Abstract Patients leaving inpatient psychiatric care without informing staff can have serious consequences for patient welfare, their families and staff. Even in cases where there are no serious outcomes and patients return, treatment can... more
Abstract Patients leaving inpatient psychiatric care without informing staff can have serious consequences for patient welfare, their families and staff. Even in cases where there are no serious outcomes and patients return, treatment can be interrupted and staff morale compromised. Given these potential deleterious effects, it is important to have an in-depth understanding of why people leave when they do. The aim of this study is to examine the profile of service-users who leave in-patient psychiatric care without notifying staff and to determine their reasons for doing so, what they did when they left the hospital setting and reasons for returning. This is a prospective descriptive study of service users leaving without notifying staff from a national mental health service in Ireland. It investigated the frequency, timing, and motivations of these absconding events among a sample of in-patients over a 12-month period. This year-long review identified 75 episodes of leaving without notifying staff, 55 of which met this studies criteria. 22% of episodes were from a locked unit, 58.2% were repeated episodes. 89% of service users returned to hospital following the episode and 11% were discharged against medical advice. Although no fatalities, three service users were seen in an emergency department as a result of activity during leave. Upon return from leave, all service users were reviewed and their care plans were updated where necessary.
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AIM The aim of this study is to explore mental health student nurses' perceptions and application of a CBT-orientated training programme - the Decider Life Skills programme. BACKGROUND The undergraduate nursing degree programme is a... more
AIM The aim of this study is to explore mental health student nurses' perceptions and application of a CBT-orientated training programme - the Decider Life Skills programme. BACKGROUND The undergraduate nursing degree programme is a challenging one and places high demands both professionally and personally on students. Mental health nursing students are faced with particular stressors including working with people in significant psychological distress, which can result in students feeling overwhelmed and emotionally burdened. There is a requirement for student nurses to be supported to cope with professional and personal difficulties while on practice placement. The Decider Life Skills is a one-day training programme that aims to build resilience and increase effective coping skills. This programme was offered to internship mental health nursing students with the aim of providing them with a toolbox of skills to maintain their wellbeing while on clinical placement. METHODS A qualitative descriptive design was used, and data were collected through two 45-min focus group interviews with mental health students (n = 10) on their internship placement. These students had received a one-day training in Decider Life Skills prior to their clinical placements. Full ethical approval was achieved for this study. RESULTS Participants reported that they found the skills imparted in the training easy to understand and apply in both their professional and their personal lives. CONCLUSIONS The findings from this study that the Decider Life Skills helped students cope in stressful situations and become more mindful of protecting their own mental health is important, as there is a need to safeguard the emotional well-being of mental health nursing students and support them to become resilient practitioners.
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Accessible SummaryWhat is known on the subject? Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short. There is a need for people who work in mental health services to... more
Accessible SummaryWhat is known on the subject? Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short. There is a need for people who work in mental health services to address and take care of their own psychosocial needs. What the paper adds to existing knowledge? This paper provides a unique insight into a care professional's recovery from mental ill health. Looked at through this dual lens of service user and care professional provide the reader with a rich narrative from the perspective of both sides of the caring role. What are the implications for practice? People who work in caring roles need to be vigilant of their own needs and the impact that the work can have on them. Safety protocol for managing one's own mental health should be a requirement for people within the caring profession. IntroductionThis is an account of my experiences becoming unwell and accessing general and mental health services in Ireland.AimIt is hoped that this lived narrative of my recovery will shed light on accessing mental health services from a dual lens; that of service user and social worker.MethodIt traces this experience from initial contact with my general practitioner, to admission to a secure psychiatric ward where recovery slowly began.ResultsIt is also hoped that reading my experiences of recovery and some of the insights shared will help those in the nursing or social care profession consider how they may be affected by their work.DiscussionIt is important to note that this account views my experiences within a neurobiology framework and this might not align to other people's experiences. However, my narrative of help‐seeking is complex and includes multiple points where I uncover insights and encounter different healthcare professionals.
