NATIONAL CENTER FOR MENTAL HEALTH

Nursing Education and Training Section

nursing.training@ncmh.gov.ph
ORIENTATION PROGRAM FOR CLINICAL INSTRUCTORS
This program is designed for Clinical Instructors of Nursing schools and
colleges who will follow-up nursing students in the clinical area. The program
requires background knowledge of the course objectives of Mental Health and
Psychiatric Nursing of the school or college they represent. The program will focus
on the rules and regulations embodied in the contract of affiliation, selecting and
organizing students learning experience in the clinical area and the processes of
coordination involved to facilitate students learning.
GENERAL OBJECTIVES:
1. Foster a climate conducive in establishing favorable rapport between the
hospital and the affiliating schools and colleges of nursing.
2. Orient the clinical instructor of the policies, rules and regulations embodied in
the contract of affilation.
3. Provide opportunity for the clinical instructor to explore the realities of
training, select and organize learning experience in the clinical area.
4. To enable the clinical instructor to participate in building and educative
environment for the students learning as well as their own.
5. Review the role of the clinical instructors, level coordinators and those
involved directly in the teaching of nursing students.
METHODOLOGY:
1. Guided tour of the physical set-up of selected clinical areas
2. Individual conferences
3. Observation and participation in the students learning activities with other
nursing schools
PARTICIPANT:
Appointed Clinical Instructor from Nursing School and colleges assigned to
follow-up nursing students at the National Center for Mental Health.
OPERATING DETAILS:
Duration:
Two (2) weeks/ 25 hours
Schedule:
Monday Friday (7:00AM-12:00NN)
Venue:
Nursing Education and Training Section Conference Room
Requirements:
Professional Portfolio/ Written Examination and Interview/
Complete
Attendance/ Evaluation

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NCMH ORIENTATION
April 11-22, 2016
Day 1 April 11, 2016

Attended Flag Ceremony

Met with Ms. Jane De Guzman, Training Coordinator for Affiliations
Attended Orientation Program for nursing students

ORIENTATION PROGRAM FOR NURSING STUDENTS

NCMH KEY OFFICIALS
1. Beverly Azucena, MD Chief, Medical and Professional Staff (Hospital Service)
2. Venus Serra Arain, MD Chief, Medical and Professional Staff (Community
Service)
ASSISTANT CHIEF NURSES
1. Rosalinda S. Mahilum, RN, MAN, Ed.D.
2. Estelita G. Pascua, RN, MAN
3. Publio B. Plotea, RN, MMHoA, MAN
4. Cesar S. ZArandona, RN, MGM Esp
CLINICAL COORDINATORS
1. Ines F. Lubo, RN
2. Ruditha E. Casalan, RN
3. Pascualito Rey A. Iballo, RN
NURSING SERVICE CLERKS
1. Aurora R. Pales
2. Jocelyn V. Gonzales
3. Aida G. Antonio
4. Marina E. Noche
5. Luisito K. Maregmen
6. Letecia Q. Larde
NETS
1.
2.
3.
4.
5.
6.

STAFF
Publio B. Plotea, RN, MMHoA, MAN
Jane P. De Guzman, RN, MPM
Laila M. Silva, RN, MGM
Julius G. Cheong, RN, MAN
Jerico H. Bajador, RN, MSc
Maria Jordana P. Dela Cruz, RN, MAN, MAEd

HISTORY of NCMH
NCMH was established in 1925 through Public Works Act 3258. It was formally opened on December 17,
1928 and was originally called the INSULAR PSYCHOPATIC HOSPITAL. It was later called the National

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Mental Hospital. On November 12, 1986, it was renamed NATIONAL CENTER FOR MENTAL HEALTH
(NCMH) through Memorandum Circular No. 48 issued by the Office of the President.
NCMH was classified as Special Research training Center and Hospital under the Department of Health
on January 30, 1987. It is licensed by the DOH and is accredited by Philhealth (Tertiary, training/teaching
hospital). The leading mental health care facility in the country, NCMH provides a comprehensive range of
preventive, curative and rehabilitative mental health services. It has an authorized bed capacity of 4,200
patients and a daily inpatient average of 3,000 patients. It serves an average of 56,0000 outpatients per
year.
Most of NCMH's patients are from Metro Manila and nearby provinces in Region III and IV. As a national
resource, NCMH also caters to patinets from other regions of the country, especially forensic cases
referred by the courts of law. Treatment of about 87% of inpatients belonging to classess C and D are
subsidized by NCMH.

