1. Tex-Nex A Texan Nursing Exchange Amy Barry, Betsy Conlon and Nathalie Mills

2. Created in 1948 following WWII The general principle is ‘health service will be available to all and financed entirely from taxation which means that people pay into it according to their means’ Private healthcare does exist but it is quite unaffordable for most Currently the NHS is a hot topic in politics and financial cuts are causing a huge strain

3. Mental Health Care Services Community – covers all ages Inpatient - ranging from Psychiatric Intensive Care (PICU), Acute, Rehabilitation, Elderly, Child and Adolescent (CAMHS) Since the recent cuts in funding we have seen a dramatic shift from inpatient services to care in the community

4. Multidisciplinary teamwork On a typical ward there will be: Registered Nurses Health Care Assistants (HCA’s) Consultant Psychiatrist Occupational Therapist Social Worker Music Therapist Advocate Animal Therapist Physiotherapist/Dietician

5. Admission for Treatment The Mental Health Act works in conjunction with the Mental Capacity Act Patients will be brought to a ward on a section or informally The common sections that are used are Section 2 Section 3 Section 136 Patient’s can appeal their sections if they wish

6. Post Graduate Diploma in Mental Health Nursing We all have a previous degree in Psychology The course is two years as apposed to 3 because of our previous degree The second year is Masters level We all have previous experience in working with vulnerable people When we graduate in February we will be Registered Mental Health Nurses (RMN’s)

7. Post Graduate Diploma in Mental Health Nursing 40% of the course is theory and 60% is made up in practice hours Theory involves being in university and is in the form of lectures and practical's So far we have had placements in: Elderly, Rehabilitation, Acute care and Community Settings

8. Placements A placement ranges from 6 – 14 wks working 37.5 37.5 hours per week We shadow a registered nurse We have a ‘placement book’ which has to be filled in at the end of the placement showing that we have adequately completed competencies required to qualify as a nurse On placement you are expected to work as part of the team – dispensing medications, coordinating shifts, managing the ward

9. Challenges facing Recovery in Mental Health Funding cuts from government Stigma and discrimination Families Recovery vs medical model Challenging old school thinking

10. Theory The first semester covered an introduction to basic nursing skills and medication management Core aspects of the course have been: Care planning Clinical Skills Leadership and Management We also complete Mental Health ‘simulations’ http://www.youtube.com/watch?v=uPurxufCj_Q

11. Substance misuse We haven’t had the opportunity to gain any experience in this as yet but from what we understand in the UK: Substance misuse is mainly treated in the community Some people have a short stay in a unit where they have access to 24 hour medical care if necessary

12. Places we have visited in Texas! Recovery Resource Council Serve Denton SARC Solutions Maggie’s House Our Calling Denton County Juvenile Detention Centre Enterhealth talk Kristin Farmer Autism Centre TAAP Centre for Neuro Skills Epilepsy talk Stewpot Presbyterian Hospital Sante Terrell State Hospital

15. Denton Juvenile Detention Centre

16. How do things differ? As we are much more familiar with inpatient wards we have chosen to compare what we have seen of the hospitals here Daily routine Leave Modern Technology Grouped according to disorder Restraint Follow up care State funded care has more similarities to the UK

17. Suggestions for future exchanges Advise that it is necessary to rent a car Advise to make a blog CRB Outline beforehand what the objectives of the exchange are and what would be beneficial A schedule in advance Would be beneficial to attend some lectures if possible

18. Things we really enjoyed Having a guide (Amy) Being given enough downtime to explore The weather The Detention Centre Terrell Hospital Presbyterian Hospital Stewpot Maggie’s House How hospitable everyone has been The expertise of everyone who we have spoken with

19. What we all have in common is a desire to care for others and ultimately that is all that matters. www.tex-nex.com