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ABSTRACT LGBTI clients present specific challenges for the mental health profession with key issues for transgender people identified as including isolation, fear, stigma, and family rejection, all of which contribute to the transgender... more
ABSTRACT LGBTI clients present specific challenges for the mental health profession with key issues for transgender people identified as including isolation, fear, stigma, and family rejection, all of which contribute to the transgender community's high levels of depression, anxiety, substance misuse, self-harm, and suicide. This qualitative research paper explores the experiences of Irish psychotherapists working with transgender clients to explore specifically the nature of the therapeutic relationship. Using an interpretive phenomenological approach, it examines the subjective experience of three participant psychotherapists and endeavours to make sense of the phenomenology that emerged from semi-structured interviews. The phenomenological analysis of the data collected resulted in three salient themes emerging: (i) Therapeutic identification, (ii) Maternal countertransference, and (iii) Confusion. It is hoped that these findings which relate to the therapeutic relationship will be of utmost importance to others working within the mental health profession where recovery is dependent on the strength of this relationship.
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Background: Instruments that measure clinical learning environments have lacked rigorous methodological approaches in their development and validity. Method: Development research using a survey design approach was conducted for an... more
Background: Instruments that measure clinical learning environments have lacked rigorous methodological approaches in their development and validity. Method: Development research using a survey design approach was conducted for an instrument to evaluate the quality of nursing students' clinical practice placement. Results: The development and validity of the Student Nurse Subjective Evaluation of Completed Clinical Practice Placement (SNEP) resulted in a 40-item instrument to evaluate nursing students' experience of their completed clinical practice placement. Adequate level of model fit was indicated (χ 2 [719] = 1909.47, p < .001) for the confirmatory factor analysis (χ 2 / df = 2.66, comparative fit index = 0.92, Tucker-Lewis Index = 0.92, and root-mean-square error of approximation = 0.07). Standardized factor loadings were high, ranging from 0.68 to 0.95. Conclusion: The SNEP was designed and validated incorporating the perspective of various nurse stakeholders and can be used in both research and clinical learning environments. [ J Nurs Educ . 2022;61(10):559–569.]
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Objectives: An increasing number of young people are experiencing mental health difficulties and schools have been identified as environments that can support them. However, it is unclear how students feel about the current supports in... more
Objectives: An increasing number of young people are experiencing mental health difficulties and schools have been identified as environments that can support them. However, it is unclear how students feel about the current supports in school and whether they are used. The aim of this study is to explore the perceptions of young people in Irish post-primary schools regarding mental health and well-being supports in schools. Methods: An online survey was conducted with (n=109) young people to determine the perceptions of mental health and well-being supports in post-primary Irish schools. Using a convenience sampling method, an online survey was distributed via gatekeepers in local youth and sporting groups. Data collection was completed using the Barriers to Seeking Help-brief version (BASH-B) and additional tailored questions. Results: Qualities like being ‘trustworthy’ and ‘a good listener’ were reported as key for adults to be considered a good support in schools. Current mental ...
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Background: Instruments that measure clinical learning environments have lacked rigorous methodological approaches in their development and validity. Method: Development research using a survey design approach was conducted for an... more
Background: Instruments that measure clinical learning environments have lacked rigorous methodological approaches in their development and validity. Method: Development research using a survey design approach was conducted for an instrument to evaluate the quality of nursing students' clinical practice placement. Results: The development and validity of the Student Nurse Subjective Evaluation of Completed Clinical Practice Placement (SNEP) resulted in a 40-item instrument to evaluate nursing students' experience of their completed clinical practice placement. Adequate level of model fit was indicated (χ 2 [719] = 1909.47, p < .001) for the confirmatory factor analysis (χ 2 / df = 2.66, comparative fit index = 0.92, Tucker-Lewis Index = 0.92, and root-mean-square error of approximation = 0.07). Standardized factor loadings were high, ranging from 0.68 to 0.95. Conclusion: The SNEP was designed and validated incorporating the perspective of various nurse stakeholders and c...
