Mental health nursing: Daring to be different, special and leading recovery‐focused care?

Abstract

How mental health nursing is differentiated from other disciplines and professions, and what special contribution mental health nurses make to health services, is a question at the heart of contemporary practice. One of the significant challenges for mental health nurses is identifying, developing and advancing those aspects of their practice that they consider differentiate them in the multi‐disciplinary mental health care team and to articulate clearly what a mental health nurse is and does. This paper draws on data from interviews with 36 mental health nurses in Australia who identified their practice as autonomous. Participants were asked the question, “What's special about mental health nursing?” Constructivist grounded theory techniques were applied to the research process. Findings were formulated and expressed as the ‘Ten P's of the professional profile that is mental health nursing’, which are ‘present’, ‘personal’, ‘participant partnering’, ‘professional’, ‘phenomenological’, ‘pragmatic’, ‘power‐sharing’, ‘psycho‐therapeutic’, ‘proud’ and ‘profound’. The combined elements of the findings present a theoretical construct of mental health nursing practice as something distinctive and special. It provides a model and exemplar for contemporary practice in mental health nursing, embracing the role of mental health nurses in the health care workforce as being well placed as providers of productive and effective care.

Mental health nurses and mental health peer workers: Self‐perceptions of role‐related clinical competences

“…Hospitalized mental health patients perceive that nurses are often too involved in rule enforcement, medication administration, and ensuring security in wards, while they want nurses to focus on genuine therapeutic engagement (Santangelo et al 2017;Stewart et al 2014). They invest a lot in discussing and checking their actions with their team members.…”

“…The peer workers selected for the present study were all recently employed and were adopting a new role. By doing so, nurses put in practice what is echoed by nursing theories (Santangelo et al 2017). The findings can be interpreted in the perspective of collaborative engagements between nurses and peer workers (Wiggins 2008).…”

“…The findings revealed how nurses and peer workers are dependent on teams to feel competent and satisfied. When nurses succeed in articulating the unique, complex, challenging, and often intangible work they perform in a person-centred manner, it will not only increase their visibility within a team but can also enhance their sense of professional identity, empowerment, and even personal identity (Hurley et al 2009;Santangelo et al 2017). Although it can be justified to be subservient to the team, this should not rule out speaking and acting from their own perspective as nurse or as peer worker.…”

“…Consequently, opportunities to trust and offer their unique and specific expertise are often considered unimportant or ignored. Strong nurse leadership will be needed to enable nurses to develop their professional profile as a mental health nurse based on a person-centred, wellness-oriented, and collaborative care delivery model (Santangelo et al 2017). For nurses, the results can be interpreted as a call to adopt a more tailored approach towards their clinical practice in line with contemporary mental health nursing standards of care.…”

‘Promoting and preserving safety and a life‐oriented perspective’: A qualitative study of nurses’ interactions with patients experiencing suicidal ideation

“…As an example, Manuel et al () uncovered conflicts between policy recommendations to increase the use and restrictive level of protocol‐based interventions to ensure patient safety and the views of clinicians, including nurses, that such recommendations undermine their intentions to develop therapeutic engagement with patients. While such findings reflect the challenge for research and practice of integrating clinical knowledge into the evidence base of suicide prevention (O’Connor & Portzky ), they also reflect that nurses’ perspectives are often overlooked and that there is no clear articulation of what nurses do and what contribution they (can) make (Browne et al ; Santangelo et al ).…”