Tag: Mental Health Nurse

Pragmatism & Empathy in Mental Health Nurses

Published on by Andrew Marshall1 Comment

Research Paper Title

Mental health nurses’ understandings and experiences of providing care for the spiritual needs of service users: A qualitative study.

Background

Mental health nurses have a professional obligation to attend to service users’ spiritual needs, but little is known about specific issues related to provision of care for spiritual need faced by mental health nurses or how nurses understand this aspect of care and deliver it in practice.

To explore mental health nurses’ ́understandings of spiritual need and their experiences of delivering this care for service users.

Methods

A qualitative study was conducted in one NHS mental health service. Interviews were undertaken with seventeen mental health nurses practising in a variety of areas.

Results

Four themes were generated from thematic analysis of data in the template style:

  1. Expressing personal perspectives on spirituality;
  2. Expressing perspectives on spirituality as a nursing professional;
  3. Nursing spiritually; and
  4. Permeating anxiety (integrative).

Conclusions

Participants had complex understandings of spiritual need and evident anxieties in relation to this area of care.

Two different approaches to nursing spiritually are characterised as:

  • Pragmatic (concerned with procedural aspects of care); and
  • Spiritually empathetic.

Mental health nurses were uncertain about the acceptability of attention to spiritual issues as part of care and anxious about distinguishing between symptoms of mental ill health and spiritual needs.

Educational experiences need to emphasise both pragmatic and empathetic approaches, and work needs to be organised to support good practice.

Reference

Elliot, R., Wattis, J., Chirema, K. & Brooks, J. (2020) Mental health nurses’ understandings and experiences of providing care for the spiritual needs of service users: A qualitative study. Journal of Psychiatric and Mental Health Nursing. 27(2), pp.162-171. doi: 10.1111/jpm.12560. Epub 2019 Sep 16.

Is It Important that Health Promotion be a Focus that Permeates the Entire Organisation of Mental Health Care?

Published on by Andrew Marshall1 Comment

Research Paper Title

Mental health nurses’ experience of physical health care and health promotion initiatives for people with severe mental illness.

Background

Health care for people with severe mental illness is often divided into physical health care and mental health care despite the importance of a holistic approach to caring for the whole person.

Mental health nurses have an important role not only in preventing ill health, but also in promoting health, to improve the overall health among people with severe mental illness and to develop a more person-centred, integrated physical and mental health care.

Thus, the aim of this study was to describe mental health nurses’ experiences of facilitating aspects that promote physical health and support a healthy lifestyle for people with severe mental illness.

Methods

Interviews were conducted with mental health nurses (n = 15), and a qualitative content analysis was used to capture the nurse’s experiences.

Results

Analysis of the interviews generated three categories:

  • To have a health promotion focus in every encounter;
  • To support with each person’s unique prerequisites in mind; and
  • To take responsibility for health promotion in every level of the organisation.

Conclusions

The results show the importance of a health promotion focus that permeates the entire organisation of mental health care.

Shared responsibility for health and health promotion activities should exist at all levels:

  • In the person-centred care in the relation with the patient;
  • Embedded in a joint vision within the working unit; and
  • In decisions at management level.

Reference

Lundstrom, S., Jormfeldt, H., Ahlstrom, B.H. & Skarsater, I. (2020) Mental health nurses’ experience of physical health care and health promotion initiatives for people with severe mental illness. International Journal of Mental Health Nursing. 29(2), pp.244-253. doi: 10.1111/inm.12669. Epub 2019 Oct 29.

Changing Attitudes & Stigma toward Mental Health in Nursing Students

Published on by Andrew Marshall2 Comments

Research Paper Title

Attitudes and stigma toward mental health in nursing students: A systematic review.

Background

This systematic review seeks to ascertain whether mental health-specific education reduces stigmatising attitudes in nursing students.

Methods

A systematic review of the literature was performed.

