The clinical skills of community psychiatric nurses working with patients who have severe and enduring mental health problems: an empirical analysis (original) (raw)
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Role of the community psychiatric nurse in the management of schizophrenia
Advances in Psychiatric Treatment, 2000
This paper will describe the increasingly important role of the community psychiatric nurse (CPN) in the treatment and management of people with schizophrenia, and draw attention to new training programmes which have a focus on skills acquisition in evidence-based methods. However, before describing the way in which these programmes of training improve CPN skills, it is worth examining the history of community psychiatric nursing.
The Mental Health Nursing Review: implications for community psychiatric nurses
Psychiatric Bulletin, 1995
The recent review of mental health nursing recommended that nurses refocus their attention on people with serious mental illness. There are some encouraging trends in the training of nurses in problemoriented case management. However, mental health nursing needs to face various problems. These include the need for the large-scale retraining of nurses currently working in traditional psychiatric hospitals and difficulties in the new Project 2000 programmes. In addition, there is a clear lack of leadership in the profession, largely because of the recent emphasis on management rather than clinical and academic attributes. Finally, nursing needs people who care what happens to the seriously mentally ill.
Response to ?training residents for community psychiatric practice?
Community Mental Health Journal, 1993
There is a critical need for more psychiatrists capable of community psychiatry practice, and effective residency education in community psychiatry is crucial to fill this need. In addition to developing residency curricula in community psychiatry, there are some additional steps that we believe are necessary to fill the need for psychiatrists capable of community psychiatry practice. (1) We need a process to get more training programs to implement good curricular suggestions. (2) We need to appreciate that many of our graduates will work in systems that have a limited view of the role of a psychiatrist, and we need to train residents to be able to enter a clinical setting and develop an effective role for themselves. (3) Quality training experiences in community psychiatry should encourage more graduates to work with seriously ill persons in community settings. In order for this to happen, however, we need to deal with a problem more general than adopting curricular suggestions: that of attracting professionals to work with poor, disenfranchised, low-status individuals. (4) Finally, we need to appreciate that there are major conflicts between the attitudes and roles needed to be a successful community psychiatrist and the attitudes and roles taught throughout the rest of medical education, from medical school through residency.
Journal of Psychiatric and Mental Health Nursing, 2010
Accessible summary• Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes.• The transfer to community mental health services requires a re-conceptualization of nurses' roles.• Education can be a basic mechanism for eradicating the institutionalized ways of work.• Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes.• The transfer to community mental health services requires a re-conceptualization of nurses' roles.• Education can be a basic mechanism for eradicating the institutionalized ways of work.Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes.The transfer to community mental health services requires a re-conceptualization of nurses' roles.Education can be a basic mechanism for eradicating the institutionalized ways of work.AbstractFor centuries psychiatric services were provided by mental health hospitals, which were operating upon bureaucratic principles: strict hierarchies, slow processes and segmentation of duties. Research has shown that psychiatric nursing, as exercised in these traditional settings, has dealt with several problems in relation to: the amount and quality of time spent with patients, the type of duties performed, the lack of autonomy etc. The closure of many psychiatric institutions and their substitution with community-based settings, signified that health professionals should perform a variety of new duties, exhibit new skills and develop new perceptions about their work and the patients. In order for such alterations to occur, education can play a vital role in the re-conceptualization of psychiatric nursing and in the practical preparation of students for their future work. The present paper focuses on the contradiction between nursing as practised in Greek mental health hospitals and the current trends and demands placed upon nurses, to exhibit a new ‘face’. The purposes of this paper are: first, to review the research on psychiatric nurses' behaviours in mental health hospitals. Second, to present the outcomes of bureaucracy on employees and finally, to propose an educational scheme that could reinforce the shift from institutionalized work to de-institutionalized.For centuries psychiatric services were provided by mental health hospitals, which were operating upon bureaucratic principles: strict hierarchies, slow processes and segmentation of duties. Research has shown that psychiatric nursing, as exercised in these traditional settings, has dealt with several problems in relation to: the amount and quality of time spent with patients, the type of duties performed, the lack of autonomy etc. The closure of many psychiatric institutions and their substitution with community-based settings, signified that health professionals should perform a variety of new duties, exhibit new skills and develop new perceptions about their work and the patients. In order for such alterations to occur, education can play a vital role in the re-conceptualization of psychiatric nursing and in the practical preparation of students for their future work. The present paper focuses on the contradiction between nursing as practised in Greek mental health hospitals and the current trends and demands placed upon nurses, to exhibit a new ‘face’. The purposes of this paper are: first, to review the research on psychiatric nurses' behaviours in mental health hospitals. Second, to present the outcomes of bureaucracy on employees and finally, to propose an educational scheme that could reinforce the shift from institutionalized work to de-institutionalized.
Community psychiatric nurses and the care co-ordinator role: squeezed to provide 'limited nursing
Journal of Advanced Nursing, 2005
S I M P S O N A . ( 2 0 0 5 ) S I M P S O N A . ( 2 0 0 5 ) Journal of Advanced Nursing 52 , 689-699 Community psychiatric nurses and the care co-ordinator role: squeezed to provide 'limited nursing' Aim. This paper reports a study illuminating the factors that either facilitate or constrain the ability of community psychiatric nurses, in their role as care co-ordinators, to meet service users' and carers' needs. Background. The Care Programme Approach is the key policy underpinning community-focused mental health services in England, but has been unevenly implemented and is associated with increased inpatient bed use. The care co-ordinator role is central to the Care Programme Approach and is most often held by community psychiatric nurses, but there has been little research into how this role is performed or how it affects the work of community psychiatric nurses and their ability to meet the needs of service users. Methods. A multiple case study of seven sectorised community mental health teams was employed over 2 years using predominantly qualitative methods including participant observation, semi-structured interviews and document review. The data were collected in one National Health Service trust in south England between 1999 and 2001. Findings. Additional duties and responsibilities specifically associated with the care co-ordinator role and multidisciplinary working, combined with heavy workloads, produced 'limited nursing', whereby community psychiatric nurses were unable to provide evidence-based psychosocial interventions that are recognized to reduce relapse amongst people with severe mental illness. Conclusions. The role of the Care Programme Approach care co-ordinator was not designed to support the provision of psychosocial interventions. Consequently, community psychiatric nurses in the co-ordinator role are faced with competing demands and are unable to provide the range of structured, evidence-based interventions required. This may partially account for the increased inpatient bed use associated with the Care Programme Approach.
Training in community psychiatry
Romanian Journal of Psychiatry and Psychotherapy
Training in community psychiatry is an essential aspect of psychiatric education in Europe. Community psychiatry is a branch of psychiatry that focuses on the prevention and treatment of mental illness in the community, with an emphasis on promoting recovery and social inclusion. Training in community psychiatry in Europe typically involves a combination of didactic and clinical experiences, including classroom lectures, group discussions, and supervised practice in community-based mental health services. The curriculum covers topics such as community mental health policy, community-based care, social determinants of mental health, and recovery-oriented approaches to care. The training also emphasizes the importance of inter professional collaboration and the need to work closely with other healthcare professionals, service users, and family members. Overall, training in community psychiatry in Europe is designed to equip psychiatrists with the knowledge, skills, and attitudes neces...