Teaching mental health nursing is, at the very least, a craft, an art, and a science

'In the middle': A qualitative study of talk about mental health nursing roles and work

Professional identities are important in defining workers' roles, and are concerned with attributes relating to those roles and how they are performed. Evidence shows mental health nurses undertake many different roles as part of their work. Yet, the roles of mental health nurses are insufficiently understood by healthcare staff, service users, and nurses themselves. Mental health nursing work has been deemed invisible and lacking in role clarity. Poor understandings about professional identity of mental health nurses result in difficulties recruiting to the profession, nurses lacking confidence articulating the value of their work, with misunderstandings apparent with service users about the specific role of mental health nursing in their care. The primary focus of this study, conducted in Wales, United Kingdom, was to examine how talk about mental health nursing was handled by participants from multiple perspectives. Data consisted of 17 individual interview transcripts with mental health nurses and 13 interview transcripts from mental health service users, and three focus groups with nursing students. Participants' talk was analysed using thematic analysis. This paper reports how participants described mental health nursing work to have significant role overlap with other multidisciplinary team members. Participants highlighted that mental health nurses often have an 'in the middle' label because the complexity of their work can be hard to describe. The implications are pertinent for nurses because if they are considered to be in a liminal position, they risk being perceived as neither one role nor another, resulting in nurses struggling with professional identities and role confidence.

Troublesome Knowledge: A New Approach to Quality Assurance in Mental Health Nursing Education

Background Quality assurance and quality enhancement processes in nursing education are vital to the establishment of a strong program. Existing quality assurance methods in nursing education such as professional self-regulation and external examination rely on provincial and national nursing associations for evaluation, putting minimal responsibility and accountability on internal program examiners. Threshold concepts and troublesome knowledge provide a framework as outlined by Land that utilizes internal examiners from both student and faculty groups and represents an alternative to traditional quality assurance in nursing education. Purpose To identify troublesome mental health nursing content in a nursing curriculum by exploring students and faculty perspectives. Method A sequential mixed methods design that utilized surveys and focus groups to explore student and faculty perspectives on troublesome mental health nursing content. Results The project data were able to be organized into five main content themes that were identified as being troublesome: the spectrum of mental illness, therapeutic relationships and boundaries, praxis, professionalism in nursing, and brain chemistry and its management. Conclusion The findings from this project are unique to the program of review but show the potential of this new approach to quality assurance and program enhancement initiatives in nursing education.

Trauma-informed Care and the Research Literature: How Can the Mental Health Nurse Take the Lead to Support Women Who Have Survived Sexual Assault?

Many women who access mental health services have been subjected to violent acts, including childhood sexual abuse and adult sexual assault, often at the hands of family members and partners. The vulnerability of these women can be further complicated when health professionals lack sensitivity to the issues involved; and the treatment received by the women is insensitive, leading to experiences of re-traumatisation. This article considers the principles of trauma-informed care and practice, as represented in the literature; and explains how mental health nurses can lead the way in multidisciplinary environments to ensure that women who have experienced violence receive the most appropriate health care, and are thereby supported to attain the best possible outcome.