Results

Thirteen studies met the inclusion criteria.

Most of the results show an improvement in attitudes toward mental health, both in theory and clinical experience, but a greater improvement toward these stigmatising attitudes was observed in clinical placements than in theory.

Conclusions

Mental-health-specific training seems to improve perceptions toward mental health.

Clinical placement underpins theory, leading to a decrease in negative attitudes and stigma regarding mental health.

Reference

Palou, R.G., Vigue, G.P. & Tort-Nasarre, G. (2020) Attitudes and stigma toward mental health in nursing students: A systematic review. Perspectives in Psychiatric Care. 56(2), pp.243-255. doi: 10.1111/ppc.12419. Epub 2019 Jul 28.

How can Psychiatric Mental Health Nurse Practitioners Meet Rural Mental Health Challenges?

Published on by Andrew Marshall1 Comment

Research Paper Title

Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges.

Background

To describe the current rural mental health system crisis in the United States and how psychiatric mental health nurse practitioners (PMHNPs) can holistically mitigate this systemic issue.

Methods

Respective to the objective, relevant literature is reviewed.

Results

PMHNPs have successfully increased access to care in under-served rural communities by practising at the fullest extent of their scope without mandated supervision, utilising telepsychiatry practice, while expanding PMHNP rural mental health education and research to meet and absolve pressing rural mental health challenges.

Conclusions

Current evidence supports that rural mental health care improves when PMHNPs have full scope of practice, utilise telepsychiatry, engage in related scholarly activity, and have formalised education and training for rural health care delivery, which collectively answer the professional and moral call serving the under-served rural population with mental illness.

Reference

Finley, B.A. (2020) Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges. Journal of the American Psychiatric Nurses Association. 26(1):97-101. doi: 10.1177/1078390319886357. Epub 2019 Nov 15.

Is More Clarification is Needed of Mental Health Practitioner’s Engagement Experiences in Early Intervention Settings?

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Research Paper Title

Mental Health Practitioner Experiences of Engaging With Service Users in Community Mental Health Settings: A Systematic Review and Thematic Synthesis of Qualitative Evidence.

What is Known on the Subject?

Engagement is regarded as important and beneficial for service users and mental health services A universal definition of engagement is not yet fully agreed upon.

What this paper adds to existing knowledge?

Based upon their experience, mental health staff use varied engagement approaches to fit with the changeable and unique needs of people who use services (service users). Mental health staff demonstrate qualities such as persistence and adaptability to successfully engage with service users.

What are the implications for practice?

Irrespective of professional background, the role of community mental health staff is not restricted to any single approach. Practical help and social support are as seen as important as clinical treatment to establish successful engagement. Little is known about the engagement experiences of mental health staff working in early intervention settings as most studies in this review focused on the perspectives of staff based in assertive outreach or community mental health teams. There is a need to further understand staff experiences of engagement with service users in early intervention settings. Role descriptions and expectations of community mental health workers should account for the wide-ranging flexible approach required in order to deliver appropriate interventions. This may involve a focus on engagement in training programmes.

Background

Effective mental health care is dependent on engaging service users, but some individuals do not actively attend appointments, and may stop engaging with mental health services. Quantitative studies reveal some salient factors that seem to predict engagement, but these studies miss the nuances of good clinical practice in this area. A number of qualitative studies of health professionals’ experiences and understanding of effective engagement have been published.

This review aimed to systematically identify, evaluate and synthesise results from these studies with a view to informing effective practice in this area.

Methods

Electronic databases MEDLINE, EMBASE, CINAHL, PsychINFO and AMED were searched (PROSPERO systematic review protocol registry (www.crd.york.ac.uk/prospero/; ID CRD42017083976). Of 799 records, ten papers met the inclusion criteria. All papers were subjected to quality appraisal based on the CASP checklist and data systematically extracted. A thematic synthesis of included studies examining mental health practitioners’ experiences of engagement in community mental health settings was conducted.

