Clinical instruction in mental health nursing: students' perceptions of best practices.

OBJECTIVES: Negative clinical educational experiences for student nurses are predictors of negative attitudes and perceptions towards mental health. In clinical education, instructors take on this important role often with little to no formal training. This study explored nursing students' perceptions of instructional best practices in mental health clinical education. METHODS: A qualitative descriptive design was used, and 10 Canadian baccalaureate nursing (BN) students were interviewed. These students had completed a six-week practicum on an acute inpatient psychiatric unit in either their second, third or fourth year of study. RESULTS: Through thematic analysis, three themes were identified: (1) Students valued feeling prepared at the beginning of the clinical placement. (2) Students felt empowered when instructors encouraged self-direction. (3) Students appreciated positive role modeling by their instructors. CONCLUSIONS: Suggestions for clinical teaching strategies are made to mitigate student stress, increase confidence, and address the influence of mental health stigma on learning.

Older people in custody in a forensic psychiatric facility, prevalence of dementia, and community reintegration needs: an exploratory analysis.

BACKGROUND: Across much of the developed world, the number of older people in custody has been increasing, which presents challenges for correctional systems due to the complex social, medical and mental health needs of this subgroup, especially those living with dementia. The present study therefore aimed to increase insight into the extent to which older people in custody are (a) potentially living with dementia and (b) receiving appropriate supports/services (particularly, with respect to community reintegration). RESULTS: Cross-sectional data were drawn from a sample of 29 older people in custody and 20 correctional health care professionals at a regional forensic psychiatric hospital in a medium-sized Canadian city. In general, analyses revealed that: (a) scores from a modified version of the Community Screening Instrument for Dementia (CSI'D') suggest that 45% of older individuals screened positive for dementia; (b) 35% of Social Workers and 25% of Primary Nurses (i.e., RNs/RPNs) suspected that at least one older individual on their caseload has dementia, and there was adequate agreement between health staffs' perception of the presence or absence of dementia and the CSI'D' assessment; (c) varying supports/services may be required for older individuals' successful community reintegration and living; and (d) Social Workers and Primary Nurses generally lack training/education to adequately support older people in custody. CONCLUSIONS: A substantial number of older people in custody may experience age-related challenges, including dementia. This necessitates the development and implementation of programming to effectively address older individuals' needs during incarceration and community reintegration and living.

Transition of Mental Health Service Delivery to Telepsychiatry in Response to COVID-19: A Literature Review.

Due to COVID-19, face-to-face mental health service delivery has been interrupted by social distancing and stay-at-home orders. To abridge physical distance between patients and healthcare providers, while limiting exposure to COVID-19, telepsychiatry has been widely adopted to provide services to patients with pre-existing mental health disorders. Though telepsychiatry has become more mainstream in delivering mental health services during COVID-19, evaluation studies of the rapid conversion of care delivery from face-to-face to telepsychiatry have been limited. The aim of this study was to review the literature on the transition of mental health service delivery to telepsychiatry during COVID-19. The findings of the current review showed that a majority of patients and healthcare providers were satisfied with telepsychiatry services, and suggest that telepsychiatry is feasible and appropriate for supporting patients and healthcare providers during COVID-19.

Modification, Translation, and Psychometric Testing of the Arabic Version of the Belongingness Scale-Clinical Placement Experience.

BACKGROUND: This paper aimed to describe the modification, translation, and psychometric testing of the Arabic version of the Belongingness Scale-Clinical Placement Experience (BES-CPE). METHODS: This study included the following phases: modification of the original BES-CPE based on the qualitative findings from a previous study; translation and back-translation of the scale; evaluation of the content validity by experts from Saudi Arabia; evaluation of the internal consistency reliability; and other psychometric properties of the Arabic BES-CPE. RESULT: The results demonstrated acceptable psychometric properties. The Cronbach' s alpha ranged from 0.68 to 0.92. CONCLUSION: The Arabic BES-CPE is a promising tool that can be used to assess Saudi nursing students' sense of belonging. However, testing the tool with other undergraduate nursing students in a different context is recommended.

The implementation of correctional nursing practice-Caring behind bars: A grounded theory study.