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Accessible SummaryWhat is known on the subject? Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short. There is a need for people who work in mental health services to... more
Accessible SummaryWhat is known on the subject? Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short. There is a need for people who work in mental health services to address and take care of their own psychosocial needs. What the paper adds to existing knowledge? This paper provides a unique insight into a care professional's recovery from mental ill health. Looked at through this dual lens of service user and care professional provide the reader with a rich narrative from the perspective of both sides of the caring role. What are the implications for practice? People who work in caring roles need to be vigilant of their own needs and the impact that the work can have on them. Safety protocol for managing one's own mental health should be a requirement for people within the caring profession. IntroductionThis is an account of my experiences becoming unwell and accessing general and mental health services in I...
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LGBTI clients present specific challenges for the mental health profession with key issues for transgender people identified as including isolation, fear, stigma, and family rejection, all of which contribute to the transgender... more
LGBTI clients present specific challenges for the mental health profession with key issues for transgender people identified as including isolation, fear, stigma, and family rejection, all of which contribute to the transgender community's high levels of depression, anxiety, substance misuse, self-harm, and suicide. This qualitative research paper explores the experiences of Irish psychotherapists working with transgender clients to explore specifically the nature of the therapeutic relationship. Using an interpretive phenomenological approach, it examines the subjective experience of three participant psychotherapists and endeavours to make sense of the phenomenology that emerged from semi-structured interviews. The phenomenological analysis of the data collected resulted in three salient themes emerging: (i) Therapeutic identification, (ii) Maternal countertransference, and (iii) Confusion. It is hoped that these findings which relate to the therapeutic relationship will be of...
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This research addresses the impact of working with spirituality from the perspective of the addiction worker with five separate interviews conducted with people who have been working in the area of addiction for ten years or more.... more
This research addresses the impact of working with spirituality from the perspective of the addiction worker with five separate interviews conducted with people who have been working in the area of addiction for ten years or more. Interview transcripts were analysed using qualitative thematic analysis. Three themes emerged, the findings of which indicate that there is an impact on the addiction worker when spirituality is part of the recovery process. The themes that emerged are (A) Being Constructive (B) Productivity and (C) Managing Therapeutic Ruptures. The findings pose important implications for training and supervision of people involved in addiction work in that there needs to be an openness and awareness around spirituality whether the worker believes in it or not. The findings show that when spirituality is part of the recovery process, it enables the addiction worker to deal with and manage all issues that arise with the person with the addiction, as well as enhancing the ...
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Accessible summaryWhat is known about the subject? A therapeutic relationship with a professional who displays an informed approach has a positive effect on outcomes for young people presenting with an eating disorder. There is a dearth... more
Accessible summaryWhat is known about the subject? A therapeutic relationship with a professional who displays an informed approach has a positive effect on outcomes for young people presenting with an eating disorder. There is a dearth of research available on the student mental health nurse experience of working with young people with an eating disorder both internationally and from the Republic of Ireland. Within this limited literature, nursing students were found to hold more negative perceptions towards this group than more experienced clinicians. The causes of eating disorders are complex, which make education and support to understand the individual with an eating disorder essential. Within the Republic of Ireland, child and adolescent mental health historically has received very little attention in the undergraduate mental health nursing curriculum. What does the study add to existing knowledge? Findings from this study recommend that a set of guidelines are made available ...
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The aim of this review is to synthesize the best available qualitative evidence on the experiences and support needs of people with serious mental illness (SMI) regarding sexuality and intimacy within hospital and community settings. The... more
The aim of this review is to synthesize the best available qualitative evidence on the experiences and support needs of people with serious mental illness (SMI) regarding sexuality and intimacy within hospital and community settings. The objectives of the present study are.
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BACKGROUND Nurses who work with very unwell or dying children may experience intense sorrow and distress in response to loss, which can take an emotional toll on them, potentially affecting care provision. AIM This study aimed to explore... more
BACKGROUND Nurses who work with very unwell or dying children may experience intense sorrow and distress in response to loss, which can take an emotional toll on them, potentially affecting care provision. AIM This study aimed to explore the experiences of children's nurses who work with seriously ill children and to gain an insight into the dynamics involved in working with children and their families, as well as the nurses' experiences of managing their own vulnerability. METHODS In-depth interviews were conducted with five children's nurse participants, and data were analysed using interpretive phenomenological analysis. FINDINGS Three thematic categories were identified - 'being emotionally full', 'navigating the rules of grief' and 'prism of time'. Caring for seriously ill and dying children is a unique type of nursing and is often regarded as contrary to the 'natural' process of life. Findings were dominated by unresolved grief and the mechanisms used to cope with this emotional pain. CONCLUSION Nurse educators must be aware of the strategies that people use to avoid engaging with painful emotional experiences. Without this understanding and self-awareness, children's nurses can be caught in a cycle of unresolved grief that affects their own health and could affect their ability to engage with children and families in an empathetic and supportive way.
