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Nursing students urged to challenge practice and 'managerialism'

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Mental health student nurses have been urged by leading academics and nurses to challenge conventional practice and take the lead in future research to develop new models of care and treatment.

Students were called on to contest “managerialism” within mental health organisations and ensure to always have “clinical curiosity” in their working lives.

Speaking at a conference on the future of mental health nursing this week, experts highlighted the importance of evidence-based practice and the need for research to change current ways of working.

“Is it possible that…in 50 years’ time some of the practices and interventions we are involved with today will be perceived as barbaric?”

Professor Hugh McKenna

However, the audience was warned that mental health nursing had very little evidence compared to other nursing disciplines.

One professor noted that in 50 years’ time and with more evidence to inform practice, current treatments, such as electro convulsive therapy, could be viewed as “barbaric”.  

Professor Hugh McKenna, pro-vice chancellor of research and innovation at the University of Ulster, said: “Is it possible that…in 50 years’ time that some of the practices and interventions we are involved with today will also be perceived as barbaric?”

“I suspect that electro convulsive therapy will no longer be used. It’s possible also that polypharmacy and the use of major tranquilisers will no longer be used and will be perceived as something that shouldn’t have happened,” he added.

Professor McKenna cited barriers to evidence-based practice being implemented as nurses who only felt comfortable conforming to the status quo and nurse managers that blamed clinicians for failing to engage with new ways of working.

“Managers are there to manage services. They are not there to create an environment where care takes place, because that is your job”

Professor Tony Butterworth

He urged clinicians and researchers to work closely on research from “design to dissemination”, so that new evidence could be used in practice rather than remain in theory.

Professor Tony Butterworth, chair of the Foundation of Nursing Studies, pointed to current “poor” research into how mental health nurses could create environments for varying types of care and treatment across a range of settings.

“There is significant development to be done in that area and it is absolutely your job,” he said to the audience of 500 mental health student nurses.

He also encouraged them to lead service innovation and to challenge “managerialism” – a way of managing that he claimed was leading to a culture in which financial outcomes took precedence.

“Managers are there to manage services. They are not there to create an environment where care takes place, because that is your job,” added professor Butterworth.

Mental health funding

Meanwhile, Seamus Watson, Public Health England’s national programme manager for wellbeing and mental health, said “heavy” investment was required to ensure mental health research could influence policy.

“Relative to other disciplines we [mental health nursing] are starting at quite a low baseline [of evidence],” he said.

“A big part of what is happening nationally now is to try and generate even more knowledge and evidence,” he added.

In addition, consultant dual diagnosis nurse Phillip Cooper urged mental health student nurses to always question the reason behind practice and to maintain “clinical curiosity”.

He said: “When I was a student nurse and getting close to the end of my second year I dared to ask qualified staff what they knew about ECT and continued looking into those issues – and there were lots of confused ideas about it.

“So you as a student could begin to influence that practice, so I would encourage you to be as curious as you possibly can be,” he added.

The free conference was jointly organised by the Department of Health, NHS England, Public Health England, Oxleas NHS Foundation Trust and the University of Greenwich.

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