Access courses and their contribution to the widening participation agenda in the UK

Reasons for mental health nursing shortages in the UK are many and complex. The COVID-19 pandemic has highlighted the need to fill vacant posts, while at the same time negatively impacting on the UK's international recruitment strategy. Whereas international recruitment is essential to reduce workforce shortages, it offers only a short-term solution and potentially leaves lower-income countries with increased nursing shortages themselves. This article considers that a long-term domestic approach to recruitment is needed to reduce future workforce deficits. It is argued that benefits of access courses are increased if delivered by the university directly, as a familiarity with systems, the campus and supportive networks are promoted, and the potential for targeted support is increased. Further research is needed to establish the benefits, but access courses delivered this way may provide a more sustainable solution to nursing workforce shortages in the UK and beyond.

The development of the rehabilitation community transition support team as a response to COVID-19

Background/aims The rehabilitation community transition support team was created as a response to the COVID-19 pandemic, resulting in faster discharges from the inpatient rehabilitation service. The aim of this evaluation was to explore the perspectives of staff and patients on their experience of the rehabilitation community transition support team. Methods Staff and patients in the new team were interviewed using semi-structured interviews. The data were analysed using thematic analysis. Results Staff interviews generated seven main themes: positive staff experiences; defining the ‘team’; mode of working; link role for the team; technology; relationships with patients; and support from colleagues. The patient analysis generated five themes: positive experiences of the rehabilitation community transition support team; relationship with rehabilitation community transition support team worker; mode of working; handling the hurdles of discharge; and defining the ‘team’. There were crossovers of staff and patient themes, particularly surrounding around face-to-face visits, defining the team and relationships. Patients indicated that contact with the community team helped them to overcome both practical and emotional hurdles of discharge. Conclusions The presence of a team supporting the transition from hospital to a community setting may be helpful for people who have been discharged.

Positive psychology: hope and its role within mental health nursing

This is the twelfth article in a series that explores the meaning of positive psychology and the impact it has on the wellbeing of the mental health workforce. It will focus on positive psychology interventions that help to develop hope and considers how its uplifting effect, through contemporary use in the field of mental health nursing, can be experienced. This article initially introduces the concept of hope then links it with the field of positive psychology. It then focuses on Snyder's theory of hope and its use in promoting wellbeing. It follows with the application of hope within the nursing context. Finally, it refers to the ongoing coronavirus pandemic and how hope may be used to support the mental health nursing workforce. The practical activities provided in the article will help the reader increase their own awareness of hope and consider ways to develop its use and transferability within their own life..

Patient social functioning in acute mental health inpatient wards: the role of emotional regulation, attachment styles and nurse–patient relationships

Background/aims Improvement in social functioning is an important aspect of recovery from severe mental health problems. Nurses on acute mental health wards play an important role in facilitating this recovery. Therefore, it is important to explore potential predictors of social functioning and the quality of nurse–patient relationships. The aim of this study was to explore associations between patient social functioning, nurse–patient therapeutic alliances, emotional regulation, attachment style and nurse distress in acute mental health settings. Methods: A questionnaire-based, cross-sectional approach with correlational and regression analyses was used for this study. A total of 50 nurse–patient dyads in acute mental health inpatient wards across four NHS trusts in the north-west of England took part. Patients and nurses completed questionnaires regarding demographic information, emotional regulation, attachment style and alliance. Nurses also rated patient social functioning and their own distress. Results The patient anxious attachment style was associated with difficulties in regulating emotions. Patient emotional regulation, patient insecure attachment and the patient-rated alliance predicted nurse-rated patient social functioning. Nurse emotion regulation, nurse insecure attachment style and nurse-rated alliance did not significantly predict nurse-rated patient social functioning and correlations were non-significant. Nurse distress was associated with nurse emotion regulation, nurse anxious attachment and nurse-rated alliance. These factors significantly predicted nurse distress. Conclusions: Patient social functioning is predicted by emotion regulation, attachment and alliance. Similarly, nurse distress is predicted by nurse emotion regulation, attachment style and alliance. Interventions targeting emotion regulation or attachment-informed wards would be beneficial.

