The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements

Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements

Pre-requisite units

This unit must be assessed after successful achievement of pre-requisites:

HLTAP501B Analyse health information

HLTEN507B Administer and monitor medication in the work environment

HLTEN509B Apply legal and ethical parameters to nursing practice

HLTEN510B Implement and monitor nursing care for consumers with mental health conditions

HLTEN606B Assess clients and manage client care

ELEMENT

PERFORMANCE CRITERIA

1. Work as part of the multidisciplinary health care team for the consumer requiring mental health care

1.1 Contribute appropriately to support the role of the multidisciplinary health care team in managing care of the consumer requiring mental health care

1.2 Contribute to achieving effective team work and supportive group dynamics when working with health care colleagues

1.3 Establish appropriate relationships with other members of the health care team

1.4 Incorporate into own nursing practice the philosophical and policy frameworks for managing care for the consumer requiring mental health services

1.5 Incorporate into own nursing practice the legal framework for managing care for the consumer requiring mental health services

1.6 Recognise the contributions of emergency service personnel, referring agencies, hospital and community team staff and community support groups to the care needs of the mental health services consumer

1.7 Participate safely as part of team in interventions involving chemical or physical restraint

2. Clarify the impact of mental health consumer's treatment and rehabilitation on the consumer and/or their family

2.1 Perform a holistic assessment of the consumer in consultation/collaboration with the registered nurse

2.2 Incorporate an understanding of anatomy and physiology and mental health disorder classifications into nursing practice

2.3 Work with a knowledge of various manifestations of consumer's area(s) of mental health problem

2.4 Discuss with consumers the psychosocial impact of their mental health problem on their activities of daily living

2.5 Assist the consumer and family to identify common problems, complications and resources available for the consumer with a mental health problem

2.6 Communicate effectively with consumers, family (including children) and health team members

2.7 Clarify the care needs of the consumer with a mental health problem in terms of the phases of care required

3. Contribute to planning appropriate care for the consumer with a mental health problem

3.1 Accurately use a range of contemporary assessment tools, including mental state examination and psychiatric assessment

3.2 Establish and use a database of resource personnel to assist in care for the consumer with a mental health disorder

3.3 In consultation/collaboration with the registered nurse, recognise and understand a range of therapeutic interventions available in planning appropriate nursing management strategies

3.4 In consultation/collaboration with the consumer and the health care team, develop an individualised plan of care for the consumer with a mental health problem

3.5 In consultation/collaboration with the registered nurse, and treating team, undertake risk assessment

3.6 In consultation/collaboration with the registered nurses, determine observational category for a consumer with a mental health problem

3.7 In consultation/collaboration with the registered nurse, incorporate into own practice health teaching, referral and discharge planning for the consumer with a mental health problem

4. Implement nursing care plan for the consumer with a mental health problem

4.1 In consultation/collaboration with consumer, promote a consistent, structured approach to management of consumer/s behaviours

4.2 Involve the consumer and family in assessing, planning, implementing and evaluating care and outcomes

4.3 Maintain focus on consumer/s independent living and social skills

4.4 Promote education and awareness about early warning signs and relapse prevention

4.5 Maintain a physically and psychologically safe environment

4.6 In consultation/collaboration with the registered nurse, recognise crisis situations and implement emergency management according to organisation policy and procedure and within legal and professional requirements

4.7 Implement nursing interventions in accordance with legal, professional, ethical and organisation requirements

4.8 Recognise, report and document consumer responses to specific types of medication used in mental health care

4.9 Recognise and respond appropriately to ethical issues related to use of psychopharmacological medication

5. Relate therapeutically to consumers with mental health problems

5.1 Respond to consumer behaviour in a therapeutic manner, recognising antecedents for behaviour, as appropriate

5.2 Acknowledge individual consumer experiences in a non-judgemental manner

5.3 Demonstrate an understanding of the stages and philosophy of therapeutic relationships

5.4 Prioritise consumer care issues in accordance with consumer's presentation and behaviour

5.5 Maintain professional boundaries and set limits for therapeutic interventions with consumers

5.6 Recognise and address own verbal and non-verbal cues that may impact on consumers and others

5.7 Reflect on interactions in order to evaluate their therapeutic impact

6. Assist to evaluate the outcomes of planned nursing actions for the consumer with a mental health problem

6.1 Monitor consumer response to planned nursing interventions and progress toward planned goals and interventions, and document and report to the appropriate members of the health care team

6.2 Initiate appropriate first aid/emergency treatment in response to adverse reactions or complications

6.3 Report and document first aid/emergency treatment and consumer response to the treatment

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Actions, therapeutic and adverse effects of mental health pharmacology

Admission and transfer between health care environments

Consumer rights and responsibilities

Critical thinking and problem solving

Cultural and spiritual beliefs and practices

Culturally appropriate health promotion activities for consumers with mental health problems

Diagnostic tests and their meanings

Emergency and first aid management

Ethical issues associated with the use of antipsychotic medications

Evidence based practice

Factors influencing growth and development

Factors influencing self esteem

Health - illness continuum

Legal standards for practice

Legislation related to mental health care practice, including:

