Monthly Archives: April 2022

Why choose Mental Health Nursing?

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This blog post accompanies a chat with 3rd / 4th year James Cook University (JCU) Nurse/Midwife students at an industry presentation day on 12th May 2022. Here is a copy of the slide show I’ll be using for the presentation @ JCU on the day:

Below are snippets and elaborations of the info we will touch-on/discuss on the day. Parking the information online just in case any of the JCU Students want to come back to it, and/or if it happens to be of interest to others.

Slide 1
As part of introducing myself, I’ll also introduce the idea/example of nurses intentionally making themselves visible on social media (eg: linktr.ee/meta4RN). More about that sort of thing here and here.

Slide 2
The day of the JCU student nurse industry presentation = 12th May = Florence Nightingale’s birthday = International Nurses Day.
Coincidence?
Yeah, probably.
But anyway, here’s a link to 20 tweetable fun facts that I like to trot-out to celebrate International Nurses Day: meta4RN.com/nurses2020
Also, check out the #IND2022 hashtag on social media.

Slide 3
Mental Health Nursing is vastly different to other hospital-based specialist nursing roles. I reckon it’s a very good fit for people who are very adaptable. A few years ago Australian researchers coined the ‘Ten P’s of the professional profile that is mental health nursing’:

present
personal
participant partnering
professional
phenomenological
pragmatic
power-sharing
psycho-therapeutic
proud
profound

(Santangelo, Procter & Fassett, 2018)

Slides 4 & 5
Part of what makes Mental Health Nursing different is the structure of public mental health services. Inpatient care is just a small part of the service structure, and there is a lot of emphasis on outpatient/community based services. There are options to specialise (as I have done, more about that here and here), or – as Mental Health Nurses who work in rural and remote areas do – do a little bit of nearly everything on the list of services of slide 5/in the table below.

Intake PointsInpatient/Residential ServicesOutpatient/Community Services
Central Intake Service
Emergency Department
Consultation Liaison Psychiatry Service		Psychiatric Intensive Care Unit
Mental Health Unit
Step-Up/Step-Down Unit
Community Care Unit		Acute Care Team
Continuing Care Teams
Mobile Intensive Treatment Team
Older Persons Mental Health Service
Child & Youth Mental Health Service
Evolve Therapeutic Services
Perinatal & Infant Mental Health
NQ Eating Disorder Service
Forensic & Prison Mental Health
Alcohol Tobacco & Other Drugs
Rural Mental Health
Remote Mental Health
Examples of mental health services/settings

Slide 6
On any given day, less that 1% of people who are open the Mental Health/Alcohol, Tobacco & Other Drugs Service that I work for are receiving specialist psychiatric inpatient treatment. The vast majority of mental health and addiction support and recovery happens in community settings, as evidenced by the data (collected on 12/04/22) below:

Cairns Hospital PICU/MHU Beds, n = 48
Cairns & Hinterland MHATODS Case Load, n = 5531

Slide 7
What do Mental Health Nurses do? Well, it’s pretty varied, but includes:

  • Responding to trauma/people experiencing crisis
  • Assessment – this mostly consists of looking, listening and asking – not necessarily in that order.
  • Coordinating and collaborating with the person and their family to plan and deliver care
  • Liaising with other members of the clinical team and other local services (eg: @CairnsHelp) to ensure holistic, person-centred care
  • Providing support
  • Act as an educator/resource person
  • Provide therapy (eg: Solution-Focused Therapy, Acceptance & Commitment Therapy)
  • Work across clinical and community settings
  • Work anywhere – including rural and remote areas (see: The challenges of mental health nursing in rural Australia)
  • Provide holistic care (ie: specialising as a Mental Health Nurse doesn’t suddenly mean you forget everything you’ve learned as student nurse/RN)
  • Being consumer-focused and trauma-informed
  • Acquiring and using specialised skills and knowledge

More info @ ACMHN.org/what-mental-health-nurses-do

Slide 8
As articulated by Hildegard Peplau (one of the earliest rockstars of Mental Health Nursing) our speciality places a premium on therapeutic use of self, and the therapeutic relationship.

Slide 9
Mental Health Nurse core competencies include:

  • assessment and management of risk
  • understanding recovery principles
  • person- and family-centred care
  • good communication skills
  • knowledge about mental disorders and treatment
  • evaluating research and promoting physical health
  • a sense of humour
  • physical and psychological interventions

(Moyo, Jones & Gray, 2022)

Slide 10
A specialist Mental Health Nurse is a…

  • psychotherapist
  • consumer advocate
  • physical health therapist
  • psycho-pharmacological therapist
  • relationship-focused therapist
  • aggression management therapist

 (Hurley & Lakeman, 2021)

Slide 11
Steps to becoming a Credentialed Mental Health Nurse:

  1. Graduate with an undergraduate degree in Nursing
  2. Complete a Graduate Diploma, Postgraduate Diploma or Masters in Mental Health Nursing
  3. (Optional) Undertake additional training in specific psychological therapies
  4. Successfully apply to be credentialed by the Australian College of Mental Health Nurses –  the peak professional mental health nursing organisation and the recognised credentialing body for Australia’s mental health nurses.

