MHN103 Unit 1 Assessment
The following essay intends to show how my understanding of mental health nursing, and role that I will play working and supporting individuals with mental health conditions has developed over the course of this module. I will address this by firstly looking at what I believe to be the definition of a mental health nurse, looking at their role and responsibilities; a definition I feel is vital for directing the focus of my studies. I will then look at where I place mental health nursing in relation to other fields of nursing and other disciplines that work within the field. I intend to look at how the field has emerged and how it has changed over the years, the role of the nursing and midwifery council. Lastly, I will look at the challenges I see facing the discipline.
The role of a mental health nurse varies widely, from taking care of patients with acute conditions, caring for older adults with dementia, caring for people with substance addictions, children and young people with mental health issues, to community care. Mental health nurses deliver appropriate care to patients, this care is evidence based
that is expressly centred on the needs and wellbeing of individuals; patient centred care (Kitson et al., 2012). At the heart of patient-centred care lies the philosophy that all patients are treated as individuals and unique, with support and care being based on their terms; they are the experts in their own world and should be consulted and listened to with regards to their own recovery (Epstein and Street, 2011). Patient care can consist of giving medication and treatment, but also involves working with patients’ and their families and carers as well as other professionals and agencies to provide seamless care. Due to the Integration of Health and Social Care, mental health nurses work alongside other professionals such as GPs, social workers, and other care professionals to ‘plan and deliver services that provide care for individuals in their community or in a homely setting’ (Audit-scotland.gov.uk, 2018). The support and care provided is in the interest of the patient and focuses on sharing information and sourcing of resources and ultimately avoiding unnecessary admissions to hospital.
Whilst providing a high level of care the role of a mental health nurse, as well as the role of myself as student is to always be professional and to adhere to the Nursing and Midwifery (NMC) code of conduct. The NMC Code is a set off professional standards that must be upheld. The NMC Code is a register of nurses and midwives in England, Wales, Scotland and Northern Ireland. The NMC focus on 4 key points; ‘Prioritise people’, ‘Practise effectively’, ‘Preserve safety’ and ‘Promote professionalism and trust’ (Nmc.org.uk, 2018). This exists as a safeguard to protect the public through education, training, conduct and performance so that the highest quality of care is delivered by nurses throughout their career, making sure all skills are up to date and that they uphold professional conduct. It protects their general health and well-being and makes sure all nurses adhere to the same rules and framework, values and principles (Nmc.org.uk, 2018).
Members of the public cannot always see the difference between a student and a registered nurse, qualified and registered with the NMC. Therefore as a student our conduct is important to uphold the reputation of the profession, both when studying and in our personal life. An example of remaining professional within our personal life is the use of social media. |Students as well as fully qualified nurses can benefit from the use of social media. This is a great resource for continuing development as it provides a great support network and allows professional relationships to form. The NMC include guidelines for the use of social media which tell us ‘use all forms of spoken, written and digital communication responsibly’ (The code, paragraph 20.10). Be sensible about information shared on social media as you can never be sure who sees it. Protect your reputation and think before you post! Being professional also means good spoken language, be polite, follow the rules, be non-judgemental, kind and be empathetic and to stay safe. Empathy being the ability to put yourself into someone else’s shoes. (Mccabe, 2004 cited in nursingtimes.net).
Mental Health nursing has also become more integrated with other fields of nursing, with research highlighting that there is ‘no health without mental health’ (Nhmh.org, 2018). Physical and mental health should not be separated, our mental health can be affected by our poor physical health just as our physical health can be affected by poor mental health (Nash, 2014). An example of how a person’s mental health can negatively affect their physical health can be seen through an individual’s use of self-harm such as eating disorders. An example of a long-term physical health condition that could potentially affect a person’s mental health is diabetes. If we were to look depression among school ages children with type 1 diabetes, statistical evidence varies due to large numbers of these children being left undiagnosed and untreated, however, there is a higher rate of depression among school age children with type one diabetes in relation to their peers without type 1 diabetes (Alvar et al., 2018). In essence each branch of nursing could require the involvement of a mental health nurse at some stage of a patient’s recovery.