1. Hospicio de San Jose Early part of 19th century

2. Insane Department at San Lazaro Hospital 1925
3. Insular Psychopathic Hospital December 17, 1928; it was built under
Philippine Public Works Act No. 3258, 64 hectares in Barrio Mauway,
Mandaluyong, Rizal
4. National Psychopathic Hospital
5. National Mental Hospital renamed due to stigma attached to the word
Psychopathic
6. National Center for Mental Health November 12, 1986, given name thru
Memorandum Circular No. 48 of the Office of the President
ABOUT NCMH:
The National Center for Mental Health is categorized as a Special Research Training Center and hospital
under Department of Health. The NCMH is a special training and research hospital mandated to render a
comprehensive (preventive, promotive, curative and rehabilitative) range of quality mental health services
nationwide. It also gives and creates venues for quality mental health education, training and research
geared towards hospital and community mental health services nationwide.
NCMH services include:

o Community Service
o Hospital Service
o Training and Research
o Human Resource Assessment Center

PhilHealth Accredited
ARTA Seal of Excellence
ISO 9001: 2008 Certified
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DOH retained hospital

Tertiary level (specialized in teaching, training and research)
Authorized bed capacity 4,200 (Biggest in ASIA)
Average in-patient of 3,000
300 OPD 24/7
28 Pavilions and 55 wards

NCMH Quality Policy

Globally accepted, the National Center for Mental Health is committed to provide
responsive and comprehensive mental health services that will promote a healthy
nation.
We nurture a team of competent, compassionate, and empowered staff through
continuous education, training, and provision of equal opportunity for professional
growth and development.
We continuously provide safe environment and state-of-the-art facilities and
equipment that are acceptable, accessible, and affordable to the clients we serve.
We go beyond our clients expectations: We CARE, We EMPOWER, We EXCEL
NCMH OBJECTIVES

Provision of care, treatment and rehabilitation to the mentally-ill clients.

Promotion of mental health and prevention of mental illness
Training, education and research.
Promotion of community awareness on the care of the mentally-ill.

AREAS IN NCMH:
Community Service
1. Psychiatric Emergency Room
2. ACIS (Admission Crisis Intervention Service)
a. ACIS I
b. ACIS II (Socialized Fee)
c. ACIS III
3. Drug Detoxification Unit (DDU)
4. OPS (Charity/ Paylane)
5. Pulic Health Unit (PHU)
6. Specialty Clinics
Receiving Pavilions
Male
o Pavilion 1 (Ward 2 and 5)
Female
o Pavilion 3 (Unit 2)
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Child and Adolescent

o Pavilion 14 (Shangrila) - Male
o Pavilion 12 (Zonta) -Female

Forensic Service
Pavilion 4
Pavilion 35
Continued Treatment
Pavilion 1 (Wards 3, 4, 6, 7, 8, 9, Open Ward)
Pavilion 3 (Unit 1)
Pavilion 5 (Unit 1-4)
Pavilion 6-2E
Geriatric Wards
Pavilion 28 (Cottage 9)
Pavilion 8 (Unit 1 and 2)
Rehabilitation
EDMRV (Elias Domingo Memoral Rehabilitation Village)
o 1st Filipino Psychiatrist
o 1st Director of NCMH
Male Custodial Care
o Pavilion 18 (Cottage 1)
o Pavilion 19 (Cottage 2)
o Pavilion 21 (Cottage 3)
Female Custodial Care
o Pavilion 10 (Dorm 1)
WAB (Pavilion 9)
Pavilion 10 (Dorm 2)
Pavilion 11
Pavilion 34
Pavilion 30 (Chinese Pavilion)
Pavilion 20 (Psychosocial Rehabilitation and Training Center)
Physically-Ill Section
Infirmary
o Emergency Room
o Out-Patient Department (OPD)
o TB DOTS Clinic
o Male and Female Medical/Surgical Ward
o Intensive Care Unit
o Operating Room
o PhilHealth Ward
TB Cottages
o Pavilion 22 (Sub-infirmary)
o Pavilion 26 and 27 (Male TB Ward)
o Pavilion 23 (Female TB Ward)
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General Guidelines for School Affiliates:

No cellphones or camera or any recording device
Proper grooming, uniform at all times
CI must wear blazer
No pictures with patient; CI only person allowed to take pictures