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Abstract Prescribing in mental health nursing in the Republic of Ireland is still an unusual occurrence and despite an uptake in prescriber training, this does not often translate to practice. Recent Irish research, however, has... more
Abstract Prescribing in mental health nursing in the Republic of Ireland is still an unusual occurrence and despite an uptake in prescriber training, this does not often translate to practice. Recent Irish research, however, has identified that nurse prescribing when offered, is perceived to enhance care and offer better delivery of services. Since the legislation was introduced in the Republic of Ireland to enable nurses and midwives to prescribe in May 2007, there are now 1,123 nurses registered to prescribe medication. Mental health nurses, however, do not tend to be a priority when it comes to training in prescribing; in the UK it took two years after nurse prescribing was rolled out to extend the scheme to mental health nursing. Although nurse and other professional perspectives explored this topic, there is limited research specifically detailing the experience of service users in long term care who are prescribed by mental health nurse practitioners in a home care setting. This research follows a qualitative exploratory research design using thematic analysis to explore service user (n = 12) experiences of mental health nurse prescribing. The following four themes emerged from the analysis: ‘empowerment and trust’; ‘person-centered care’; ‘time and flexibility’ and ‘collaborative approach’. Results indicate a positive and rich experience of nurse prescribing, which facilitate a more trusting, holistic and autonomous therapeutic relationship. Future research looking at other issues relating to medication including reduction and support for coming off where appropriate is recommended
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Mental health nurses have been at the forefront of adjusting practice during the COVID-19 pandemic through novel means, including the delivery of technology-mediated interventions, upskilling on infection control and adapting practice to... more
Mental health nurses have been at the forefront of adjusting practice during the COVID-19 pandemic through novel means, including the delivery of technology-mediated interventions, upskilling on infection control and adapting practice to ever-changing national guidelines. The aim of this article is to describe an Irish mental health service's adaption to the global pandemic from the perspective of the nurse leadership involved. A case study approach was used describing the degree of adjustment and collaborative practice in ‘tackling the spread’ documented with both staff and service users in mind. The case describes how mental health nurses were central to designing and overseeing the implementation and delivery of numerous initiatives across the service. They were also required to respond quickly and sensitively to service users' needs, while remaining true to the core values of mental health nursing practice. As the backbone of our health service, nurses continue to prove their ability to adapt flexibly, operationalise change at high intensity, provide quality care to service users in a professional and compassionate manner while managing their own safety, fears, personal circumstances and mental health.
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Throughout the COVID-19 pandemic, mental health services were confronted with significant challenges and mental health staff have not only had to provide a continued service for, often distressed, service users but have had to adapt... more
Throughout the COVID-19 pandemic, mental health services were confronted with significant challenges and mental health staff have not only had to provide a continued service for, often distressed, service users but have had to adapt practice and comply with the ever-changing public guidelines for containing the virus. There is a pressing need, therefore, to learn from the challenges that mental health services have faced and continue to face throughout different stages of the pandemic. While uncertainty is inevitable in pandemics, mental health nurses as a community can learn from individual experiences of adaptation. This article describes the unique and rapid transition of one Irish mental health facility to a COVID-19 isolation ward and unit for delivery of remote admission to a mental health service (home care admission). In order to capture this transitory experience, the areas discussed include preparation of the site, key challenges and the role of nursing staff, mental healt...
