Jules A, MSN · Nov 29, 2008

We actually had a fair amount of students fail out based on our psych class. The complaint was that the exam questions seemed more subjective than what we were used to with med surge, for example. I didn't have any problems but I tend to test good and what probably helped me the most was doing tons of NCLEX practice questions and reading the rationales. If there is any way you can incorporate that in their assignments it might make things clearer. Oh and be quick to "nip in the bud" the students that just want to go round and round arguing about why their answer choice was the correct one because imo that blocks any chance of learning why certain answers are better than others and is a big, fat waste of time. :)

Kudos to you for investigating ways to better teach your students!

medsurgrnco, BSN, RN · Nov 29, 2008

Yes I agree about the movies. That is one reason one of the criteria they must meet is to elaborate on the movies and show what was or was not realistic. ... So part of the assignment is for them to decide if it is all "Hollywood" or if there is some realism in it. ... They have to discuss meds that are commonly used, therapeutic treatments, statistics related to the illness, etc.

Thanks for clarifying - sounds like a much better assignment now.

Another assignment you might consider is one my class did. We had to find a way to present the psychiatric disorder of our choosing. We could do a presentation, use a video, have a speaker, whatever. I found the speakers very interesting & informative, and students actually met someone with a psychiatric diagnosis and possibly became more comfortable with this area of nursing. You could have this idea replace the movie, and still use the other aspects you mentioned in your current assignment of a movie.

MissGwen · Nov 30, 2008

I am not a nurse yet, but in January I begin nursing school. However, I do have a BS in Psychology and have worked as a tech at two psych facilities.

From what I have seen, it seems some nurses do not seem to fully understand the disorders. I had to educate the nurses periodically on what certain disorders were and why patients were exhibiting the behaviors,etc. they were. What I am basically saying is I feel as though understanding the illnesses in-depth is crucial to giving patients the best possible care.

I think that having your students read a book might prove more beneficial than watching a movie. Perhaps "The Bell Jar" (another movie you could add if you go the movie route), "The Quiet Room," etc. A lot of the movies you listed were based on books.

Another good idea might be to have them do an in-depth paper or presentation on the various classes of disorders. I actually think that would be a very good idea and it could be a group project as well. One group could be assigned the mood disorders, another one anxiety disorders, schiz/psychotic disorders, etc. Substance abuse and childhood disorders as well.

From what I have seen, a greater knowledge base of what the patients are dealing with is needed, but I could be wrong.

:)

Gwen

Thunderwolf, MSN, RN · Nov 30, 2008

I am not a nurse yet, but in January I begin nursing school. However, I do have a BS in Psychology and have worked as a tech at two psych facilities.
From what I have seen, it seems some nurses do not seem to fully understand the disorders. From what I have seen, a greater knowledge base of what the patients are dealing with is needed, but I could be wrong.
:)
Gwen

Nope...you are correct.

Nursing school does not prepare nurses enough for psych. Like in many areas of nursing, it is "on the job" training....and whatever that individual nurse decides to take in addition to that...once completing nursing school. However, this is not just in psych nursing, but in many areas of nursing when a new grad or new nurse begins practice.

And I totally agree with you...if you work in psych as a new grad or as a new psych nurse...additional training is needed and should be encouraged. Otherwise, what you don't know will either get you hurt or will be harmful to the patient.

insatiable · Nov 30, 2008

I am not a nurse yet, but in January I begin nursing school. However, I do have a BS in Psychology and have worked as a tech at two psych facilities.
From what I have seen, it seems some nurses do not seem to fully understand the disorders. I had to educate the nurses periodically on what certain disorders were and why patients were exhibiting the behaviors,etc. they were. What I am basically saying is I feel as though understanding the illnesses in-depth is crucial to giving patients the best possible care.
I think that having your students read a book might prove more beneficial than watching a movie. Perhaps "The Bell Jar" (another movie you could add if you go the movie route), "The Quiet Room," etc. A lot of the movies you listed were based on books.
Another good idea might be to have them do an in-depth paper or presentation on the various classes of disorders. I actually think that would be a very good idea and it could be a group project as well. One group could be assigned the mood disorders, another one anxiety disorders, schiz/psychotic disorders, etc. Substance abuse and childhood disorders as well.
From what I have seen, a greater knowledge base of what the patients are dealing with is needed, but I could be wrong.
:)
Gwen

During my counseling graduate program when we were learning about disorders we did a project that was a combination of what the OP suggested and MissGwen suggested...it was very educational.

This is how we did it:

In groups of three or four we were each assigned one group of disorders (mood, personality, dissociative etc). We then had to do a presentation about what the disorder grouping is, statistics, definitions, list the disorders under that grouping (example: mood disorders include major depression, dysthymia, bipolar etc). Then we had to pick a specific disorder under that grouping to focus on in more detail. Say we were assigned mood disorders, well then our group could pick one of the mood disorders (say bipolar for example) to talk about in more detail such as treatment, medications, etc etc for that specific disorder...now I realize nursing is different than counseling so there may be other topics you may include to fit the needs of the nursing students.

We had to do a power point for the information part but that was really the only requirement..well aside from having to cover all of the information on the disorder. We pretty much had to be creative (creativity was one of the sections we were graded on so we couldnt just read straight from a power point) and teach the class about the disorder...and by teaching we were learning too.

Here are some examples of what some of the students did:

-In the power point some included a slide of person in history that had whatever disorder they were assigned and talked about how it impacted thier life (example: Van Gogh, major depression-included some pictures of his artwork etc)

-Included a clip or two from a movie that depicts an example of disorder and discussed the symptoms etc the character was exhibiting of that disorder ooor in what ways the movie clips misrepresent the disorder

-Some included clips from youtube of actual persons talking about their disorder

-Some put poetry written by person with mental illness

-Some did a breif skit

-Some handed out material on the disorder to the class to keep

-Some did a brief game, like jepordy, at the end on the information covered and gave a prize (like a peice of candy ha) to who won

-Some played a part of song that had lyrics relating to the disorder and then talked about how its portrayed in modern society

A lot of people even did a combination of the things above. Like a power point, a figure in history, and a movie clip.

The only thing our professor assigned was the disorder grouping, what topics she wanted us to cover, and we had to include at least 3 article or book references...and she wanted at least part of it on a power point. The rest was up to us to figure out which really helped us learn and understand the disorders better. The whole thing was supposed to be about 30 mintues long.

I think it helps to just give a few directions on what you want then let them figure out the rest...makes them think more. For example, if you are wanting them to use movie clips maybe dont give them a list and let them figure out a movie of their own..just my opinion from a students perspective.

Opps, that got kinda long didnt it, sorry

felixfelix · Dec 1, 2008

Doing initial psych assessment I find it useful to know how to be able to do a neuro exam, especially cranial nerves. Not that you should know how (it's for my own peace of mind with some first-time psychotic presentations), but the 1 MD who I watched do a 5 minute run through on a psych pt. to r/o organic causes (poor man's ct?) was worth it's weight in gold to me now.