Nurse, 1 year’s experience, UK

Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter

This chapter describes the experience of a Mental Health Nurse at a tertiary neuroscience unit in the UK. In nearly two years of working at the unit, the nurse has not encountered many patients with non-epileptic seizures. As such, the nurse’s main reaction to these patients is uncertainty. It is very hard for the nurse to understand that a psychological response can produce a seizure. Moreover, the nurse often assumes that all patients with non-epileptic seizures have a personality disorder of some kind. The distrust toward these patients is partly because the nurse has no concept of how the psychological can impinge upon the physical brain, and the driver of the of the nurse’s insensitive inner response to these patients is therefore ignorance of the condition. Thus, the likely solution is to learn more about the diagnosis and do as much background reading as possible in an effort to overcome one’s own ignorance—or at the very least, construct some good counterarguments to deploy against one’s own ignorant thoughts.

Author(s):  
Tony Warne ◽  
Gareth Holland

The chapter first explores the issues involved in how and why mental health nurses come to learn about the decisions that they need to take in clinical practice, and why these are crucial to the establishment and maintenance of therapeutic relationships. It must be noted that various terms will be used throughout this chapter that refer to individuals requiring care and support from nurses—that is, ‘patients’, ‘service users’, and ‘clients’. We will also explore some of the challenges and tensions that can arise when there is a difference between what the professional and the service user might feel is the right decision. Reference is made to the prevailing mental health legislation in the United Kingdom and, in particular, the legislation around care being provided possibly against an individual’s wishes and while he or she is living in the community. If you are not living or studying in the UK, you should seek out the relevant legislation that applies to your country. You might want to see where the similarities and differences are between that and the UK legislation. The chapter concludes with a discussion of how the mental health nurse can ensure that inclusive and informed decision making leads to safe, secure, and effective mental health care. By means of the case studies and the discussion, it will enable you, as the student nurse, to learn how different kinds of decision making can influence outcomes of care, and it will also help you to work towards achieving the Nursing and Midwifery Council (NMC) competencies as they relate to decision making in nursing practice. Note that while the case studies are based on real-life examples of decision-making situations, all names in the case studies have been changed, in keeping with The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives (NMC 2008). Mental health nurse education, practice, and research have long championed innovative approaches to improving our understanding of the impact, on individuals, the communities in which they live, and wider society, of the decisions and actions taken in the name of therapeutic endeavour.


2018 ◽  
Vol 62 ◽  
pp. 36-38 ◽  
Author(s):  
Mark Pearson ◽  
Timothy Carter ◽  
Damion McCormick ◽  
Nicola Wright

2013 ◽  
Vol 37 (8) ◽  
pp. 272-275
Author(s):  
Laura Boyd ◽  
Colin Crawford ◽  
Eugene Wong

Aims and methodWe examined the impact of implementing a new Acute Mental Health Emergency Assessment Protocol (AMHEAP) on joint psychiatric assessments out of hours within Forth Valley, Scotland, over the course of 4 calendar months. The protocol states that assessments should be carried out by a junior doctor and a registered, qualified mental health nurse. The impact measures were taken as admission rates and experience of the doctor in training.ResultsIn the 4 months that were examined (1 June–30 September 2011), 79.5% of out-of-hours emergency assessments were performed jointly. Admission rates were significantly decreased (P<0.001) compared with a similar period in 2008, before the AMHEAP protocol was developed. Most junior doctors valued the experience of joint assessment.Clinical implicationsJoint assessment can enhance patient experience, reduce hospital admission, and provide a learning opportunity for junior doctors in emergency psychiatric assessments. However, it represents a move away from the doctor as sole decision maker.


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