Results

Mental health practitioners see engaging service users as depending upon complex, multi-dimensional phenomena which should include individualised person-centred approaches as well as practical, social and clinical support. Mental health practitioners demonstrate qualities such as determination and adaptability to establish and maintain engagement with service users.

Conclusions

As a core aspect of nurse education, registered mental health nurses and other professionals would benefit from systematic guidance regarding engagement strategies. Most studies in this review focused on assertive outreach or community mental health teams, more clarification is needed of practitioner’s engagement experiences in early intervention settings.

Reference

Henderson, P., Fisher, N.R., Ball, J. & Sellwood, W. (2020) Mental Health Practitioner Experiences of Engaging With Service Users in Community Mental Health Settings: A Systematic Review and Thematic Synthesis of Qualitative Evidence. Journal of Psychiatric and Mental Health Nursing. doi: 10.1111/jpm.12628. Online ahead of print.

Psychiatric Nurses & Personal Initiative: What are the Factors to Consider?

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Research Paper Title

Personal and organisational factors related to initiative behaviour among psychiatric nurses.

Background

To identify the degree of personal initiative (PI) among psychiatric nurses and to examine the influence of personal and organisational characteristics on their PI.

Methods

Ninety-seven nurses completed a questionnaire on PI, work climate, self-efficacy toward initiatives and innovations, nursing work environment, and actual initiative at work.

Results

Differences in actual initiative at work according to the level of education, and negative association between PI and age were found.

Self-efficacy and work climate explained 56% of PI; self-efficacy, work climate, and age explained 30% of initiative behaviour.

Conclusions

Investing in young nurses, fostering higher education, and creating a supportive work environment can help in conversion of innovative vision into actual initiatives.

Reference

Hendel, T., Chor, R., Kigli-Shemesh, R. & Kagan, I. (2020) Personal and organizational factors related to initiative behavior among psychiatric nurses. Perspectives in Psychiatric Care. doi: 10.1111/ppc.12471. [Epub ahead of print].

Book: Psychiatric-Mental Health Nursing

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Book Title:

Psychiatric-Mental Health Nursing.

Author(s): Sheila L. Videback.

Year: 2019.

Edition: Eighth (8th); North American Edition.

Publisher: Wolters Kluwer Health.

Type(s): Paperback and Kindle.

Synopsis:

With an accessible, clear and student-friendly approach, Psychiatric-Mental Health Nursing clarifies challenging concepts and helps you build a foundation for working successfully with clients experiencing mental health challenges regardless of care setting. The text explores the full spectrum of psychiatric nursing, helping you master specific nursing interventions, hone your therapeutic communication skills and learn to apply content effectively within the framework of the nursing process.

  • New! Unfolding Patient Stories written by the National League for Nursing put the nursing process in a realistic context to prepare you for successful client interactions and interventions.
  • Clinical Vignettes familiarise you with the features of major disorders you are likely to encounter in practice.
  • Therapeutic Dialogues help you perfect your communication skills with specific examples of nurse-client interactions.
  • Best Practice boxes provide the latest evidence-based findings in psychiatric nursing.
  • Self-Awareness features foster your personal and professional development through self-reflection.
  • Concept Mastery Alerts clarify important concepts essential to your classroom and clinical success.
  • Watch and Learn icons point you to corresponding true-to-life Lippincott(R) Theory to Practice Video Series videos for a richer understanding of important mental health disorders.
  • Built-In Study Guide reinforces your understanding with multiple-choice questions, multiple-response questions and clinical examples at the end of each chapter.
  • Nursing Care Plans demonstrate effective approaches for addressing specific client disorders.
  • Drug Alerts highlight essential concerns related to psychotropic drugs.
  • Warning boxes alert you to FDA considerations for specific medications.
  • Cultural Considerations help you ensure culturally sensitive care for a wide range of client populations.
  • Elder Considerations sections prepare you to care for the growing population of older adults.
  • Client/Family Education boxes boost your teaching capabilities.
  • Nursing Interventions etail key treatment strategies for specific disorders.
  • DSM-5 Diagnostic Criteria boxes summarise the medical diagnostic features of specific disorders.

