A practical guide to writing clinical articles for publication.

The sharing of nursing knowledge between clinicians can strengthen the profession. Clinicians often underestimate the relevance and importance of what they may contribute and feel daunted by the idea of writing for publication. This article presents a practical approach to writing clinical articles for publication in professional journals such as Nursing Older People. It considers: what is a clinical article; the structure of a clinical article (Why? Where? How? What? What now?); choosing the journal; and understanding the editorial process.

Reflection without shame--reflection without blame: towards a more collaborative understanding between mental health consumers and nurses.

It is now a clear policy expectation that consumers of mental health services be given the opportunity to be active participants in all aspects of mental health service development and delivery. Psychiatric nurses have an important role to play in ensuring opportunities for genuine participation; however, the literature suggests that this role is not always realized in practice. Negative attitudes of health professionals (including nurses) to consumer has been identified as a significant barrier to the realization of this policy goal, with education and training recognized as an important strategy for developing more positive attitudes. This paper describes the implementation of a mental health consumer academic position, through the personal reflections of a nurse academic and a consumer academic. More specifically, the paper addresses the reactions of some nurses to the work of the consumer academic and the apparent feeling of being attacked as nurses. By recognizing this defensiveness, nurses and other health professionals may more effectively move towards promoting consumer participation in mental health care.

The role of the nurse practitioner in psychiatric/mental health nursing: exploring consumer satisfaction.

There is a substantial body of literature pertaining to the role of the nurse practitioner. Research directed towards consumer satisfaction suggests that the care provided by nurse practitioners is perceived as at least equal to that provided by a medical practitioner. However, there is a paucity of literature examining the nurse practitioner role in the psychiatric/mental health field. An evaluation of a Nurse Practitioner demonstration model has recently been undertaken in the Crisis, Assessment and Treatment Team in Victoria, Australia. This article presents the findings of a qualitative, exploratory study. Individual interviews were conducted with consumers (n = 7) who had received care and treatment provided by the nurse practitioner candidate. Data analysis revealed two main themes: the quality of the service provided, and the unique role of the nurse. The findings supported the available literature in articulating the specific aspects of the nurse practitioner role that are favourably perceived by consumers of services. This study contributes to the limited body of knowledge in the psychiatric/mental health nursing field and specifically emphasizes the importance of the relationship between nurse practitioner and consumer in facilitating the provision of effective care and treatment.

Coping with uncertainty within the preceptorship experience: the perceptions of nursing students.

A substantial amount of time and resources are channelled into supporting clinical practicum in nursing education programmes. Attention is targeted at the most effective models to achieve this aim. The provision of sound support models regardless of specific clinical setting is recognized as integral to student development and transition periods throughout nurses' careers. Within the mental health setting, this situation is compounded by the negative attitudes nursing students tend to hold towards people experiencing a mental illness. Preceptorship has been widely used both nationally and internationally for clinical practicum. Although this model seems to have been endorsed by virtue of its increasing use, additional examination is necessary to assess efficacy and effectiveness across clinical practicum, including those in mental health settings. In utilizing a grounded theory approach, this study addresses the question: what is the experience of preceptorship for undergraduate nursing students in the mental health setting? The major themes identified include: 'fear of the unknown', 'reconciling difference between general acute health and mental health settings' and 'supporting practice'.

Barriers to exercise prescription and participation in people with mental illness: the perspectives of nurses working in mental health.

ACCESSIBLE SUMMARY: Exercise is valuable in the treatment of mental illness, yet personal and organizational barriers limit widespread implementation by nurses in mental health settings. Using a self-report questionnaire, we sought to identify how often nurses prescribe exercise and their level of agreement with previously identified barriers to exercise prescription and participation for mental health consumers. Nurses disagree that many of the previously identified barriers should impede exercise prescription for people with mental illness. Nurses agree that many of the barriers expressed by mental health consumers might prevent exercise participation. Our study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness; however, it is limited to a small sample. Confirmation of these findings in larger, geographically and professionally diverse groups is needed. ABSTRACT: Evidence is mounting for the efficacy of exercise in the treatment of people with mental illness. Nurses working in mental health settings are well placed to provide exercise advice for people with mental illness. However, quantitative examinations of the barriers to exercise prescription experienced by nurses, or their views regarding the barriers to exercise participation experienced by people with mental illness, are lacking. In this study, 34 nurses completed the Exercise in Mental Illness Questionnaire-Health Professionals Version (EMIQ-HP). This survey examined the frequency of exercise prescription and the level of agreement with statements regarding barriers to exercise prescription for, and exercise participation by, people with mental illness. The level of agreement scores for statements for each section was summed, with a higher score indicating a higher level of agreement. Nurses disagree with many of the barriers to exercise prescription presented in the literature. The level of agreement scores did not differ between nurses who prescribe exercise 'Always', 'Most of the time', 'Occasionally' or 'Never'. We found a non-significant negative relationship between frequency of exercise prescription and summed level of agreement scores for barriers to exercise prescription. Consensus regarding barriers to exercise participation by mental health consumers is less clear. This study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness. Confirmation in larger samples is needed before translation of research to practice.

