Community psychiatric nursing in the Netherlands: a survey of a thriving but threatened profession

Abstract

The aim of this paper is to describe and analyse the Dutch community psychiatric nursing profession. In spite of their large numbers, estimated at 2900, Dutch community psychiatric nurses (CPNs) have contributed little to the international literature. The history of the profession reveals a relatively isolated development, resulting in few connections with nursing and mental healthcare research. Because of various developments in these fields, CPNs appear under threat. A survey design was used to administer a 43-item electronic questionnaire, which yielded a response rate of 40%. The Dutch CPN has a mean age of 48 years, works about 32 h per week and has over 20 years of nursing experience. The Dutch CPN has a caseload of 48 patients, often participates in clinical intervision and hardly works according to evidence-based methods. Dutch community psychiatric nursing is, paradoxically, both thriving and threatened. CPNs seek to maintain a model that pays attention to both social needs and explanations, and to psychiatric diagnoses. This broad orientation may be considered essential to nursing. However, it is also a huge drawback as CPNs have not succeeded to clearly articulate what their profession adds to the care and treatment of psychiatric patients.

What makes community psychiatric nurses label non-psychotic chronic patients as ‘difficult’: patient, professional, treatment and social variables

“…The Delphi-variables were valid translations of data provided by community mental health experts in an extensive Delphi-study that has been reported on in detail before [15]. We have reason to believe that the results of our study also apply to CPNs outside the Netherlands since their role is relatively comparable worldwide [28]. They often, if not always in long-term care, work in close collaboration with psychiatrists.…”

“…The percentages of non-psychotic patients in long-term community mental health services are estimated between 20 and 50% [21–25]. The key clinicians in long-term care for these patients often are community psychiatric nurses (CPNs), the most numerous professionals in community mental health in several countries [23, 26–28]. In this paper, we report on the perception of CPNs in community mental health care for non-psychotic chronic patients.…”

Collaborative Care for patients with severe borderline and NOS personality disorders: A comparative multiple case study on processes and outcomes

“…Poor quality of life, severe suffering, high risk of suicidal behaviour, and high health care use (and corresponding costs) of this population without access to these psychotherapies, justify the development of a structured, easy-accessible intervention program. Our Collaborative Care Program may function as a valuable alternative for the relatively unstructured treatment which dominates the care as usual within existent community mental health care teams [16,17]. Within these CMHC teams nurses are the main care providers, although they are not always equipped to meet this responsibility.…”

“…These patients often receive community mental health care (often referred to as a team: CMHC team), mostly provided by (community) mental health nurses [10,14]. The treatment delivered by CMCH teams is, however, not standardized and highly unstructured [16,17]. …”

Talking about mental health nursing: a qualitative analysis of nurses’ and service users’ accounts

“…In addition a high volume of task-based activities and a lack of resources have long been highlighted as an everyday reality for hospital nurses (Currid, 2009;Nolan & Cushway, 1995). Comparably, community mental health nurses experience similar challenges, such as limited resources, high caseloads, and long waiting lists (Koekkoek et al, 2009;Keogh, Callaghan & Higgins, 2015). In order to accommodate a range of demands, the mental health nursing role may require nurses to have knowledge of a wide range of topics, and a flexible approach regarding how they undertake their work.…”