Book: Psychiatric-Mental Health Nursing

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Book Title:

Psychiatric-Mental Health Nursing: Evidence-Based Concepts, Skills, and Practices.

Author(s): Wanda K. Mohr.

Year: 2013.

Edition: Eighth (8th).

Publisher: Lippincott, Williams, and Wilkins.

Type(s): Hardcover and Kindle.

Synopsis:

This edition focuses on evidence-based practice and rational practice with more case-oriented content that helps students better understand how to apply key concepts to practice.

Plus, new illustrations, photographs, and special features actively engage students in learning and appeal to a variety of different types of learners.

Wanda Mohr aims to empower students by the down-to-earth discussion of theory and theoretical frame-work.

Talking about Benzodiazepine Use with Patients

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Research Paper Title

Let’s Talk About Benzodiazepine Use: Inpatient Psychiatric Nurses Initiating the Conversation.

Background

Inpatient psychiatric nurses regularly dispense pro re nata (PRN) medication to individuals during their psychiatric hospitalisation.

International studies indicate that 66% to 90% of patients receive PRN medications during hospitalisation, a large percentage of which are benzodiazepines (BZDs).

Although clear opportunities exist for nursing intervention to reduce BZD use, there is little recent US literature on inpatient psychiatric nurses’ proactive approach to the issue.

The current article examines the factors that support BZD use during inpatient hospitalisation, including nurses’ attitudes around BZD use, the perceived effectiveness of the medication to address difficult situations, and the barriers to using alternative nonpharmacological methods.

Suggestions are presented for how nurses might begin dialogues with patients around BZD use and alternative strategies to manage distress.

It is recommended that the specialty initiate a research agenda for reducing BZD use during inpatient psychiatric treatment and champion the issue as a focus for systematic improvement efforts.

Reference

Delaney, K.R. (2020) Let’s Talk About Benzodiazepine Use: Inpatient Psychiatric Nurses Initiating the Conversation.

What Can We Learning from Nurses’ Experiences of Events involving Physiological Deterioration of Consumers in Acute Inpatient Mental Health Settings?

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Research Paper Title

Clarity, confidence, and complexity: Learning from nurses’ experiences of events involving physiological deterioration of consumers in acute inpatient mental health settings.

Background

The objective of the current study was to capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer.

Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus, and cancer.

There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting.

Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting.

Methods

An exploratory, descriptive study was employed using focus groups to gather narrative data which was then subject to qualitative analysis.

Eleven mental health inpatient wards within a local health district in Sydney, Australia were studied, comprising ward-based nurses (n = 64) and nurse unit managers (n = 8).

This paper follows the COREQ guidelines for reporting qualitative health research.

Results

Qualitative data analysis revealed three themes central to the nurses’ experience:

  1. Lack of clarity (subthemes: procedures and leadership accountability);
  2. Confidence in the workforce (subthemes: knowledge & skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and
  3. Complexity (subthemes: complexity as the new norm, and suitability of the mental health environment).

Conclusions

The themes found in this study can be used to guide and inform health care policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer.

Findings provide a rich dataset for the generation of measurement tools and protocols to guide physical healthcare and evaluate performance.

Reference

Brunero, S., Everett, B., Ramjan, L.M., Salamonson, Y., Steel, K., Johnson, A.M., Stokes, M., Langdon, R. & Dickens, G.L. (2019) Clarity, confidence, and complexity: Learning from nurses’ experiences of events involving physiological deterioration of consumers in acute inpatient mental health settings. Journal of Clinical Nursing. doi: 10.1111/jocn.15126. [Epub ahead of print].