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'No support' among mental health nurses for generic training

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Mental health nurses have “no support” for suggestions that the four fields of nursing should be discontinued under plans to move to a more generic model of training, according to a new report by a charity.

They “fundamentally disagree” that a potential move to single registration with the Nursing and Midwifery Council would be the most effective way of improving mental and physical health assessment skills among all nurses, said the Foundation of Nursing Studies in a wide-ranging report looking at the work of mental health nurses.

“There have been suggestions that a single nurse registration is now desirable…We fundamentally disagree”

Playing our Part report

However, those behind the report did agree there was currently very little opportunity for student mental health nurses to learn physical health assessment skills – and vice versa with trainee adult nurses and mental health assessment – on university courses.

They said this shortfall in skills must instead be addressed by universities, including more of these elements within courses, and also through increased continuing professional development opportunities for nurses.

“There have been suggestions that a single nurse registration is now desirable and would help address the deplorable fact that people living with mental illness are more likely to die earlier by 10 or more years,” said the Playing our Part report.

“We fundamentally disagree. A more sustainable strategy would be to ensure that CPD and undergraduate programmes in all branches of nursing attend to deficiencies,” it stated.

The NMC is currently revamping its pre-registration education standards for nurses and universities and there has been speculation that, as part of this work, there could be a move to create a single registration for all nurses after a national review recommended more generic training.

However, the regulator has confirmed to Nursing Times that it is currently bound by legislation to offer all four fields of registration – in adult, mental health, children’s and learning disability nursing – although this legislation will need to be reviewed when it begins regulating nursing associates.

In today’s report looking at the work of graduate and registered mental health nurses, the foundation made a series of recommendations about the changes needed to improve nursing care for people with mental health issues.

Following a year-long consultation with the profession, it found undergraduate mental health nursing courses were lacking in a “relevant evidence base” that was consistent across all programmes, creating problems around professional identity. It said a “consensus on an evidence-based spine to the undergraduate curriculum will be vital”.

In addition, it urged the chief nursing officers of all four UK countries to “endorse the good work of graduate and registered mental health nurses more regularly and publicly” to help underline the unique, professional identity of the workforce.

“Concerns around the mental health of children and young adults are currently high on the national agenda but we are not preparing graduating students”

Playing our Part report

Mental health nurses also reported they had limited impact on children and young adults, despite recent government commitments to improve this area of care.

“Concerns around the mental health of children and young adults are currently high on the national agenda but we are not preparing graduating students to work confidently in these specialist community and inpatient services,” said the report.

The report also referred to the removal of student bursaries in England from later this year. It said it was particularly important to monitor applications to mental health nursing courses in the immediate future as it ”might become situation critical” if fewer people were deterred from joining the profession.

Meanwhile, in practice, mental health nurses are being “under-used by service providers” and some employers are being too risk-averse in their deployment of the profession, said the report.

Problems with some employers not making full use of mental health nurses’ drug prescribing skills or failing to deploy registrants to work more in primary care and prevention were uncovered.

The increasing lack of CPD for mental health nurses was also described as “lamentable”, while concerns were raised about the variation in clinical supervision opportunities.

“Nurses must be more resolute when it comes to shaping their own future through active engagement in policy”

Playing our Part report

“As new workforce roles in mental health and nursing begin to emerge, good practice would suggest these new staff will require purposeful clinical supervision.

“The needs of the existing workforce must not be sidelined amid the dash for a quick ‘workforce fix’. Such new roles place additional demands on graduate and registered mental health nurses in terms of teaching, supervision and support,” said the report.

In their introduction to the report, Professor Tony Butterworth, who chaired the group leading the work and Dr Theresa Shaw, chief executive of the Foundation of Nursing Studies, noted the renewed political focus on mental health.

They stressed that graduate and registered mental health nurses were well-placed to play a “significant part in public mental health and wellbeing”.

“As a largely graduate profession, nurses must be more resolute when it comes to shaping their own future through active engagement in policy,” they said later in conclusion.

Professor Tony Butterworth

Professor Tony Butterworth

Tony Butterworth

“Nursing in general is undergoing seismic changes and therefore needs to take control of the agenda rather than sit back and allow ‘others’ to determine the direction of the profession,” they added.

Commenting on the report, Unite’s professional office for mental health, Dave Munday, said the concerns raised about the potential removal of a specific registration for mental health nurses was further evidence of opposition to a more generic form of nurse training.

He said there was widespread recognition that mental health and adult nurses needed more rounded training to ensure they could carry out both physical and mental health assessments, but that less specialist training was not the solution.

He added that it was important to establish a new set of clear standards for mental health nursing courses to provide more consistency in training, but that the move to a loans system for students meant universities were in fact more likely to want to tailor their courses as they compete for applicants.

“We need good, clear national standards that mean that we get good nurses coming out at the end of these courses but the system that is being set up is one that is running counter to that,” he said.

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