The role and responsibilities as well as the place of mental health nursing in relation to other disciplines in the field and in nursing has not always been as it is now. The practice has seen many changes in both medicine, treatments and way the needs of the patients are met. In the 18th and 19th century, a nurse’s role was more one of control and restriction in buildings called asylums. The asylum, the mental hospital, or psychiatric hospital was a place where the mentally ill would be locked away. REF?Nowadays times have moved on and asylums no longer exist. Care can be delivered in a variety of places for example psychiatric intensive care units/wards, outpatient units, eating disorder clinics, GPs, prisons, care homes, and even the patient’s own home. The focus now is on social integration of care. It is also important to look at what recovery means in a mental health situation. It can be said that ‘a person with mental illness can recover even though the illness is not cure’ (Anthony, 1993). Recovery is living a fulfilled and satisfied life even when it is limited by mental illness. A significant percentage of people diagnosed with mental illnesses experience unemployment, poverty, poor physical health, disrupted relationships, and impaired functioning. These factors can also affect a person’s recovery but it is about learning to live with your illness and learning the triggers to your illness to function at best. Avoiding triggers and learning about your illness so you can lead as fulfilling a life as is possible. It is important to take account of all evidence provided and find what works for a patient. Evidence based practice is the result of looking at patient values, preferences and clinical expert evidence that is available (based on Sackett et al, 1996). Condense this too long and woffle
Serious mental illness can significantly affect the quality of a person’s life, and discriminatory and prejudicial attitudes, stigma attached to mental health issues, often make it hard for individuals to seek help from appropriate professionals (Corrigan, Druss and Perlick, 2014). Wrongful perceptions of mental health can cause judgemental attitudes towards people facing mental illness. A survey done of 1700 adults in the UK found that the most common belief held by people was that mental health patients were in fact dangerous; those with drug and alcohol dependencies and schizophrenia (Crisp et al, 2000) . Another common view was that some issues are self-inflicted, for example eating disorders and again substance and alcohol abuse. There are two types of stigma, the first being social stigma which is the way the public see those with mental health problems and the second is self-stigma. This can lead to feelings of shame on the part of the patient and low self-esteem and low worth, making the outcome poor (Psychology Today, 2018). Lack of education and understanding is also a definite challenge. There are a number of Anti-stigma campaigns which aim to raise awareness, for example ‘Time to Change’.
Reflection is a tool mental health nurses use to help improve and maintain their practice and is the basis for continuous professional development which mental health nurses are required to manage to maintain their NMC registration. Revisiting and reconsidering our previous knowledge and adding to it to improve on practice. This can be done in many ways eg: essays, notes, reading and when practicing. Life-long learning means these transferrable skills are continued and developed throughout working careers and they can be drawn from and adapted to different working environments. It is said that ‘we learn by doing and realising what came of what we did’ (Dewey J, 1938). Looking at the experience, the outcome of that experience and reflecting back on what was good and what could be improved on within it. REF?? for reflection ..add to the middle part??
To conclude this essay I feel I have developed my knowledge on the role of a mental health nurse within society, past and present. From asylums to integrated care we see today within our mental health system it.
Alvar, C., Coddington, J., Foli, K. and Ahmed, A. (2018). Depression in the School-Aged Child With Type 1 Diabetes: Implications for Pediatric Primary Care Providers. online Jpedhc.org. Available at: https://www.jpedhc.org/article/S0891-5245(17)30229-8/pdf Accessed 19 Oct. 2018.
Audit-scotland.gov.uk. (2018). What is integration? A short guide to the integration of health and social care services in Scotland. online Available at: http://www.audit-scotland.gov.uk/uploads/docs/report/2018/briefing_180412_integration.pdf Accessed 19 Oct. 2018.
Corrigan, P., Druss, B. and Perlick, D. (2014). The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychological Science in the Public Interest, 15(2), pp.37-70.
Crisp, AH., & G Gelder, M & Rix, S & I Meltzer, H & J Rowlands, O. (2000). Stigmatisation of people with mental illness. The British journal of psychiatry : the journal of mental science. 177. 4-7. 10.1192/bjp.177.1.4.
Epstein, R. and Street, R. (2011). The Values and Value of Patient-Centered Care. The Annals of Family Medicine, online 9(2), pp.100-103. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056855/ Accessed 17 Oct. 2018.
Kitson, A., Marshall, A., Bassett, K. and Zeitz, K. (2012). What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of Advanced Nursing, online 69(1), pp.4-15. Available at: https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2648.2012.06064.x Accessed 19 Oct. 2018.
Nash, M. (2014). Physical health and well-being in mental health nursing. 2nd ed. New York: Open University Press
Nhmh.org. (2018). No Health Without Mental Health Home Page. online Available at: http://www.nhmh.org/ Accessed 17 Oct. 2018.
Nmc.org.uk. (2018). The Code Professional standards of practice and behaviour for nurses, midwives and nursing associates. online Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf Accessed 20 Oct. 2018.