Slide 12
That’s it. Questions? 🙂

Video

Key References/Further Reading

Australian College of Mental Health Nursing acmhn.org

Hurley, J. & Lakeman, R. (2021), Making the case for clinical mental health nurses to break their silence on the healing they create: A critical discussion. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12836

Isobel, S., Wilson, A., Gill, K., Schelling, K. & Howe, D. (2021), What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12811

McKenna Lawson, S. (2022), How we say what we do and why it is important: An idiosyncratic analysis of mental health nursing identity on social media. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12991

Moyo, N., Jones, M. & Gray, R. (2022), What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups. International Journal of Mental Health Nursing. doi.org/10.1111/inm.13003

Santangelo, P., Procter, N. and Fassett, D. (2018), Mental health nursing: Daring to be different, special and leading recovery-focused care?. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12316

End

As always, feedback is welcome via the comments section below.

Naturally, if you think it will be of interest to any nurse/nearly-nurse you know, you are very welcome to forward the info on by whatever means you see fit. 🙂

Paul McNamara, 15th April 2022

Short URL meta4RN.com/JCU

freedumb

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Once upon a time – a long, long time ago (2021, I think it was) – I put a lot of effort into promoting COVID-19 vaccination.

I have stopped doing that.

As of April 2022 it looks like nearly 5% of adult Australians will choose to never be vaccinated against COVID-19 [source]. It’s been over a year since vaccines arrived in Australia. In the first couple of months it was tricky to access the vaccines, but since mid-2021 it’s been pretty easy. The unvaccinated are unvaccinated by intent, not by lack of information or opportunity.

By comparison, about 11.6% of adult Australians smoke tobacco daily [source]. Smokers ignore the health warnings intentionally – it’s certainly not through lack of information: over 75% of packaging space on tobacco products consists of graphic and text information about the harmful effects of smoking [source].

Smoking is not illegal. Vaccines are not mandatory. Adults do what they want and accept the consequences of their choices. 

Despite what people have been shouting at their ‘freedom rallies’ and in courtrooms, vaccines are not mandatory. Never have been. On 07/04/22 it was reported that Simon Ower QC said his client did not get vaccinated because she believed the mandate direction left her with no choice and it was being forced on her [source]. There was a choice then, wasn’t there? It’s not mandatory/forced on you if, as per this example, you get to say “no thanks”.

Vaccines are a condition of employment for many jobs and remain condition of entry for some venues, but they’re not mandatory. Never have been. Nobody will hold you down and inject you with a vaccine. You get to choose. As articulated in a recent eloquent editorial in the International Journal of Mental Health Nursing, “The heavy hand of coercive care is still reserved for those hearing voices and seeing things, rather than someone at risk of spreading a deadly pathogen to an unvaccinated community.” (Keep, 2021).

Let’s not muck-around here. The people who have chosen not to be vaccinated have grabbed more than their share of media space, and some people (eg: Clive Palmer and Craig Kelly) are prosecuting a peculiar political message to tap-in to that disaffection.

Let’s not buy into their frogshit. It’s more sensible to mock people like Clive Palmer and Craig Kelly (fragile manipulative narcissists hate mockery), and stick with the data.

The data shows that Australia’s COVID-19 strategy has been pretty successful [source]:

Cumulative COVID-19 deaths 29 February 2020 – 6 April 2022 (comparison of selected countries)

Out of interest, Australia’s anti-smoking strategy has also been pretty successful [source]:

Annual smoking death rate 1990 – 2019 (comparison of selected countries)

With the exception of people under the coercive/mandatory treatment conditions of the Mental Health Act, people get to choose what – if any – health advice they follow and what health interventions they receive. .

Smoking is not outlawed. Although smoking and death rates have fallen markedly in that last 20 years, more than 11% of Australian adults choose to smoke daily.

Vaccines are not mandatory. Although more than 95% of Australia adults have had two or more COVID-19 vaccines, over 4% of Australian adults have decided not to have the COVID-19 vaccine.

Some people make good health decisions. Some people make not-so-good health decisions.

Clinicians are very accustomed to providing health care to those who make not-so-good health decisions and/or are pre-contemplative to change. My concern is that if people are taking health advice from Clive Palmer and Craig Kelly are they exercising freedom or freedumb?

Reference

Keep, J.R. (2021), Enter the plague. International Journal of Mental Health Nursing, 30:5, pp. 1037-1039. doi.org/10.1111/inm.12924

End

That’s it for this angrier-than-usual blog post. The blatant distortions of truth by some incredibly well-funded politicians has made me a tad cranky.

As always, feedback is welcome in the comments section below.

Paul McNamara, 8 April 2022

Short URL: meta4RN.com/free