As a psychiatric nurse practitioner, Michelle Giddings has assessed and helped treat people with substance abuse problems, criminal offenders, and suicidal patients. She's helped grieving mothers work through the loss of a child and plenty more.
The Trinidad and Tobago native came to America in the late 1980s and now is using those years of experience to help UNLV's nursing students work more effectively with all patients, particularly those with mental illness. She also maintains her clinical practice skills at a local health care facility.
Giddings recently helped establish a psychiatric simulation model inside the School of Nursing's simulation center. The center helps nursing students better understand symptoms and treatment of mental illness before entering the field. The already successful addition to the simulation program appears to be only the start of future collaboration with other health care disciplines.
Simulation and psychiatry
UNLV's nursing simulation center is a critical part of educating students. The center's simulation equipment gives them hands-on experience and enables them to assess their performance and address mistakes. Psychiatric assessment is based on observation and interaction with the patient, which is difficult to simulate with a mannequin. So [in 2012] we started using trained actors to mimic the psychiatric symptoms that we manage as nurses. Different patient scenarios were developed for each disorder. Students then interview and assess the "patient" to come up with a nursing diagnosis and interventions. We have prepared an article detailing how we implemented the simulation program as part of undergraduate psychiatric nursing education.
Students' view of psychiatry
I truly love educating nursing students and seeing their attitudes change as they become more informed. They come into the course with a certain perception of psychiatric nursing and psychiatric patients. Most of their perceptions are based on media representation of mental illness, which is unfortunate. When I ask students what they expect when we go to a psychiatric hospital, you'll hear anxiety, that they're scared and that they're just doing this as a requirement and aren't looking forward to it. Then, there are those students who are curious and want to see what happens. By the end of the class it's a total change.
My goal is to break down some of the stigma about mental illness and get students to look at the person and their treatment. What is your role (as a nurse) in caring for that person? Why are we giving medication? Do you understand the side effects and can you identify them before they become critical to the patient? ... The role of the nurse is to look at the whole person. Take away the stigma and bring some level of vigilance to their care, to know boundaries, and to understand what their illness entails.
Why the anxiety is there ...
I think a lot of people are afraid of mental illness because of its association with criminal behavior. If someone does something horrible, the first thing (people) say is, "That person was mentally ill and that's why they did this." The fact is that most mentally ill people are not dangerous. Look at how many people are just plain dangerous and it has nothing to do with mental illness. ... I don't think we see enough positive portrayals of persons with mental illnesses in the media.
Nurse practitioner autonomy ...
Nurse practitioners have been practicing independently in several other states for many years. Until recently in Nevada, nurse practitioners were required to have a collaborating physician to practice their specialty. With Assembly Bill 170 now signed into law, nurse practitioners can practice at their full scope autonomously in Nevada. This change will attract more nurse practitioners to our state and improve access to health care for Nevada residents, especially in rural areas where there are critical shortages of health care providers.
Nurse's role in mental health care ...
The class I teach is specifically about psychiatric nursing. One of the things I tell my students is that you will encounter these patients regardless of where you are practicing. Patients with mental illnesses have cardiac arrests. They have kids. You'll see a pediatric patient who may have a bipolar mother. You will see them in every clinical setting, and you have to know how to talk to them, how to care for them, and how to identify when something else is in play.
