As the professional association for Psychiatric Technicians in
California, CAPT is often asked for a list of functions that Psychiatric
Technicians are allowed to perform under their state license. There is no such
list, aside from some basic language in the Psychiatric Technicians Law as
described below. Essentially, the scope includes everything that is taught in
the Psych Tech education program that must be completed before taking the
licensing examination.
The state Board of Vocational Nursing and Psychiatric Technicians
(BVNPT) is often asked whether a certain procedure is included in the scope of
practice. If you have such questions, you may contact the BVNPT's Nursing
Education Unit at (916) 263-7843. You can also download our brochure on the Psych Tech scope of practice. (Call CAPT Headquarters at (800) 677-2278 for multiple brochure copies.)
From time to time, the BVNPT issues written decisions on scope of
practice issues. CAPT publishes them in our Outreach magazine and
includes them on our website. Here are links to some items related to scope and
supervision.
Scope of Practice issues in the Psychiatric Technicians
Law
(This law starts with Business and Professions Code
Section 4500)
4502. As used in this chapter, "psychiatric
technician" means any person who, for compensation or personal profit,
implements procedures and techniques which involve understanding of cause and
effect and which are used in the care, treatment, and rehabilitation of
mentally ill, emotionally disturbed, or mentally retarded persons and who has
one or more of the following:
(a) Direct responsibility for administering or implementing
specific therapeutic procedures, techniques, treatments, or medications with
the aim of enabling recipients or patients to make optimal use of their
therapeutic regime, their social and personal resources, and their residential
care.
(b) Direct responsibility for the application of
interpersonal and technical skills in the observation and recognition of
symptoms and reactions of recipients or patients, for the accurate recording of
such symptoms and reactions, and for the carrying out of treatments and
medications as prescribed by a licensed physician and surgeon or a
psychiatrist.
The psychiatric technician in the performance of such
procedures and techniques is responsible to the director of the service in
which his duties are performed. The director may be a licensed physician and
surgeon, psychiatrist, psychologist, rehabilitation therapist, social worker,
registered nurse, or other professional personnel.
Nothing herein shall authorize a licensed psychiatric
technician to practice medicine or surgery or to undertake the prevention,
treatment or cure of disease, pain, injury, deformity, or mental or physical
condition in violation of the law.
4502.1. A psychiatric technician, working in a
mental health facility or developmental disability facility, when prescribed by
a physician and surgeon, may administer medications by hypodermic injection.
4502.2. A psychiatric technician, when prescribed by
a physician and surgeon, may withdraw blood from a patient with a mental
illness or developmental disability if the psychiatric technician has received
certification from the board that the psychiatric technician has completed a
prescribed course of instruction approved by the board or has demonstrated
competence to the satisfaction of the board.
4502.3. (a) A psychiatric technician, when
prescribed by a physician and surgeon, may perform the following activities on
a patient with a mental illness or developmental disability:
(1) Tuberculin, coccidioidin, and histoplasmin skin tests,
providing the administration is within the course of a tuberculosis control
program.
(2) Immunization techniques, providing the administration is
upon the standing orders of a supervising physician and surgeon or pursuant to
written guidelines adopted by a hospital or medical group with whom the
supervising physician and surgeon is associated.
(b) In performing activities pursuant to subdivision (a),
the psychiatric technician shall satisfactorily demonstrate competence in all
of the following:
(1) Administering the testing or immunization agents, including
knowledge of all indications and contraindications for the administration of
the agents.
(2) Recognizing any emergency reactions to the agent that
constitute a danger to the health or life of the patient.
(3) Treating those emergency reactions by using procedures,
medication, and equipment within the scope of practice of the psychiatric
technician.
Psychiatric Technicians education
The state requires that a graduate from a Psych Tech program must have
completed at least 1,530 hours of instruction in both classroom and clinical
settings.
Minimum number of hours
for Psychiatric Technician education
(Business and Professions Code Section 2586)
| Subject Area |
Classroom Theory |
Supervised Clinical |
Total Hours |
|
| Pharmacology |
54 |
0 |
54 |
|
| Nursing Science |
126 |
270 |
396 |
|
| Mental Disorders |
108 |
270 |
378 |
|
| Developmental Disabilities |
108 |
270 |
378 |
|
| Additional Courses |
180 |
144 |
324 |
|
To expand on those general requirements, the BVNPT has adopted
regulations further defining the Psych Tech curriculum. These are in Section
2587, Title 16, California Code of Regulations.
This regulation specifies that the curriculum "shall develop the
knowledge, skills and abilities necessary to care for patients of all ages in
current health care settings." It requires the content of the curriculum to
include the following:
1. Pharmacology, including knowledge of commonly used drugs and their
action, computation of dosages, preparation of medications and principles of
administration.
2. Nursing science, which shall include nursing fundamentals and basic
medical/surgical nursing.