AIM: To understand how registered nurses implement their nursing practice in correctional institutions with healthcare governance by a health authority (e.g. Ministry of Health). DESIGN: Straussian grounded theory. METHODS: Simultaneous data collection and analysis were undertaken using theoretical sampling, constant comparison and memo writing. Thirteen registered nurses engaged in semi-structured telephone interviews about implementing their correctional nursing practice including, providing direct care to adult offenders. Data were collected (December 2018 to October 2019) until saturation occurred. Analytic coding (open, axial and final theoretical integration) was performed to identify the core category and subcategories around which the substantive theory was developed. RESULTS: The theory of Caring Behind Bars refers to the process of how registered nurses implemented their correctional nursing practice to care for offenders. The core category of Caring Behind Bars is comprised of five subcategories: tension between custody and caring, adaptability and advocacy, offender population, provision of care, and challenging and positive elements. CONCLUSION: Caring Behind Bars required registered nurses to address tension between custody and caring by adapting and advocating to access offenders. The provision of care required registered nurses to use assessment skills and numerous resources to provide a variety of patient focused care to offenders. The consequences of Caring Behind Bars had challenging and positive elements. IMPACT: The tension provides purposeful space to continue improving teamwork among correctional officers and registered nurses. More research is required about the impact of correctional healthcare governance models on professional practice and health outcomes. Frontline registered nurses can use the theory to make informed choices when providing care. Registered nurses practising in other domains of correctional nursing (i.e. administration, education and research) can also use this theory to advance and inform practice with the goal of promoting offender health.

Saudi female nursing students experiences of sense of belonging in the clinical settings: A qualitative study.

Many studies have reported that nursing students' sense of belonging during their clinical experiences is essential to their motivation to learn. This study was conducted to learn more about the meaning of sense of belonging, the consequences of sense of belonging, and the factors that affect Saudi female nursing students' sense of belonging in clinical settings. Using interpretive description methodology, the data were collected via semi-structured interviews with 16 students about their sense of belonging in clinical settings. It was conducted in three baccalaureate nursing programs in government institutions in Saudi Arabia. Each interview was audiotaped, transcribed verbatim in Arabic, and translated into English, and the data were analyzed using thematic analysis. The results indicated that participation in patient care, a welcoming environment, English language skills, the nationality of nursing staff, and acceptance by nursing staff, patients, and other health care professionals are some of the factors that affect Saudi female nursing students' sense of belonging in clinical settings. The findings may contribute to the creation and support of more effective clinical learning situations for nursing students in Saudi Arabia, improving the quality of their educational experiences and retaining them in the nursing profession.

Studying abroad: Exploring factors influencing nursing students' decisions to apply for clinical placements in international settings.

BACKGROUND: For over 15 years the College of Nursing at the University of Saskatchewan has facilitated study abroad clinical placements in a number of countries to enhance student learning. Nursing students often find their study abroad experience to be a defining moment in their educational program, and in their personal and professional growth. OBJECTIVES: The main objective of this research was to explore factors influencing nursing students' decisions to study abroad. DESIGN: A descriptive longitudinal design study was conducted using an online survey. SETTINGS: The Study Abroad Survey was distributed to all undergraduate and graduate nursing students, in all years of all programs, at all sites of the College of Nursing, University of Saskatchewan in Saskatchewan, Canada. PARTICIPANTS: A total of 1058 nursing students registered in the 2013-2014 academic year were surveyed. METHODS: The data were collected using an online survey administered by Campus Labs™ (2014). RESULTS: Students indicated that their interest in study abroad international experiences was high (84%), with many perceived benefits, but barriers to participation were also high for these students. Financial barriers topped the list (71%), followed by family responsibilities (30%) and job obligations (23%). CONCLUSION: The research highlights the factors behind student decision making related to international placements, and provides the basis for improvements to the College of Nursing's International Study Abroad Program (ISAP). Previous travel and international service learning, resulting in increased perceived value of a study abroad experience may prove to be the more significant factor influencing decision making, rather than financial barrier.

Toward the establishment of a forensic nursing specialty in Brazil: an integrative literature review.

BACKGROUND: Over the past two decades, Brazil has made progress in bringing political and community attention to issues related to violence. The recognition of links between violence and health has intensified calls to accelerate the development of a forensic nursing specialty in Brazil. AIM: The aim of this study was to systematically examine and synthesize the literature on the development of the forensic nursing specialty around the globe and to extract important lessons for the establishment of a forensic nursing specialty in Brazil. METHOD: An integrative review was conducted according to the method described by Whittmore and Knafl (2005). Electronic searches of the following databases were conducted between December 2012 and March 2013: CINAHL Plus with Full Text, Criminal Justice, Index to Legal periodicals, MEDLINE, Soc Index with Full Text, Social Work Abstracts, SCOPUS, and PsycINFO. The search terms used were: [(TI nurs* or SU nurs*) and [TI (forensic* or penal or prison*) or SU (forensic* or penal or prison*)] and (sexual assault nurse examiner*). Preestablished inclusion/exclusion criteria were used to select published articles for review. RESULTS: Twenty-three articles met inclusion criteria and were included in the full review. Important lessons for Brazil are discussed in terms of education and curricular issues and forensic psychiatric nursing. CONCLUSIONS: In Brazil, there is a window of opportunity to contribute the theoretical foundations of forensic nursing science and to advance nursing specialty practice in the areas of Sexual Assault Nurse Examiners and forensic psychiatric nurses.

