A ‘domains of practice’ approach to the standards of psychiatric and mental health nursing

Abstract

Standards have considerable influence on the practice of a discipline. As the written and explicit expectations of nurses held by their professional group, nursing practice standards serve as a basis for performance evaluation and as a clarification of the areas of nurses' accountability. Delineated here are the issues that the Canadian Federation of Mental Health Nurses faced as they attempted to identify and describe the nursing behaviours essential to this specialty area. A rationale for the 'domains of practice' approach is provided. The problems inherent in creating such a national document are addressed. Seven practice domains are described; the standards for two domains, the 'Helping' and the 'Effective Management of Rapidly Changing Situations', are outlined in detail.

Consumer input into standards revision: changing practice

“…The third edition of the Canadian Standards for Psychiatric‐Mental Health Nursing (Canadian Federation of Mental Health Nurses 2006) contributes towards an improved field of practice for psychiatric mental health nurses across the country. Practitioners will notice that, as in previous editions, the standards continue to use Benner’s (1984) domains of practice as the conceptual framework (Austin et al . 1996).…”

“…In keeping with this priority, the ongoing development, critique and revision of standards for practice is considered a vital part of the work of the Canadian Federation of Mental Health Nurses (CFMHN). In general, Standards for Practice: (1) document specific expectations of a professional group (Austin et al . 1996); (2) articulate to others what is the desired achievable level of performance (Canadian Nurses Association 2002); and (3) inform professional bodies about the development of rules and regulations that guide practice (American Psychiatric Nurses Association 2000).…”

“…The first edition of the Canadian Standards for Psychiatric‐Mental Health Nursing was developed by experts in psychiatric mental health nursing and published in 1995 (Austin et al . 1996).…”

Impact of health reform on registered psychiatric nursing practice

“…Reform effects were felt by registered psychiatric nurses (RPNs), one of the three regulated professions comprising the Canadian nursing workforce and the largest single group of mental health professionals in western Canada (Canadian Institute for Health Information 2003). Within nursing itself there are some territorial difficulties; RPNs are only educated and recognized in western Canada, where their practice is distinctly regulated by separate legislation, complete with their own standards for practice, and provincial licensing bodies (Austin et al . 1996).…”