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We should be calling for a mental health-only degree


OK, I realise I may be out of touch. I don’t watch soap operas and I thought Lady Gaga was a mouthwash.

I don’t understand how Come Dine With Me - which is essentially an opportunity to watch some strangers cook food you can’t eat and give it to people you don’t know - is any different to standing outside a chip shop. And I don’t get how Celebrity Big Brother can be remotely entertaining to anyone unless someone releases 40 snakes and some lions into the house.

And of course I realise - because I have been in nursing for over 20 years and I am compelled to reflect on my own frailties - that I am out of touch, not simply because cultural activity does not move me, but because it is not designed for me. I am a bald man in his 40s who likes obscure pop music and growing vegetables. I am nobody’s target audience. Unless you include Alan Titchmarsh’s wig emporium.

‘I don’t think of myself as grumpy. Usually. Hell, I’m absurdly optimistic most of the time. I still hold out hope that Bambi’s mum might get better’

More importantly I notice that my distaste or confusion may sometimes be expressed as grumpiness rather than bemusement and I don’t think of myself as grumpy. Usually. Hell, I’m absurdly optimistic most of the time. I still hold out hope that Bambi’s mum might get better. Indeed, I try to approach most things now with a quizzical uncertainty for fear of simply being grumpy or out of touch with its cultural or political resonance - and this is what I did last week in reading the discussion about whether or not community nursing should be a separate degree from what I imagine might be called ‘hospital nursing’. I read the article on and I found myself vaguely agreeing with lots of people who didn’t agree with each other. And then, inevitably, I got dizzy.

Because frankly I can’t help thinking that before we establish community nursing as a separate and distinct educational and professional route, we might like to address the anomaly that is mental health nursing not requiring distinct and separate training.

I may be being out of touch again here but I simply do not believe that mental health nursing is the same endeavour as adult nursing. It may have a similar objective (patient recovery), it may require similar qualities but a mental health nurse has more in common in their day to day work with a mental health occupational therapist or social worker, particularly if they are all working in a community mental health team, than with an adult or child nurse working in a hospital or a GP surgery. The skill base, the professional relationships and the role are all different.

So while considering the subtle distinction between community and hospital nursing, might we not also consider the wholesale distinction between adult and mental health nursing? Mental health nursing cannot be seen as an add on to its better populated sister and still play the role of which it is capable in leading progressive and recovery based services. It needs more educational time and attention than joined training offers. Patients deserve better. And so do student nurses.


Readers' comments (7)

  • I believe that the mental health course is already different from that of an adult nurse.
    Only the first year of the course is similar. However a module on community mental health nursing would be useful for new mental health nurses as community nursing is the future.
    I mentor MH nurses in the community and some have excellent skills, others less so.
    Unfortunately the most important skill for MH nurses is communications and interpersonal skills and theses are often the hardest skills to teach.
    However a module based around looking after people in the community could cover things including :- Funding, relapse prevention, anxiety management, PSI, introductory CBT, spotting relapse, working with other professionals etc.
    I feel a seperate degree however would be over the top, we all still need the basic training or we wouldn't be nurses any more.

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  • Mental Health is already a different branch. They do have their own course, aside from the CFP, which teaches basic nursing for all. Your argument is weak.

    The difference between community and hospital nursing isn't "subtle" either, it's a whole different ball game.

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  • My concern is the reverse- perhaps adult nurses need more mental health content in their training- I always felt it was the missing link but I suppose that is another debate.

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  • I may be mistaken but was not the original RMN a role specific training?
    Having worked both in the U.K and Australia, I feel I need to beg the NMC to return to ward based training, it would stop less than enthusiastic Nurses completing degrees then realising they are not cut out to care in acute settings. I felt my training was character building and also enabled development of personal skills 80% of what is valued by service users.
    We need achademic underpinning to ensure best practice but not at the cost of working humanely with the ability to offer unconditional positive regard.

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  • Couldn't agree more with the above comments. My training in adult branch comprised 2 weeks in a mental health setting which was supposed to be mental health module!! I've since done a person centred counselling training and after more than a few earth moving and illusion shattering experiences, I find looking back at my nurses training, and how I have been as a nurse meanwhile, quite a spectacle!

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  • As a 3rd year mental health student I would have loved to have more than a 2 week adult branch placement.

    I do agree that perhaps adult branch students should have more training in mental health also. A mentor once told me that all branches used to do a number of weeks in the other branches.

    The second and third years of mental health and adult are very different from my experience and what friends in adult tell me, as it should be.

    We will be using very different skills when we qualify, but I will still need an understanding of physical illness and its management and the adult nurses will still encounter people with mental health problems.

    We need a good understanding of all areas, I think longer out of branch placements in the first year would help with this, leaving the second and third years to develop the particular skills needed for our own branch.

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  • Regarding community nursing and hospital nursing as separate training courses - how about a general registered nurse training first with the choice of a fourth year diploma or a post graduate course in public health. This works well in Switzerland and those with the higher diploma are also registered nurses with all the relevant training and experience. One could also offer this additional public health option to those undergoing mental health nurse training. It works well in Switzerland.

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