Preceptorship in Mental Health Care: Personal and professional development Fiona Couper/Debbie Spain Dept. of Mental Health Florence Nightingale School of Nursing & Midwifery

Overview AIMS: 1.To consider the role of transition, personal and professional development LEARNING OUTCOMES: To discuss implications and opportunities for personal and professional development To review intended learning outcomes To address queries relating to the module assignment

The process of transition Fisher’s Personal Transition Model Anxiety Happiness Fear Threat Guilt Depression Disillusionment Denial Gradual Acceptance and Moving Forward Lewis-Parker’s Transition Curve Immobilisation…reality shock Denial of change Incompetence Acceptance of reality Testing new ways of dealing with reality Searching for meaning Integration of meanings and behaviours

Fisher’s Personal Transition Model

Preceptorship framework (DH, 2010)

The developing role of mental health nurses …

‘That it (the stethoscope) will ever come into general use, not with standing its value,is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble; both to the patient and practitioner. Its hue and character are foreign and opposed to all our habits and associations.’ The Times (1834)

The developing role of the mental health nurse … New roles re the Mental Health Act Clinical Commissioning Groups Non-medical prescribing Delivery of psychological / psychosocial interventions

New Roles in the Mental Health Act Mental Health Act 2007 amended 1983 Act Follows New Ways of Working workforce strategy by extending RMO and ASW role to nurses and other professions Responsible Clinician: community practitioner who works most closely with patient (for patients admitted to hospital, RC is still usually a psychiatrist) Approved Mental Health Practitioner: to ensure social perspective, training approved by General Social Care Council and based on ASW course Concern that provisions of Mental Health Act 2007 shift nursing from care to control Ethical issue: administering (and prescribing) mandatory treatment, with potentially adverse effects High level of responsibility not fully rewarded

Clinical commissioning groups Health and Social Care Bill Changes to payment structure for use of (mental) health services PCTs to be replaced with Clinical Commissioning Groups (CCG) A role for ‘lead nurses’ - strategic focus; quality improvement e.g. patient care and safety

Frances Inquiry Key Recommendations for Nursing Culture of nursing-compassionate care, measure cultural health of front- line work places. Pre-registration education-consistent standards, practical experience, aptitude test for compassion and caring at selection for training and recruitment for employment;.

Stronger nursing leadership and nursing voice Key/named nurses Registered older person’s nurse Minimum staffing levels to be developed

Non-medical prescribing Independent / supplementary prescribing NMC requirements and guidance Post-qualification experience with particular clinical populations Support from clinical area / pharmacy Supervision from approved mentor

Nurses as therapists ? Increasing evidence for the effectiveness of psychological interventions for symptoms of mental disorders (e.g. NICE, 2011) In particular interventions derived from behavioural, and cognitive-behavioural theories / therapies CBT training - former ENB 650 Psychosocial interventions and family-work Is effectiveness of therapy mediated by core profession?

‘Nursing interventions’: strengthening the evidence-base What are nursing interventions? How can we measure content, process and outcome of our interactions / interventions ? Qualitative versus quantitative research methods

Personal and professional development Maintaining a portfolio of evidence KSF / Agenda for Change – appraisal system NMC guidelines Clinical supervision – self / others / peers

Continuing professional development Defining CPD Mandatory training In-house / Trust-specific KCL modules

Module evaluation (Please also fill in the electronic version on Keats)

References Borg, M. and Kristinsen, K. (2004). Recovery-oriented professionals: Helping relationships in mental health services. Journal of Mental Health, 13, pp DH (2006). The Chief Nursing Officer’s review of mental health nursing: From Values to Actions. London: HM Stationary Office. DH (2010). Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals. London: HM Stationary Office. Hardyman, R. & Hickey, G. (2001): What do newly-qualified nurses expect from preceptorship? Exploring the perspective of the preceptee. Nurse Education Today 21, Nursing and Midwifery Council (2008): Code of Professional Conduct. Sainsbury Centre for Mental Health. (2004). The Ten Essential Shared Capabilities. London: Sainsbury Centre for Mental Health. Shepherd, G., Boardman, J. and Slade, M. (2008). Making Recovery a Reality. London: Sainsbury Centre for Mental Health.