Met with Mr. Publio Bonn Plotea, Asst. Chief Nurse for Training and
Education
o He explained that there is a new Orientation Program for Clinical
Instructors and we are the first 4 to undergo this training program
o He expects that Clinical Instructors must:
Teach new terms and accepted Psychiatric Terminologies from
DSM V
Explain to Student Nurses the medications, their usage and
different treatment modalities
Teach proper and Therapeutic Communication
o Affiliates must:
Submit a communication letter to the Medical Chief through OIC
Nursing Chief Nurse
12 students max/group
Certification from school
Provide list of CI and student as well as requested schedule
7:00am-3:00pm with students
Submit their PCIP (1 copy for Nursing Office, 1 copy for Ward
assigned)
Perform self-awareness prior to exposure to area
Use Joharis Window
o Ex. Doing Nothing (students back to teacher)
Make sure No notes/paper-pen while interviewing client
Permit to go on duty must be given to guard
CI will be given patient assignments
NPR
Allow Student to perform NPR
Do bedside conference, ask about patient, and planned
nursing interventions
Students are allowed to read charts only at the nurses
station
PROCESS RECORDING depends on:
Pre-orientation
Orientation
Working
Termination
Only get highlights of therapeutic communication used.
Pre and Post Conference at ward assigned
Nameplates
For both student and student nurse
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Courtesy call to Nursing Chief Nurse

o OIC, Ms. Rosalina Evasco
Day 2 April 12, 2016

Met with Ms. Narizah Tribio, Supervisor; Pavilion 1

Shadow with a Clinical Instructor from UST, MS. Jer Medrana
Observed orientation with students
Give scenarios to the students, teach TheraComm, as well as appropriate
responses to situations.
SAMPLE SCENARIOS:
1. Question 1: Sama ako sayo umuwi
Answer 1: Sorry po, wala pa po kasi sinabi si Doc na pwede na kayo umuwi,
san panandalian po pwede kayo sumali muna sa ibang activity. (Divert
Attention)
2. Q2: San ka nakatira?
A2: DO NOT GIVE DIRECT ADDRESS. Redirect to your topic.
3. Q3: Pengeng candy? Gutom na kasi ako.
A3: Mamaya po meron po kaming activity, pagkatapos po nuon may pakain
po kami.
4. Q4: Pwede ba kita i-add sa FB? Twitter? Cellphone number na lang?
A4: Remind patient that you are the nurse and she is the patient. Sorry po,
hindi po pwede kasi Student nurse niyo ako at kayo ang patient ko. Meron pa
naman pong staff na pwede niyong makausap pag wala na ako. (Limit
Setting)
5. Q5: Pwede mob a text nanay ko? Pwede mo ba tawagan KFC para
magdeliver?
A5: Pasensiya na po, hindi po kami pwede magtext pero pwede ko kayo
samahan sa staff para sila ang tumawag sa kamag anak ninyo. May contract
po sila sigurado nun. (Offering Self)
6. Q6: Pahiram ng ballpen para ma-correct ko yung spelling sa name plate na
bigay mo.
A6: Ako na lang po magsusulat para sa inyo. Hindi po kailangan ng Ballpen
ngayon, pagpatuloy po muna natin an gating activity.
7. Q7: May boyfriend/girlfriend ka na ba?
A7: Answer no, then say kayo po ba? Pag-usapan na lang po natin kung
kayo ang may bf/gf?
8. Q8: Ang ganda mo naman! (with touching the student nurse in an intimate
way)
A8: (Distance yourself at arms length, from where the patient touched you)
Sir, hindi niyo po dapat ako hawakan. Student nurse niyo ako at patient ko
kayo, sa susunod po na hawakan niyo ako, istostop kop o ang interaction
natin, at ibabalik kayo sa ward. (Remind client that you are a privilege,
because of you they are able to go out.)
THERAPEUTIC COMMUNICATION
1. Divert attention
2. Offering Self

NON-THERAPEUTIC COMMUNICATION
1. Givig Ideas
2. False Hope/assurance
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3. Explore
4. Limit Setting

3. No asking WHY

PAVILION 1
1. Ward 1
Open ward
With bed, cabinet, fan, TV
More stable patients are already here
Ready for discharge
They are given tasks, groom the garden, laundry, assist in different
tasks
They are paid 10 pesos/day
2. Ward 2
Receiving unit of Pav 1
From ACIS
Admitted here for a week
3-5 days in observation room until they can interact with other patients
Transferred to either Ward 3,4; 5,6; 7,8 after they are stable
3. Ward 3 and 4
Semi Open Ward
4. Ward 5
Isolation ward
2 Wings
o Infectious
o Non-infectious
ISOLATE
o Physically and verbally assaultive
o Communicable disease
o For behavior modification
DO NOT ISOLATE: Depressed, Suicidal, and Withdrawn
TIP: make student nurse check rooms, have a feel of how it feels to be
isolated. Ask them what would make rooms safer?
o Padded walls
o Rubberized flooring
o CCTIV Camera
o Low-lying beds/mattress
5. Ward 6 and 7
Beds in corridor for restraint
6. Ward 8 and 9
Thought/ Mood disorder
Census: 86
No table, CR only
No underwear (garter may be used for strangulation)
7. Ward 2 and 5 no student nurse assigned
Patients are very disturbed
ECT (Electro Convulsive Therapy)
o Last done in February 2015
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o WHO anti-human rights

