1. The Skills to Succeed -The Values that Guide 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

2. The Skills to Succeed -The Values that Guide Purpose: Describe an educational initiative for nursing personnel caring for adolescents and children in a dedicated psychiatric facility 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 Assumption: The knowledge, skills and attitudes of care providers can be changed through targeted, on-site education

3. The Skills to Succeed -The Values that Guide Mental Illness in Childhood Approximately 1 in 5 American children have diagnosable mental illness in any given year (US Surgeon General) 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 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 most severely affected children require some type of acute/longer term intervention in a dedicated psychiatric setting

4. The Skills to Succeed -The Values that Guide Mental Illness in Children Mental Illness in Children Anxiety Disorders Anxiety Disorders Disruptive behavior disorders Disruptive behavior disorders Developmental disorders Developmental disorders Eating & Elimination disorders Eating & Elimination disorders Learning & communication disorders Learning & communication disorders Affective/mood disorders Affective/mood disorders Schizophrenia Schizophrenia “Tic” disorders “Tic” disorders Dual Diagnoses Dual Diagnoses

5. The Skills to Succeed -The Values that Guide Treatment Medication Medication Psychotherapy (directed counseling) Psychotherapy (directed counseling) Expressive therapies (music, play, art) Expressive therapies (music, play, art) Team approach; all care providers are involved in therapy Team approach; all care providers are involved in therapy

6. The Skills to Succeed -The Values that Guide Nursing Role Therapy involves changes in life patterns and responses Therapy involves changes in life patterns and responses Therapy is not confined to encounters with psychiatrist, but also occurs in groups and individually Therapy is not confined to encounters with psychiatrist, but also occurs in groups and individually Nursing personnel are present 24 hours Nursing personnel are present 24 hours

7. The Skills to Succeed -The Values that Guide The Concern Massive shortage of nurses Massive shortage of nurses Even greater shortage of psychiatric nurses because of need for special skills, stigma of mental illness Even greater shortage of psychiatric nurses because of need for special skills, stigma of mental illness Balance between RN, LPN and psychiatric technicians Balance between RN, LPN and psychiatric technicians The role of culture and education upon knowledge, skills and attitudes of nursing personnel The role of culture and education upon knowledge, skills and attitudes of nursing personnel

8. The Skills to Succeed -The Values that Guide 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

9. The Skills to Succeed -The Values that Guide Grant Goals Develop career advancement program for culturally diverse nursing personnel Develop career advancement program for culturally diverse nursing personnel Augment skills in current child and adolescent psychiatric-mental health care roles across clinical settings Augment skills in current child and adolescent psychiatric-mental health care roles across clinical settings Promote entry into nursing and advancement through nursing degree Promote entry into nursing and advancement through nursing degree

10. The Skills to Succeed -The Values that Guide Partners School of Nursing: The Catholic University of America School of Nursing: The Catholic University of America Adventist Behavioral Health Network Adventist Behavioral Health Network (Potomac Ridge) (Potomac Ridge) (Crownsville Hospital) (Crownsville Hospital) (Adventist Healthcare Group Homes) (Adventist Healthcare Group Homes) (Runaway Program) (Runaway Program) Montgomery County Community Mental Health Center/Linkages Montgomery County Community Mental Health Center/Linkages

11. The Skills to Succeed -The Values that Guide Potomac Ridge Adventist Behavioral Health Acute children’s unit Acute children’s unit Acute adolescent unit Acute adolescent unit Two long term units for girls who have been sexually abused Two long term units for girls who have been sexually abused Sexual offender unit for boys Sexual offender unit for boys

12. The Skills to Succeed -The Values that Guide Nursing Personnel Roughly 30% registered nurses, 20% licensed practical nurses & 50% psychiatric technicians 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 Many of the nurses have been educated outside of the United States, most notably in the Caribbean & African nations Multicultural staff Multicultural staff

13. The Skills to Succeed -The Values that Guide Orientation Unit-based training of nursing staff Intro to Psych. Nursing Certificate Offerings Nursing Degree Programs Pre-nursing transition REMEDIATION Proposed Developmental Pathways Through Career Advancement

14. The Skills to Succeed -The Values that Guide Strategy Non-degree certificate program Non-degree certificate program Articulation into nursing degree program Articulation into nursing degree program Pre-nursing transition program Pre-nursing transition program Computer Labs & Web-Enhanced Learning Computer Labs & Web-Enhanced Learning

15. The Skills to Succeed -The Values that Guide Certificate Programs Caring & The Healing Arts of Psychiatric- Mental Health Nursing Caring & The Healing Arts of Psychiatric- Mental Health Nursing Human Growth & Development in the Early Years Human Growth & Development in the Early Years Social Justice & Mental Health Care Ethics for Children & Adolescents Social Justice & Mental Health Care Ethics for Children & Adolescents Clinical Observations & Assessment of Children & Adolescents Clinical Observations & Assessment of Children & Adolescents

16. The Skills to Succeed -The Values that Guide Certificate Programs (cont) Clinical Interventions for Children & Adolescents 1 Clinical Interventions for Children & Adolescents 1 Clinical Interventions for Children & Adolescents 2 Clinical Interventions for Children & Adolescents 2 Evidence-Based Clinical Practicum Evidence-Based Clinical Practicum Each module is about 20 hours Each module is about 20 hours

17. The Skills to Succeed -The Values that Guide Outcomes Computer labs/learning centers established at two sites Computer labs/learning centers established at two sites Long distance teleconferencing/telelearning packages in place Long distance teleconferencing/telelearning packages in place Courseware for online learning functional Courseware for online learning functional Certificate modules available via face to face and online Certificate modules available via face to face and online

18. The Skills to Succeed -The Values that Guide Outcomes 27 nursing staff employees of the Adventist Behavioral System have taken classes in certificate program (19 nurses and 8 technicians) 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 Approximately 1 on 5 nursing staff employees have taken certificate programs 27% decrease in turnover rates for the combined group 27% decrease in turnover rates for the combined group

19. The Skills to Succeed -The Values that Guide Outcomes (cont) Pilot of streamlined admission process to MSN program at CUA through elimination of GRE requirement 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 Research project entitled “Hospitalized Psychiatric Patients’ Perceptions of Nurse Caring Behaviors” is under development Poster presentation at American Psychiatric Nurses Association 2005 conference Poster presentation at American Psychiatric Nurses Association 2005 conference

20. The Skills to Succeed -The Values that Guide Issues Computer competence of nursing personnel; in-service education required Computer competence of nursing personnel; in-service education required Poor staffing and inclement weather affect ability to attend face to face classes 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 Different learning needs of ABH nursing personnel and Linkages to Learning personnel Challenges involving nursing staff in research & evidence-based practice opportunities Challenges involving nursing staff in research & evidence-based practice opportunities

21. The Skills to Succeed -The Values that Guide Conclusion Personnel costs of grant offset by retention benefits Personnel costs of grant offset by retention benefits Nursing workplace program is cost-effective and should ultimately improve patient care Nursing workplace program is cost-effective and should ultimately improve patient care

22. The Skills to Succeed -The Values that Guide 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 project described in this presentation was supported by a grant (D65HP03108) from the Bureau of Health Professions. Their support and assistance is gratefully acknowledged.