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Abstract Prescribing in mental health nursing in the Republic of Ireland is still an unusual occurrence and despite an uptake in prescriber training, this does not often translate to practice. Recent Irish research, however, has... more
Abstract Prescribing in mental health nursing in the Republic of Ireland is still an unusual occurrence and despite an uptake in prescriber training, this does not often translate to practice. Recent Irish research, however, has identified that nurse prescribing when offered, is perceived to enhance care and offer better delivery of services. Since the legislation was introduced in the Republic of Ireland to enable nurses and midwives to prescribe in May 2007, there are now 1,123 nurses registered to prescribe medication. Mental health nurses, however, do not tend to be a priority when it comes to training in prescribing; in the UK it took two years after nurse prescribing was rolled out to extend the scheme to mental health nursing. Although nurse and other professional perspectives explored this topic, there is limited research specifically detailing the experience of service users in long term care who are prescribed by mental health nurse practitioners in a home care setting. This research follows a qualitative exploratory research design using thematic analysis to explore service user (n = 12) experiences of mental health nurse prescribing. The following four themes emerged from the analysis: ‘empowerment and trust’; ‘person-centered care’; ‘time and flexibility’ and ‘collaborative approach’. Results indicate a positive and rich experience of nurse prescribing, which facilitate a more trusting, holistic and autonomous therapeutic relationship. Future research looking at other issues relating to medication including reduction and support for coming off where appropriate is recommended
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Mental health nurses have been at the forefront of adjusting practice during the COVID-19 pandemic through novel means, including the delivery of technology-mediated interventions, upskilling on infection control and adapting practice to... more
Mental health nurses have been at the forefront of adjusting practice during the COVID-19 pandemic through novel means, including the delivery of technology-mediated interventions, upskilling on infection control and adapting practice to ever-changing national guidelines. The aim of this article is to describe an Irish mental health service's adaption to the global pandemic from the perspective of the nurse leadership involved. A case study approach was used describing the degree of adjustment and collaborative practice in ‘tackling the spread’ documented with both staff and service users in mind. The case describes how mental health nurses were central to designing and overseeing the implementation and delivery of numerous initiatives across the service. They were also required to respond quickly and sensitively to service users' needs, while remaining true to the core values of mental health nursing practice. As the backbone of our health service, nurses continue to prove ...
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BACKGROUND Nurses who work with very unwell or dying children may experience intense sorrow and distress in response to loss, which can take an emotional toll on them, potentially affecting care provision. AIM This study aimed to explore... more
BACKGROUND Nurses who work with very unwell or dying children may experience intense sorrow and distress in response to loss, which can take an emotional toll on them, potentially affecting care provision. AIM This study aimed to explore the experiences of children's nurses who work with seriously ill children and to gain an insight into the dynamics involved in working with children and their families, as well as the nurses' experiences of managing their own vulnerability. METHODS In-depth interviews were conducted with five children's nurse participants, and data were analysed using interpretive phenomenological analysis. FINDINGS Three thematic categories were identified - 'being emotionally full', 'navigating the rules of grief' and 'prism of time'. Caring for seriously ill and dying children is a unique type of nursing and is often regarded as contrary to the 'natural' process of life. Findings were dominated by unresolved grief and the mechanisms used to cope with this emotional pain. CONCLUSION Nurse educators must be aware of the strategies that people use to avoid engaging with painful emotional experiences. Without this understanding and self-awareness, children's nurses can be caught in a cycle of unresolved grief that affects their own health and could affect their ability to engage with children and families in an empathetic and supportive way.
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People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing. However, little is known about their experiences and perceptions regarding... more
People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing. However, little is known about their experiences and perceptions regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of trans people and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to January 2021 was undertaken. Studies were identified that involved trans people, and addressed issues related to their psychosocial needs. The search yielded 954 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 18 papers were considered suitable for the systematic review. Quality was assessed us...
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LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery... more
LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings o...
