The work of community psychiatric nursing*

Abstract

The findings of this study provide an explanation of how community psychiatric nurses make community psychiatric nursing work. The work of community psychiatric nursing can be usefully compared to that involved in making a theatre production. In the theatre there is a play with a plot which is conveyed through the parts played by characters. In the face of production limitations (size of theatre, costs and time constraints, for example) and the demands of sponsors, audience, theatre critics and others in the Company, the characters make use of the stage props and get the show on the road. The community psychiatric nurses can be likened to the characters in a play, whose title is 'the provision of a community psychiatric nursing service'; the plot being the provision of individualized care. Similar to the production limitations in the theatre, the community psychiatric nurses have limited care options and resources and are faced with the varied demands of patients, carers and situations, other specialists and the bureaucracy. Yet the nurses have to produce the best match of needs to resources. Maintaining a theatrical analogy, the nurses have to use what props they have on the stage, not to 'get the show on the road', but to make the community psychiatric nursing service work. Unlike a theatrical production, however, community psychiatric nurses do not appear to have an overall director controlling the work; neither are there guidelines which limit or define practice. This results in individual community psychiatric nurses establishing their own modus operandi and defining their own work practices. Two major themes pervade this account of the work of community psychiatric nurses.(ABSTRACT TRUNCATED AT 250 WORDS)

Students’ perceptions of their psychiatric mental health clinical nursing experience: a personal construct theory exploration

“…In nursing, existing research guided by personal construct theory and repertory grid technique offers important insights to nurses and nurse educators. In the practice area, the framework provided a forum for community psychiatric nurses and their patients’ and families to collaborate on nursing care and for the nurses to voice their concerns about juggling resources and legitimizing their work ( Pollock 1986, 1988, 1989). With nurse administrators, the approach facilitated an opportunity to discuss ideal performance as well as perceived shortfalls in self‐performance ( Burnard & Morrison 1989, Morrison 1989, 1990, 1991).…”

A descriptive study of multidisciplinary mental health staff moving to the community: the demographic and educational issues

“…In the community, White's (1990) national survey of CPNs suggested that 34.6% of English and 61.7% of Scottish CPNs had a CPN qualification. As confirmed by Pollock's (1989) research, it would seem that many community nurses rely on their hospital training to work in the community. However, given the evidence presented previously, hospital and community staff do not share all the same skills (Lawton 1990).…”

“…In the absence of empirical evidence to identify skill requirements for mental health staff moving from hospital to community settings, an attempt was made to identify the current staffs' skills from the literature. While a review of the literature of CPN skills (Pope 1985, Pollock 1989, Tyrer et al 1990, Morrall 1995 and legislative requirements (Scottish Home & Health Department 1988, Department of Health 1989a, Scottish Office 1991) allowed identification of some skills required for community practice, the research examined did not allow accurate prediction of CPN skills utilized in current practice. Likewise, reviewing the skills of hospital-based mental health nurses (Altschul 1972, Cormack 1983, Shanley 1984, Butterworth 1986, Shanley & Murray 1991, Health Care Assistants (HCAs) in mental health (Mosher et al, 1973, Dewar & MacLeod-Clark 1992, Chang 1995 and Professions Allied to Medicine (PAMs) in mental health (Johnson et al 1977, Joice & Coia 1989, Crews 1990) also failed to identify skills required for the current situation.…”

Severe mental illness, statutory supervision and mental health nursing in the United Kingdom: meeting the challenge

“…Butterworth (1995) associates the decline in those undertaking mental health nurse training with this lack of a clear role definition in the community context. He points to work, such as that of Pollock (1988), which found that CMHNs established their own practices in a local context to compensate for this vacuum of direction. Whilst this may work at local level, it can be seen as weakening the ability of the discipline to define itself overall, fostering a reactive rather than proactive contribution within the mental health arena.…”