3. Classifications, treatment programs and interventions for
developmental disabilities.
4. Classifications, treatment programs and interventions for mental
disorders.
5. Anatomy and physiology.
6. Nutrition.
7. Normal growth and development.
8. Psychology.
9. The nursing process.
10. Communication.
11. Gerontological nursing.
12. Patient education
13. Leadership.
14. Supervision.
15. Treatment programs for addictive behaviors and eating
disorders.
Although the scope of practice is whatever a Psych Tech has been taught
in the Psych Tech program, it also includes any procedure that's related to
basic functions, such as a new procedure or use of new equipment. This is
within the scope if the person has appropriate in-service training.
The BVNPT once developed a "skills list" that specified the all skills
that Psych Tech students should be taught. But in the early 1990s, the BVNPT
dropped the use of that list for its evaluation of a program's curriculum
content. However, CAPT believes that the skills list can still be of use as a
general reference point, since most of the skills are still taught in the Psych
Tech programs. For that reason, we offer the following list. Please note that,
since the list was developed, the education curriculum and scope of practice
has been modified in some areas:
Nursing science skills to be taught
Admission and discharge of patient
Ambulation
Application of heat and cold
Assisting with medical examination
Bathing
Bladder instillation
Bladder irrigation
Body alignment
Body mechanics
Cardiopulmonary resuscitation
Care planning
Cast care
Catheterization
Charting
Colostomy irrigation
Crutch walking
Decubitus care
Dosage computation, including pediatric
Ear, eye and nose drops
Emergency first aid
Enemas
Finger sticks for blood glucose monitoring
Gavage
Gloving
Hair care
Hand washing
Intake and output
Irrigation of indwelling catheter
Measures to stimulate voiding
Meeting elimination needs
Meeting spiritual needs
Mouth care, including dentures
Nail care
Nasogastric tube feeding
Neurological check
Non-verbal and verbal communications
Nutritional needs
Observation of response to treatment and medications
Observation of significant changes in body systems
Oral medication
Oxygen administration
Pain assessment
Parenteral medication
Positioning and draping
Positive pressure equipment
Post-operative care
Pre-operative care
Providing comfort, safety, privacy
Range of motion
Restraints
Shaving male patient
Sitz bath
Skin care
Skin testing and immunization
Specimen collection: feces, sputum, urine, urine for diabetic testing
Suppositories
Telephone manners
Topical application of medication
Turn, cough, deep breathe
Vital signs
Wound dressings
Following are procedures that the BVNPT said "may not be available" in
all Psych Tech programs, but are "desirable" for teaching to Psych Tech
students. The interpretation is that if a Psych Tech has training in these
procedures, it is within that Psych Tech's scope of practice:
Colostomy dressings
Communicable diseases
Eye and ear irrigations
Gastrostomy feeding
Insertion of nasogastric tube
Isolation and reverse isolation (Standard Precautions & Universal Precautions)
Lavage
Orthopedic tractions
Preparation for diagnostic tests
Steam inhalations
Stoma care
Tidal drainage
T-tube care
Taking and recording verbal orders
Tracheostomy care
Removal of fecal impactions
Vaginal irrigations
Behavioral science skills to be taught
Communications skills common to all areas
- Verbal
- Non-verbal
- Role-playing
- Problem-solving
- Speech therapy -- language development
Skills for developmentally disabled
clients
Self-care techniques
- Motor
- Eating
- Toileting
- Dressing Grooming
Activities of daily living
Assessment techniques
- Emotional
- Physical
- Mental
Observation techniques
Behavior modification
- Positive reinforcement
- Reward techniques
- Intervention techniques
- Contracting
- Establishing baseline data
- Sequencing techniques
Group therapy techniques
- Supportive
- Corrective
- Confrontation
Play Therapy techniques
Socialization techniques
Normalization
techniques
Application of sensory motor training techniques
Speech
development techniques
Charting, recording, reporting
Developing care
plans
- Legal aspects
- Client rights
- Commitment procedures
- Confidentiality
Management of assaultive and combative behavior (MAB)
- Seclusion and restraint techniques
Sheltered workshops
Medications for DD clients
Treatments
Admission procedures
Discharge procedures
Safety procedures
Skills for mentally disabled clients
Assessment techniques
- Emotional
- Mental
- Physical
Interviewing techniques
Observation Techniques
Activities of
daily living
Recreational activities
Socialization techniques
Therapy techniques
Developing care plans
Charting, recording, reporting
Crisis
intervention techniques
Suicidal client Behavioral modification techniques
Intervention
techniques
Management of assaultive or combative client:
- Seclusion and restraint techniques
- Anger reduction
Goal-setting techniques Legal aspects
- Client rights
- Confidentiality
- Commitment procedures
Medication for MD clients
Treatments
Admission procedures
Escorting clients
Discharge procedures
Safety procedures
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