RCN International Research Conference September 2019

QMU Nursing

QMU Research Paper explores how Scottish Community Nurses work with individuals experiencing mental distress while living with a long-term condition

Julie Churchill (Programme Leader Person-centred Practice: District Nursing & Non-medical Prescribing, Queen Margaret University Edinburgh [QMU]) and David Banks (Programme Leader Person-centred Practice: Mental Health & Wellbeing, QMU) were in Sheffield this week to present a research paper at the RCN International Research Conference. The study explored how Scottish Community Nurses work with individuals experiencing mental distress while living with a long-term condition. 25 Community Nurses employed across six Scottish Health Boards in 2018/19 were interviewed as part of this research. The team also participated in a pyramid meeting with people affiliated to COPE Scotland, who have experience of anxiety and/or depression and other long term conditions. Feedback from this event, other key informants and a literature review helped construct questions for the subsequent interviews with community nurses. The fieldwork was funded by QNIS Scotland. A briefing paper with further project details is available on request from Julie Churchill at JChurchill[at]qmu.ac.uk

In short, Community Nurse Participants came from a wide variety of hospital and community based backgrounds. Divergent practices were revealed based on their assumptions regarding job roles, workloads, the perceived needs of the person and their competence in working with people with mental health issues. There were differing levels of awareness around power relationships, specifically where interventions were taking place, specifically, home or clinic.

Interventions were more likely to be initiated by nurses with specific education/training. Another influencing factor was working relationships within the Inter-professional team and other agencies. Referral was also driven by a wide range of practices based on formal and informal working relationships. Mental health services were clearly valued, but access was problematic. For some nurses their work priorities meant the mental health of their patients was not always addressed.

Nevertheless, a small number of practitioners revealed intriguing skillsets. Some wished to consolidate this work through further education and experience. There was evidence of innovation, through service development, extension of role and advancing practice. The findings particularly challenge key assumptions by Health Education England (2017) about the limited roles of Practice Nursing in Scotland. This research points towards potential for future practice development work and the QMU team will meet soon with QNIS and Professor Brendan McCormack to discuss ways of taking this project forward.

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