Blog

Week 1: Comprehensive Integrated Psychiatric Assessment

  • Post category:Nursing
  • Reading time:8 mins read

Week 1: Comprehensive Integrated Psychiatric Assessment

“We adopted Maria from an orphanage in Guatemala when she was 4 years old. We were hoping she would love us as much as we love her, but she is always so distant and will not let us get close. She continually bumps her head on the wall and screams when we try to make her stop. She is now 5, and we have tried everything to help her understand that we just want to love her and have her be part of our family.”

Jessica and Jason, Parents of 5-year-old Maria

The delicate dance—engagement and empathy.

Laureate Education (Producer). (2017d). Working with Children and Adolescents [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.


The comprehensive integrated psychiatric assessment is one of the most important elements of the psychiatric-mental health nurse practitioner’s (PMHNP) skill set to understand, diagnose, and develop a treatment plan for Maria. The psychiatric interview is a craft by which one human being becomes acquainted with another’s deepest thoughts, fears, emotions, and behavior. “This task is not unlike exploring a darkened room in an old Victorian house” (Shea, p. 3) with only a candle for illumination. As the PMHNP sees more of the client’s life unfold, the picture becomes clearer.

This week, you explore in depth the elements of the comprehensive integrated psychiatric assessment and diagnostic process.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

American Nurses Association. (2014).
Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

  • Standard 5D “Prescriptive Authority and Treatment” (page 58)

Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014).
Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 5, “Examination and Diagnosis of the Psychiatric Patient” (pp. 192–289)
  • Chapter 31, “Child Psychiatry” (pp. 1082–1107)

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Introduction”
  • “Use of the Manual”
  • “Cultural Formulation”

 

Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from
https://web.archive.org/web/20160416180027/http://…

 

Pumariega, A. J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., . . . Smith, J. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. Journal of the American Academy of Child & Adolescent Psychiatry, 52(10), 1101–1115. Retrieved from
http://www.jaacap.com/article/S0890-8567(13)00479-…

 

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for psychodynamic psychotherapy with children. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 541–557. Retrieved from
http://www.jaacap.com/article/S0890-8567(12)00141-…

 

American Psychological Association. (2017). Code of Ethics. Retrieved from
http://www.apa.org/ethics/code/

 

Document: Child and Adolescent Diagnostic Assessment Worksheet (Word document)

Document: Practicum Journal Template (Word document)

Document: NP Student Clinical Orientation (PowerPoint file)

Required Media

 

Gajbhare, P. (2014, March 8).
Mental status examination [Video file]
. Retrieved from

Note: The approximate length of this media piece is 36 minutes.

YMH Boston. (2013a, May 22).
Vignette 1 – Introduction to a preventive services visit [Video file]
. Retrieved from

Note: The approximate length of this media piece is 3 minutes.

YMH Boston. (2013c, May 22).
Vignette 4 – Introduction to a mental health assessment [Video file]
. Retrieved from

Note: The approximate length of this media piece is 4 minutes.

 

Optional Resources

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014).
Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 1, “Neural Sciences” (pp. 1–92)
  • Chapter 31.2, “Assessment, Examination, and Psychological testing” (pp. 1107–1118)

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

Assignment: Practicum Journal Entry: Analyzing an Ethical Decision

In your role as a PMHNP, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer of how to address the issue, but your ethical decision making must be based on evidenced-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their socio-demographic and ethnic/racial background. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action. For this Assignment, you review the literature and discover the various ethical dilemmas PMHNPs encounter and how these issues are typically addressed in your state.

Learning Objectives

Students will:
  • Analyze salient ethical issues in psychiatric mental health practice
  • Compare ethical dilemmas with state health laws and regulations
  • Analyze ethical decision-making processes

To prepare:

  • Review literature for moral/ethical issues encountered by a PMHNP.
  • Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment.

Write a 2-page paper in which you do the following:

  • Summarize the moral/ethical issue in the article (no more than 1 paragraph).
  • Describe the moral and ethical dilemmas surrounding the issue.
  • Analyze the ethical issue and compare them to the state health laws and regulations in your state.
  • Outline the process of ethical decision making you would use to address this ethical dilemma.