Mental Health Act (1993)

occupational health and safety legislation

Medical terminology

Organisation policy and procedure

Participating as a member of the health care team

Philosophy underpinning mental health care

Principles of mental health assessment

Reflective practice

Research strategies and methodologies

Risk assessment

Specialised knowledge and depth of anatomy, physiology and pathophysiology of mental health problems

Specialised knowledge in the antecedents and clinical manifestations of mental health disorders

Specialised knowledge of classification systems for mental health disorders, including DSM IV and ICD-10

Essential skills

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Apply clinical nursing skills, including:

fundamental and complex nursing interventions

physical and mental assessment

neurological function

specimen collection

medication administration as per jurisdictional and legal requirements

emergency Medications

Assessment, observation and documentation of

physical assessment

psychiatric assessment

mental state assessment

mini mental state assessment

assessment of suicidal patients

risk assessment

aggression assessment

assessment of alcohol and drug use

coping skills

change to sleep and concentration patterns

Apply professional standards of practice:

ANMC code of conduct

ANMC code of ethics

ANMC national Enrolled/Division 2 nurse competency standards

state/territory Nurse Regulatory Nurses Act

state/territory Nursing and Midwifery Regulatory Authority standards of practice

scope of nursing practice decision making framework

National Mental Health Strategy

Apply principles of documentation

Apply principles of rehabilitation

Demonstrate accountability for personal outputs and broad consumer group outcomes

Maintain evidence based practice in line with current literature and work of professional bodies associated with mental health consumers

Recognise and address

needs of consumer and significant others in relation to grief and loss

religious and cultural needs of consumer and significant others

continued ...

Essential skills (contd):

Use appropriate communication skills (non-verbal, openness, sensitivity, non-judgmental attitudes):

oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service, including interviewing techniques, asking questions, active listening, asking for clarification

written communication skills (literacy competence) required to fulfil job roles as specified by organisation/service, ranging from reading and understanding consumer documentation to completion of written reports

Use interpersonal skills to work with others, use sensitivity when dealing with people and relate to persons from differing cultural, social and religious backgrounds

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Observation of performance in a work context is essential for assessment of this unit

Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered mental health nurse

Observations must include:

knowledge of mental health disorders

principles of mental health assessment, including risk assessment

nursing management of mental health disorders, specific medications and interventions within the defined scope of practice

communication skills

Context of and specific resources for assessment:

This unit is most appropriately assessed in the clinical workplace or in a simulated clinical work environment and under the normal range of clinical environment conditions prior to assessment in the workplace

Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible

Method of assessment

Observation in the work place

Written assignments/projects

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.

Questioning - verbal and writing

Role play/simulation

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander consumers and communities

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Multidisciplinary health care team members could include:

Mental health care consumer and their significant others

Psychiatrists

Psychologists

Nursing staff

Social workers

Physiotherapists

Occupational therapists

Art therapists

Speech pathologists

Dietitian

Recreation officers

Community services

Transitional rehabilitation services

Carers

Drug and alcohol workers

General practitioners

Consumer advocates

Residential care workers

Health care settings could include:

Hospitals - private or public

Short stay centres

Community living residences

Day centres

Community teams

Aged care services

Assessment of impact of mental health problems may include:

Performance of activities of daily living

Loss or limitation to physical, emotional or cognitive function

Impact on sexuality, relationships, self image, body image

Grief and loss

Eating disorders

Coping mechanisms

Personal and community support mechanisms

Level of communication

Maintenance/improvement of quality of life

Maintenance/improvement of lifestyle

Impact of secondary disease processes

Socially related adjustments and transitions may include:

Role changes

Multiple losses

Social isolation and loneliness

Depression and suicide

Community stereotyping

Changes in body image

Plans of care may include:

Nursing care plans

Social activity plans

Treatment plans

Medical notes

Community referrals

Admission and transfer

Rehabilitation plans

Legal and ethical issues include:

Rights and responsibilities of people with mental health problems

Consent

Power of attorney

Medical Power of attorney

Detention orders

Advocacy

Restraint and seclusion

Ethical principles

Legislation affecting the person with mental health problems

Confidentiality and advice to carers

Research and the person with mental health problems

Specific nursing interventions/clinical skills could include:

Foundation nursing interventions

Complex nursing interventions

Assisting with electro-convulsive therapy

First Aid

Limit setting

Use of assessment tools, including tools for risk assessment

Assistance in direct physical restraint

Group or diversional therapy

Self esteem promoting therapies

Skill building programs

Social normalisation programs

Living skills programs

Counselling

Group therapy skills

Cognitive behaviour therapy

Behaviour modification therapy

Family therapy

Stress management

Anger management

Assertiveness training

Promotion of trusting relationships

Health teaching in relation to consumers needs

Pain management

Manual handling

Rehabilitative care practices

Evaluation of planned care includes:

Level of independence in performance of activities of daily living

Participation in rehabilitation programs

Self management of symptoms

This unit contains Employability Skills