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AIM The aim of this study is to explore mental health student nurses' perceptions and application of a CBT-orientated training programme - the Decider Life Skills programme. BACKGROUND The undergraduate nursing degree programme is a... more
AIM The aim of this study is to explore mental health student nurses' perceptions and application of a CBT-orientated training programme - the Decider Life Skills programme. BACKGROUND The undergraduate nursing degree programme is a challenging one and places high demands both professionally and personally on students. Mental health nursing students are faced with particular stressors including working with people in significant psychological distress, which can result in students feeling overwhelmed and emotionally burdened. There is a requirement for student nurses to be supported to cope with professional and personal difficulties while on practice placement. The Decider Life Skills is a one-day training programme that aims to build resilience and increase effective coping skills. This programme was offered to internship mental health nursing students with the aim of providing them with a toolbox of skills to maintain their wellbeing while on clinical placement. METHODS A qualitative descriptive design was used, and data were collected through two 45-min focus group interviews with mental health students (n = 10) on their internship placement. These students had received a one-day training in Decider Life Skills prior to their clinical placements. Full ethical approval was achieved for this study. RESULTS Participants reported that they found the skills imparted in the training easy to understand and apply in both their professional and their personal lives. CONCLUSIONS The findings from this study that the Decider Life Skills helped students cope in stressful situations and become more mindful of protecting their own mental health is important, as there is a need to safeguard the emotional well-being of mental health nursing students and support them to become resilient practitioners.
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The use of physical restraint is a contentious practice in the acute mental health setting. There are a plethora of guidelines surrounding the safe use of restraint. However, there is a scarcity of literature dedicated specifically from... more
The use of physical restraint is a contentious practice in the acute mental health setting. There are a plethora of guidelines surrounding the safe use of restraint. However, there is a scarcity of literature dedicated specifically from the perspective of the patient. The existing literature suggests that there are serious physical and psychological implications associated with the use of physical restraint for both mental health patients and nurses alike. The debate surrounding this practice has been intensified by the compelling evidence suggesting that the application of restraint is not compatible with the values of recovery in mental health care. To influence clinical practice that governs the use of restraint, it is essential to explore patient experiences of its use. Therefore, this review aims to explore patient experiences of physical restraint in the acute setting. PubMed, CINAHL and PsycINFO were systematically searched using keywords; "physical restraint" and "patient experience" and "acute setting". The search yielded n = 482 papers in total. Following the application of rigorous inclusion and exclusion criteria and data extraction, a total of n = 9 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, three themes were identified: 'the bio-psychosocial impact of restraint on patients', 'the impact of restraint on the therapeutic relationship' and 'patient needs concerning the use of restraint'. Future research opportunities have been identified that will add to the body of evidence in developing appropriate health interventions and supports for this population.
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People who identify as LGBTQ+ and are in prison often experience many additional challenges. Once in prison, there is systemic discrimination against imprisoned LGBTQ+ people and a lack of understanding and concern regarding their care,... more
People who identify as LGBTQ+ and are in prison often experience many additional challenges. Once in prison, there is systemic discrimination against imprisoned LGBTQ+ people and a lack of understanding and concern regarding their care, treatment and support needs. While there is growing interest in their protection and that of other vulnerable populations in prison settings, little is known about their views and experiences regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of LGBTQ+ people in prison and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to March 2021 was undertaken. Studies were identified that involved LGBTQ+ people, and addressed their views and experiences regarding the...
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Abstract Patients leaving inpatient psychiatric care without informing staff can have serious consequences for patient welfare, their families and staff. Even in cases where there are no serious outcomes and patients return, treatment can... more
Abstract Patients leaving inpatient psychiatric care without informing staff can have serious consequences for patient welfare, their families and staff. Even in cases where there are no serious outcomes and patients return, treatment can be interrupted and staff morale compromised. Given these potential deleterious effects, it is important to have an in-depth understanding of why people leave when they do. The aim of this study is to examine the profile of service-users who leave in-patient psychiatric care without notifying staff and to determine their reasons for doing so, what they did when they left the hospital setting and reasons for returning. This is a prospective descriptive study of service users leaving without notifying staff from a national mental health service in Ireland. It investigated the frequency, timing, and motivations of these absconding events among a sample of in-patients over a 12-month period. This year-long review identified 75 episodes of leaving without notifying staff, 55 of which met this studies criteria. 22% of episodes were from a locked unit, 58.2% were repeated episodes. 89% of service users returned to hospital following the episode and 11% were discharged against medical advice. Although no fatalities, three service users were seen in an emergency department as a result of activity during leave. Upon return from leave, all service users were reviewed and their care plans were updated where necessary.
