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Lecture 1

NURS 3524 Lecture Notes - Lecture 1: Professional Boundaries, Therapeutic Relationship, Pediatrics


Department
Nursing
Course Code
NURS 3524
Professor
Mavoy Bertram
Lecture
1

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1
HH/NUR 3524 6.0: Individuals and Families in Child and Mental Health Settings WEEK 1
HH/NUR 3524 6.0
Psychiatric & Mental Health Nursing For Canadian Practice
CONTENT COVERED
Introduction to the Course
Concepts in Child Health & Pediatric Nursing
Physical Assessment; Family Centered Care
Pediatric Medication Administration
REQUIRED READINGS
Chapter 1
Chapter 4 (p. 91-150)
What to Expect?
Classes (Mental Health) 6 weeks
o Pay attention in class; she’ll tell us what to focus on
Identify the complexities of care
Examine the vulnerability, resilience and recovery of this patient population
Ethical issues
Legal requirements of nurses
Examine Therapeutic Relationships
Explore current issues in mental health
Course Themes
Therapeutic relationships and communication with individuals and families
o Effective techniques of communication (active listening, trust, empathy, open ended (gather
more Info, shows you care), mutual respect)
Vulnerability; empowerment; strength; quality of life; and health promotion
o Vulnerability*: because they are in control of there situation in the hospital and reply on health
care providers; don’t ask why questions (puts the patient in a defensive mode)
Advocacy and consent to treatment
Culturally sensitive care
Chronic illness, loss, grief, recovery, resilience, hope and coping
Health education; child/individual safety, family-centred/family sensitive care
Professional boundaries; stigma and social inclusion; violence and child abuse; legal and ethical
obligations
Grading Outcomes
Test # 1 (Mental Health) 30 % -
o Week 5: Oct 3rd/18
Test # 2 (Paediatrics) 20 % -
o Week 5 Nov 21st/18
o Tests are multiple choice
10% in class participation
Exam 40%- during YorkU exam period
o Exam is multiple choice
Hallucinations** for clinical preparation
a problem with one or more of the 5 senses

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HH/NUR 3524 6.0: Individuals and Families in Child and Mental Health Settings WEEK 1
HH/NUR 3524 6.0
o auditory hallucinations hearing sounds or voices
o visual hallucinations seeing angels
o Gustatory Hallucination tasting something that isn’t there
o Tactile hallucinations feeling something that’s not there
o grandiose delusion I think I’m the queen of England
o illusion seeing an object as something else e.g. like a cup like a snake
o ideas of reference someone getting messages from the tv or an object
o Persecutory Delusions CIA is watching me
Required Readings
Readings are assigned from the required text, and from key documents accessible electronically on
Moodle.
Successful students in this course complete required readings prior to class and ask questions and/or
engage in discussions in class, and/or Moodle discussions.
Class is a opportunity for critical dialogue, discussion, and exploration of key concepts/issues from
readings.
Not all required readings are covered in lectures and students are responsible for the content of all
required readings and class discussions.
Mental Health Definitions
WHO: “It is not just an absence of mental disorder or disability. It is defined as a state of well-being in
which every individual realizes his or her own potential, can cope with the normal stresses of life, can
work productively and fruitfully, and is able to make a contribution to her or his community.”
Mental Health is..
Life long process that includes a sense of harmony and balance in the individual, family, friends, and
community (Fontaine, 2009).
Mental Health
Poor mental health ≠ mental illness
o a person with a mental disorder can
experience optimal mental health
(quadrant A)
o a person without a mental disorder
can experience minimal mental health
(quadrant D).
Emotional distress and psychosocial
impairment
3 determinants of mental health:
o Social inclusion
o Free from discrimination and violence
o Financial resources
Not static, fluctuate over a person’s life
Mental Health and Addiction Statistics
Prevalence and Incidence:

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HH/NUR 3524 6.0: Individuals and Families in Child and Mental Health Settings WEEK 1
HH/NUR 3524 6.0
o 1 in 5 Canadians will experience a mental illness in their lifetime. The remaining 4 will have a
friend, family member or colleague who will.
o Mental illness affects thinking, mood or behaviour and can be associated with distress and/or
impairment of functioning, with symptoms that vary from mild to severe.
o About 20% of people with a mental disorder have a co-occurring substance use problem.
o Schizophrenia affects 1%, major depression impacts 8% and anxiety disorder 12% of people.
o 1 in 10 Canadians 15 years of age and over report symptoms consistent with alcohol or illicit
drug dependence.
o 3.8% of adults in Ontario are classified as having moderate or severe gambling problems.
Who is Affected:
o 70% of mental health problems and illnesses have their onset during childhood or adolescence.
o Young people age 15-24 are more likely to report mental illness and/or substance use disorders
than other age groups.
o Overall, men were 2.6 times more likely than women to meet the criteria for substance
dependence. 25% of male drinkers are high-risk drinkers compared to 9% of female drinkers.
o Women were 1.5 times more likely to meet the criteria for a mood or anxiety disorder than
men.
o Canadians in the lowest income group were 3-4 times more likely than those in the highest
income group to report fair to poor mental health.
Features of Mental Health
Emotional Intelligence: Salvoy & Mayer (1990) 4 components:
1. Perceiving emotions
2. Reasoning Emotions
3. Understanding Emotions
4. Managing Emotions
a. Emotions are skills for living.
b. Important to recognize our emotions-know ourselves.
c. Have emotional self control.
d. Recognize emotions in others.
e. Handle relationships.
RESILIENCY: the ability to emerge and grow from negative life events
Mental Illness Definitions
“…characterized by alterations in thinking, mood or behaviour (or a combination), and impaired
functioning over an extended period of time. The symptoms vary from mild to severe depending on
the type, the individual, the family and socio-economic environment” Public Health Agency of Canada
(PHAC)
A disease of the mind is like a disease of the body. No one chooses the illness and with proper
assessment, treatment and support, recovery is possible. It’s time to stop treating diseases of the mind
differently than diseases of the body. It’s time to start treating people. (CMHA, 2012)
May begin with a sense of disharmony with aspects of living that are distressing (Fontaine 2009).
Cost to Society of Mental Illness and Addictions
In Canada mental illness is the second leading cause of human disability and premature death.
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