Electroconvulsive therapy: a clinical case study and review

Electroconvulsive therapy is deemed one of the most effective treatments for alleviating symptoms in individuals diagnosed with severe depression, yet it remains one of the most controversial psychiatric treatments in contemporary mental health nursing practice. As such, its use and efficacy continue to be questioned. The following article analyses the case of Albert, a fictional character who represents the presentation of several patients who have received electroconvulsive therapy. The application of electroconvulsive therapy is evaluated, by referring to the most recent policy and national guidelines. Despite the associated stigma, electroconvulsive therapy can save lives, as portrayed by Albert. However, further research is required and updated guidance from National Institute for Health and Care Excellence is needed, specifically with regards to maintenance and relapse prevention. It is important to be aware of the implications of side effects, just as with other interventions. Overall, this article highlights the importance of safe, recovery-focused and person-centred care.

Compassion fatigue and mental health nursing: the final taboo?

For mental health nurses, a core component of the nurse–patient relationship is compassion. Bearing witness to patients' distress may lead to the manifestation of compassion fatigue; a decrease in compassionate and empathic responses because of prolonged contact with patients with mental ill health issues. Mental health nurses, particularly those who work in areas where they are exposed to frequent crisis presentations, such as inpatient settings and crisis teams, are at risk of developing compassion fatigue, yet there remains a paucity of research into the impact on those delivering mental health care in the UK. This article highlights the importance of identifying compassion fatigue, advocates for open honest and supportive discussions without fear of reprimand, and argues that possible workplace causes should be effectively addressed by nurse leaders and organisations, not just for sake of the mental health nurse and their employers, but also to ensure positive patient outcomes.

Sexuality, student mental health nurse and lecturer experience in education and practice

This article presents a critical reflection on an experience relating to sexuality from two perspectives, a mental health nursing student and a lecturer. It took place during stage 1 of a graduate entry nursing 2-year Master of Science mental health nursing programme at a UK university. Student mental health nurses in higher education who identify as lesbian, gay, bisexual or transgender can feel less safe than others, which affects performance. Lecturers can make a difference to the educational experience of student nurses who are lesbian, gay, bisexual or transgender and this can have an impact on clinical practice. The emotional impact of ‘coming out’ in the classroom can have far-reaching consequences for their mental health. The response of educational staff can have a huge impact on the ability to learn and the marks achieved. Student–lecturer relationships can have transformative consequences. Student mental health nurses make meaning from their educational experiences in the classroom and clinical practice. If they do not see themselves represented, this can affect engagement and motivation. Safe nursing practice is role modelled from lecturer to student and has implications for service user experience in clinical settings.

A systematic review of randomised controlled trials of psychosocial interventions for acute mental health inpatients

Background/Aims Inpatient wards provide an opportunity to intervene with medical, psychological and social care to contain distress and prevent future relapse. However, they have been criticised for an over-reliance on medication and risk management with limited psychosocial interventions. The aim of this study was to investigate clinical trials of psychosocial interventions for inpatients to identify interventions that are effective at improving quality of life, symptoms or patient functioning. Methods An electronic search of six databases was conducted for papers published from 1806 up until February 2017. A total of 18 randomised controlled trials was identified in which outcomes for symptoms, quality of life or functioning were reported. Results Overall, 15 trials showed a statistically significant result for at least one outcome. Seven categories were identified from the 18 studies, at least one in each category was found to be effective for symptoms, quality of life or functioning. The majority were effective (15 out of 18). Conclusions Given that the methodological quality was generally low and number of randomised controlled trials were small, it is difficult to draw definitive conclusions. Recommendations include more and repeated trials using rigorous methods of testing and reporting.