o ECT no longer done
o 70-150 voltz
o Therapeutic seizure lasts 30-60 seconds (Grand mal seizure)
o Position after: side lying to prevent aspiration
o Antidote: more than >60 secs. Give VALIUM (Diazepam)
o If <10 seconds, repeat the procedure
o Most common side effect: partial memory loss

8. FEEDING
Pantry 1 for Ward 1,2,3,4
Pantry 2 for Ward 6,7,8,9
Ward 5 food is brought to their rooms
Green receptacles for food
More food for those with doctors order that diet needs to be increased
because patient is weak, for purpose of gaining weight
9. DISCHARGE
HOME CONDUCTION
Clients who live in provinces or abroad are brought to their own houses
If patients are refused by their relatives
o Risk for relapse
Sent out with relative
10.Other Areas
Dental Clinic
Laundry Area
Doctors Lounge
Psychological Service for Psych students
Visiting Hall
Only 1 Exit, the rest are fire exits located in the pantries.
Suggested activities for Students
Day 1 perform self-awareness
o Name|Positive Traits|Weaknesses|Remarks to the Patient
Orientation to activities, policies and procedures
Tour of the area
Daily activities (Day 2-last day)
o Pre-conference
o AM Care
o NPR
Can perform MSE (Mental Status Exam)
o Activity 1 (40 minutes)
o Snacks
o NPI
o Bring patient back to ward
o Lunch Break
o FDAR Sample charting
Initial of 1st day
Working IPA End of shift
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o Succeeding most meaningful for them Process Recording

o Observe medications
o Pantry feeding
Grand Socialization
o 1 on 1 do termination phase
o Feedback on changes observed (inform patient)
o Some give token (toiletries)
Types of Therapies
o Art
o Dance
o Music
o Health Education
o Occupational
o Recreational
o Remotivation
o Adult Education
o Socialization Party

Day 3 April 13, 2016

Pav 1

shadow Mam Jordan, Catanduanes University

Observed Pre-Con
Gave activities for the day
Gave lecture regarding Psychiatric Nursing and Mental Health
Showed us their best practices Used songs to memorize drugs

Pavilion 2 Nurse Supervisor Emily Leyva

Admission comes from OPS (Out Patient Service)
They get a check-up and are classified into C3 and Class D (HSM)
HSM Hospital Sponsored Membership x 3 days
Patients are discharged from this area after 3 days and then admitted either
to Pav 1 or Pav 3
Classifications
o Possible HSM enrollee
C3 Discounted, charity
CD Pay ward
o Pay Ward classified by Social worker (8am-5pm)
Class A, B, C1, C2
C1 25% discount
C2 50% discount
C3 75% discount
ACIS patients
1. Destructive to self
2. Violent, threatening to others
3. Patient brought by social workers -> sent to Pav 1 or 3

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4. With watcher *Male patient male watcher, Female patient female

watcher
If female watcher to male patient, must sign waiver
5. 19-59 year old (60 years old are no longer admitted)
6. Foreigners (ACIS 2 Pay)
7. Detox
8. Drug Rehab
9. Patient brought by police, social worker
10.With medical problems -> Medical Infirmary
11.Surgical problems -> Medical Surgical Infirmary
12.Probable court case -> Forensic case (if with court order)
13.Alone (For discharge; home conduction)
ACIS 1 (Male and Female)
o With bed, with underwear
ACIS 2 (pay ward and detox)
o Foreigner patients
o With bed
o 25 capacity
o Drug and Abuse related (Detox) 10 capacity
o Psychotic (pay)
ACIS 1, 2, 3, Detox (Acute) brought food
Rehab with watcher eats at pantry
o 5 14 days maximum stay
o From OPS/ER social worker categorizes then transfers to ACIS
If for discharge, those who brought patient are the only people who can
discharge patient. They must present a valid ID.
o Restrain if disturbed
4 hour limit to restrain
Check first
Refer to Doctor
Order restraint
Calm patient with meds
No visitors
o Doctor on call available 24/7
1 Screener
1 consultant
1 referring resient
o If with communicable disease refer to Medical
o For

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