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INTRODUCTION The high prevalence of adults presenting to the mental health services places mental health nurses (MHNs) in a unique position to support the person with the associated challenges of CSA, yet little is known about the... more
INTRODUCTION The high prevalence of adults presenting to the mental health services places mental health nurses (MHNs) in a unique position to support the person with the associated challenges of CSA, yet little is known about the preparedness of MHNs to work with this client population. AIM To explore MHNs' perceived preparedness to work with adults who have CSA histories, and to elicit their views, skills and confidence in relation to working with this sensitive issue. METHOD In-depth semi-structured interviews were conducted with five consenting MHNs. A qualitative descriptive methodology informed the study. A thematic analysis framework guided the data analysis. RESULTS The findings assert that MHNs are willing to work with survivors of CSA despite feeling unprepared to so, MHNs described feeling ill-prepared in how to respond to CSA, calling for not just education and training specific to CSA but also citing the need for clinical supervision and additional guidelines to enhance their preparedness. DISCUSSION Results of this study further highlighted the omission of CSA within nursing curricula and the absence of role-models within clinical practice as a major barrier to preparedness to work with survivors of CSA. Recommendations are made for training, education and the inclusion of clinical supervision.
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Accessible summaryWhat is known on the subject? ECT is a fast‐working and potentially life‐saving treatment, but it is still considered a controversial treatment choice. Due to lack of knowledge and public stigma, ECT can be an... more
Accessible summaryWhat is known on the subject? ECT is a fast‐working and potentially life‐saving treatment, but it is still considered a controversial treatment choice. Due to lack of knowledge and public stigma, ECT can be an anxiety‐inducing treatment for people experiencing severe depression. The nurse's role is to alleviate this anxiety, aid recovery and minimize the risk of relapse. They manage this onerous task ideally through the therapeutic relationship, and use the skills of assessment and risk identification in order to maximize patient outcomes. What this paper adds to existing knowledge? The views of mental health nurses who provide care for adults receiving treatment of ECT for severe depressive illness are in the main positive. The knowledge of and attitude towards ECT among nurses may reflect on patients and influence treatment choice. If stigma is not addressed, then patients will not be appropriately informed regarding their treatment options. Mental health nur...
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Objective: The objective of this review is to identify, appraise and synthesize available evidence related to the experiences and perceptions of emergency department (ED) nurses regarding people with any mental health issue who present at... more
Objective: The objective of this review is to identify, appraise and synthesize available evidence related to the experiences and perceptions of emergency department (ED) nurses regarding people with any mental health issue who present at the ED. Introduction: The ED is often the first point of contact for patients with a mental health issue, due to a shortage of available mental health services. Nursing staff in the ED are involved in key clinical decision making and hands-on care for these patients, despite a lack of mental health specialist training. In order to improve patient outcomes in the ED setting, it is necessary to have a thorough understanding of how ED nurses’ experiences with this population affect their clinical decision making. Inclusion criteria: This review will consider studies that include ED nurses, with or without mental health specialist training, working in urban and rural EDs in healthcare settings worldwide. Qualitative studies that explore the experiences...
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BackgroundEmerging research coming from the person‐centred and psychodynamic traditions in the past 15 years has examined the traumatic dimension of suicidal behaviour on clinicians. However, there is limited empirical literature on the... more
BackgroundEmerging research coming from the person‐centred and psychodynamic traditions in the past 15 years has examined the traumatic dimension of suicidal behaviour on clinicians. However, there is limited empirical literature on the impact of suicidality on Irish psychotherapists. In Ireland, it is estimated that 500 citizens die by suicide each year, while approximately 11,000 accident and emergency admissions are the consequence of suicide attempts.AimThis elicits the question, how does suicide prevention impact Irish mental health professionals who work solely with these vulnerable populations?MethodIn this article, the process of interpretative phenomenological analysis (IPA) was applied to the narratives of seven experienced therapists.FindingsThe Irish Poet W.B. Yeats coined the famous refrain ‘All changed, changed utterly, a terrible beauty is born’ in his poem ‘Easter 1916’ (as cited in Martin, ). This quote aptly encapsulates the reality of seven experienced Irish psych...