Minimum Course Hours: 120

Course Description

Learners build on the theory and practice from Level 1 and 2 courses. Using a variety of approaches (such as simulation), learners continue to develop knowledge and practise comprehensive nursing assessment, planning, and interventions in community-based settings for clients across the lifespan, including those with mental health and/or substance use conditions, who are accessing care. Providing culturally safe and anti-racist care is emphasized. Learners discuss reporting and documentation as well as the leadership role of the practical nurse.

Prerequisites: Successful completion of Level 2 courses and Consolidated Practice Experience 2

Corequisites: Professional Communication 3; Professional Practice 3; Variations in Health 3; Health Promotion 3

Learning Outcomes

Upon successful completion of this course, in the simulated learning environment the learner will be able to:

1. Use the current British Columbia College of Nurses and Midwives (BCCNM) LPN Professional Standards, Practice Standards, and Entry-Level Competencies to guide decision making (including autonomous practice) in community settings.
   • 1.1 Describe the role of the practical nurse in supporting clients and families in situations where the Mental Health Act is enacted.
   • 1.2 Perform comprehensive holistic nursing assessment and interventions for clients across the lifespan in community settings, including maternity clients, newborns, children, youth, and clients with mental health and/or substance use conditions, in a competent and safe manner.
   • 1.3 Demonstrate a trauma-informed, culturally humble, and person-centred approach with clients.
   • 1.4 Document assessments and care provided using objective and non-stigmatizing language.
2. Demonstrate clinical skills and assessments for nursing practice in community settings competently and safely.
   • 2.1 Use critical thinking, clinical judgment, and knowledge of holistic assessment to plan, implement, and evaluate care of clients across the lifespan, and clients with a mental health and/or substance use condition.
   • 2.2 Perform a quick priority assessment (QPA) to prioritize and plan care.
   • 2.3 Use decision support tools (DSTs) to assist with decision making and implementation of care.
   • 2.4 Complete a point-of-care risk assessment related to infectious diseases in a competent and safe manner.
3. Initiate, maintain, and conclude therapeutic relationships with clients from across the lifespan, including clients with a mental health and/or substance use condition.
   • 3.1 Collaborate with clients, the interprofessional team, peers, and faculty.
4. Demonstrate the principles of medication administration for clients across the lifespan, including clients receiving medication for mental health and/or substance use conditions.
   • 4.1 Describe pharmacology commonly encountered in mental health and/or substance use treatment.
   • 4.2 Describe factors influencing a person’s adherence to psychotropic medications.
   • 4.3 Describe psychotropic medication toxicity and possible life-threatening adverse effects.
   • 4.4 Respond to an opioid overdose competently and safely.
5. Provide person-centred care that recognizes diversity and respects the uniqueness of each individual through cultural safety, cultural humility, and anti-racism.
   • 5.1 Identify one’s own values, biases, and assumptions as a self‐reflective, responsible, and accountable practitioner.
   • 5.2 Demonstrate appropriate and required actions in a simulated environment when observing racist or discriminatory behaviour.

Course Concepts

Course outcomes will be met through examination and exploration of the following:

• Comprehensive health assessment and care for clients across the lifespan, including maternity clients, newborns, children and youth (theory only)
• Comprehensive health assessment and care for clients with mental health and/or substance use conditions
• Suicide risk assessment
• Sterile technique and wound care
• Infusion therapy 1 including:
  • Assessment of insertion sites: short peripheral catheter, peripherally inserted central catheter (PICC), and central venous catheter (CVC) lines
  • Changing intravenous (IV) tubing and solutions
  • Regulating rate of flow
  • Setting up and priming infusion line
  • Converting IV to an intermittent infusion device
  • Flushing an intermittent infusion device
  • Discontinuing a peripheral infusion device
• Urinary catheterization
• Context-specific reporting and documentation
• Mental Health Act
• Clinical decision making
• Nursing interventions
• Risk management
• Individualizing nursing care plans across the lifespan
• Principles of medication administration for clients across the lifespan
• Pharmacology for clients with mental health and/or substance use conditions, including:
  • Drug classes: SSRIs, mood stabilizers, antipsychotics, benzodiazepines, and stimulants
  • Effects and considerations: anticholinergic effects, cognitive changes, fluctuations and/or changes in mood and energy impacting levels of risk (i.e., increased risk of suicidality), neurological changes, paradoxical responses, physiological changes, and sexual dysfunction
• Psychotropic medication toxicity, including (but not limited to) lithium toxicity, serotonin syndrome, neuroleptic malignant syndrome, metabolic syndrome
• Medications and approaches for substance use, including alcohol, benzodiazepine, cannabis, nicotine, opioid, polysubstance and stimulant use
• Factors influencing a person’s adherence:
  • Age, culture, attitudes and beliefs about medications
  • Treatment burden and benefits of oral or long-acting injectables
  • Environmental factors and support systems
  • Knowledge and understanding
  • Therapeutic responses
• Immunizations across the lifespan
• Cultural safety, cultural humility, anti-racism, particularly Indigenous-specific anti-racism
• Diversity, equity, and inclusion