The perennial issue of the distinctiveness of the mental health nurse (MHN) is once again to the fore. Previous attempts to resolve this apparent identity crisis in the discipline have included proposals for new models, new research and new educational preparation as well as new alliances, and new ways of practising. Now the politically driven concept of the generic nurse is gaining enough momentum to potentially end the discussion once and for all. This paper takes a postmodernist approach to MHN identity that questions the requirement for MHNs to articulate their distinctiveness, and offers alternative constructions of this identity to those promulgated by policy makers and by other health disciplines.

Mental health nursing, along with other professional groups, has had to adapt to new ways of delivering health services, often in response to government policy. Consequently, traditional professional boundaries and roles are being rapidly and consistently expanded, often requiring coordinated responses across strategic, educational and clinical domains to ensure service users experience high-quality mental health interventions. This paper explores and evaluates such a coordinated response in developing unplanned care services in Scotland. The evaluation, placed within a framework of realistic evaluation, highlights not only the efficacy of the provided training and education for new roles within unplanned care, but also that emotionally intelligent capabilities are required to successfully implement the level of change currently being experienced within the UK mental health services.

Aims and MethodThe project gathered data from a cohort of 300 flexibly trained female consultants in psychiatry in order to understand how their careers had progressed since the completion of their training. A postal questionnaire was used to gather this information.ResultsThese consultants were generally satisfied with their training, and were succeeding in pursuing their careers. Flexible training was developed to enable people with family commitments to train in psychiatry, and this is what it is being used for.Clinical ImplicationsFlexible training is an important avenue for an increasing number of psychiatrists to continue in their profession. With the current shortfall in consultant numbers, flexible training should be maintained and developed, and should be seen as a useful route to a consultant position.

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clinic and 507 (99.2%) of them had HIV test. From 42 patients having TOP, 6 (14.2%) women had HIV test. Discussion Not all patients might have been offered the HIV test in sexual health clinic. TOP service does not offer the HIV test routinely. Recommendations Sexual health clinic should offer HIV test to all patients accessing their service and document in patients' medical records that the HIV test was offered. When patients decline the HIV test, reasons for declining have to be documented. TOP service should update their local TOP guideline instructing their nurses, midwives and doctors to offer HIV test to all patients accessing their services. To present findings of the audit to medical staff at local, regional and national levels. To conduct re-audit in 3e6 months once changes have been implemented.