Making time for reflexive dialogue in philosophical group discussion: extending the debate on the militarization of nursing.

In the 2010 July-September issue of Advances in Nursing Science, Perron et al offered a persuasive and substantive account of the troubling incursion of military speech into nursing practice and education. The article proved contentious, resulting in accusations of fallacious misrepresentation. This article extends the philosophical debate initiated by Perron et al on the militarization of nursing and the war on terror and offers the perspectives of members of a philosophical discussion group who took up the challenge to engage in critical debate and dialogue on the ways in which external organizations penetrate nursing education, practice, and knowledge.

The alcohol-dependent patient in hospital: challenges for nursing.

Individuals who are alcohol dependent pose significant challenges for nurses when they are admitted to hospital for treatment. Clinical problems presented by these individuals are examined and the critical aspects of their care are highlighted.

Forensic psychiatric/mental health nursing: responsive to social need.

Forensic nursing is an emerging global nursing specialty, with subspecialties that focus on nursing practice at the clinical-legal interface of tending to victims and offenders, living and deceased. An integrated review of the literature provides an overview of the role development of forensic nursing subspecialties. The subspecialties of forensic nursing that deal with the mental health care of victims and offenders are the focus of this paper. Forensic nursing, like all forensic specialties, developed from a need in society for a medico-legal role. This paper discusses the global role of forensic nursing and argues that role development has been both proactive and responsive to vital needs of victims and offenders in society. Advanced practice forensic nurses have taken leadership roles in the role development of this nursing specialty. A future challenge for forensic psychiatric/mental health nurses with advanced education is to take leadership roles in all areas of psychiatric assessment, intervention, and evaluation of clients.

International nursing student exchange: rural and remote clinical experiences in Australia.

A rural and remote international clinical exchange permits the senior nursing student to experience another culture and to develop a feel for daily life and nursing practice abroad. In a student exchange between Australia and Canada, similarities exist with regard to life and work for nurses who live in these developed countries. Similarities extend to a growing population base of original inhabitants or indigenous peoples with complex health challenges. Differences, however, are also apparent in rural and remote health care delivery due to the uniqueness of each country's demographics, nursing programs, nursing culture, and health care systems. In the rural hospitals of the Riverland region, South Australia, the Australian public and private health care systems are witnessed working side by side. Aboriginal health care with its unique cultural care practices was experienced in the remote Aboriginal community of Hermannsburg in the Northern Territory, and in the district hospital in Alice Springs. The international exchange provided the opportunity to reflect on the impact of the social determinants of health, and the similarities and differences between developed countries in nursing practice and nursing culture. The sense of community and autonomy gained in rural and remote placements in Australia provided incentive for nursing students to consider this area of practice on their return to Canada.

An exploratory study of forensic nursing education in North America: constructed definitions of forensic nursing.

The aim of this study was to explore forensic nursing knowledge as a specialty area of study, and factors influencing its educational development. A purposeful sample of nurse educators who had established some of the earliest forensic nursing programs in North America were sought for their perspective to answer predominantly qualitative questions. Unexpected findings from this study resulted in the concept of forensic nursing being described, differentiated, and defined. Since the inception of forensic nursing, numerous definitions have been written to articulate the knowledge of the specialty. The constructed definitions of forensic nursing from this study not only validated prior definitions developed by individuals and associations by nonresearchable methods, but also led to a discussion of what concepts are important to include in definitions of forensic nursing.

Forensic nursing education in North America: Social factors influencing educational development.

In the mid 1990s, some of the first formal forensic nursing educational programs were established. Now more than a decade later, courses exist at educational levels from certificate to doctorate programs, with little educational research having been conducted. This recent study explored forensic nursing knowledge as a specialty area of study and factors influencing educational development. This paper reports on social factors that facilitated and impeded educational development in the forensic nursing specialty from the perspective of forensic nurse educators in North America. Changing attitudes to previously sanctioned professional roles in society provided discussion for implications for forensic nursing practice.