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While physical skills are easily evaluated using a competency scale, it is difficult to measure psychiatric nursing skills. The nature and treatment of mental health problems are varied and complex. Therefore, mastery of many skills is necessary in psychiatric nursing. If psychiatric nursing's contributions are to be valued by society, application of knowledge that demonstrates more advanced clinical judgment and outcome evaluations is essential (Reed, 1987).
Currently, nursing orientation programs teach isolated skills and procedures for all nurses (Benner, 1984). Most orientation programs are not individualized and may not focus on the unique needs of the novice nurse. Further, orientation programs may not focus on specific clinical areas, e.g., chronic psychiatric inpatient units (Harris 8c Gallien, 1989). To date, the orientation curriculum is the best attempt to formalize knowledge and skills necessary for psychiatric nursing practice. Therefore, the orientation curriculum should be framed to promote clinical knowledge development among novice nurses to the point where effective practice is possible. Thus, the novice nurse is empowered to grow and contribute to the profession of nursing soon after employment.
The absence of an individualized orientation program for the novice psychiatric nurse at a southeastern Veterans' Administration Medical Center provided the impetus for the nursing education department to examine ways to use existing resources and develop a more effective orientation program.
This article provides an overview of the development, implementation, and evaluation of an individualized orientation program for the novice psychiatric nurse. Education, practice, and research considerations also are presented.
BACKGROUND
Inherent in the role and functions of nursing education departments is contributing to the professional growth and development of nurses (American Nurses' Association, 1984; Puetz, De Janovich, Strauss, & Tobin, 1988). In an era of expansive mental healthcare needs, knowledge explosion, and role blurring of psychiatric nurses, nurse educators are in a pivotal position to develop and organize systems of knowledge that serve as the basis for psychiatric nursing practice (Carper, 1978; Martín, 1985; Murray, 1982; Wlerad, 1988). Presented as a part of orientation, the systems of knowledge provide a practice framework for novice psychiatric nurses and open avenues for examining mental health phenomena to underpin practice, research, and professional growth.
Nursing education departments would be wise to collaborate with colleagues in practice to design effective programming...