Enabling professional development in mental health nursing: the role of clinical leadership.

Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing.

Who will look after my grandmother? Attitudes of student nurses toward the care of older adults.

A review of the literature illustrates the unpopularity of nursing in the elderly population related to other areas of nursing practice. The aim of this article is to present the findings of a research project conducted in Victoria, Australia, investigating the career preferences of undergraduate nursing students. The results indicate caring for older adults is considered the least popular area of practice for Year 1 nursing students. The reason given by students for their choices demonstrates a negative view of this type of work, largely based on inaccuracies and misconceptions. The implications of these findings for the future care of elderly individuals are discussed.

Comprehensive nursing education in Victoria: rhetoric or reality?

Significant and widespread changes to the education of the psychiatric nursing workforce in Victoria, Australia are resulting in serious problems in the recruitment of new nursing staff. In reviewing the available literature, it is evident that undergraduate nursing students do not commence their educational program with a strong interest in pursuing a career in psychiatric nursing. In light of this knowledge, the role of education in providing a comprehensive view of the nursing profession becomes paramount. Research investigating the impact of education on the attitudes of students to psychiatric nursing as a career option has produced mixed and often inconclusive results. A longitudinal study was undertaken in Victoria, Australia. Students of the majority of universities in which undergraduate nursing programs were operating participated in this study. The participants were asked to rank nine areas of nursing specialty in order of preference at the commencement and immediately prior to the completion of the nursing program. Despite a significant improvement in the popularity of psychiatric nursing as a career choice, this area was ranked at number 8 at both pre- and post-program test. The analysis of open-ended questions demonstrated a marked change in the overall attitudes towards the mentally ill and psychiatric nursing.

Psychiatric nursing in Victoria, Australia: a profession in crisis.

The introduction of the Nurses Act in 1993 resulted in the cessation of separate undergraduate education as preparation for psychiatric nursing practice in Victoria, Australia. The focus of this paper is to present the nature and implications of the current legislation in light of the relative size of the psychiatric component within Victorian courses and the relevant literature and research findings regarding the position of psychiatric nursing within comprehensive courses. The potential crisis faced by the psychiatric nursing profession in securing a viable workforce for the future will be highlighted.

Psychiatric nursing: has it been forgotten in contemporary nursing education?

Contemporary nursing education in Victoria, Australia aims to produce graduates with the capacity for employment in all areas of nursing at beginning practitioner level. Despite this aim, psychiatric nursing occupies a relatively small proportion of undergraduate curricula. Research findings suggest that psychiatric nursing does not emerge as a popular career choice within comprehensive education. To prevent a crisis in nursing education, greater attention must be devoted to the theory and practice of psychiatric nursing, so that it can occupy a position of equal importance to other areas of nursing practice.

Who wants to be a psychiatric nurse? Novice student nurses' interest in psychiatric nursing.

Available research findings suggest that nursing students do not regard psychiatric nursing as a desirable future career option. This paper addresses the results of a research project conducted by the author. This research addresses the relative popularity of psychiatric nursing in comparison to other nursing specialties, within Victoria, Australia. The research was conducted by use of a questionnaire in which commencing undergraduate nursing students were asked to rank nine areas of nursing specialty in order of preference and provide some explanation for their choices. The results indicate that psychiatric nursing emerges as the second least popular career choice for student nurses at this stage of their education.

The role of a mental health consumer in the education of postgraduate psychiatric nursing students: the students' evaluation.

Recent Australian Government policy reflects the integral nature of active consumer participation to the planning and delivery of mental health services. The effectiveness of consumer participation in improving mental health services has received some attention in the literature. Commonwealth Government funding enabled the development of a partnership between the Centre for Psychiatric Nursing Research and Practice and the Melbourne Consumer Consultants' Group. The successful application enabled the employment of a mental health consumer as an academic staff member of the Centre for Psychiatric Nursing Research and Practice. One important aspect of this role involved the mental health consumer teaching a consumer perspective to postgraduate psychiatric nursing students. The primary aim was to increase the students' awareness of and sensitivity to greater consumer participation within the mental health arena. This paper presents the results of an evaluation of the consumer academic role in teaching within the Postgraduate Diploma in Advanced Clinical Nursing (Psychiatric Nursing). An evaluation form was distributed to students (n = 21) on completion of the semester. The findings suggest the experience was considered beneficial to students and was impacting significantly on their current practice. This project supports the value of consumer participation in the education of mental health professionals.

Patient satisfaction with psychiatric services provided by a Melbourne tertiary hospital emergency department.

The mainstreaming of psychiatric services within the general healthcare system has created fundamental changes to the manner in which patients access acute psychiatric services. This change was intended to reduce the stigma associated with psychiatric diagnosis and therefore contribute to improved treatment outcomes for patients. The aim of this paper is to discuss the results of a study designed to ascertain the level of psychiatric patient satisfaction with the services received in the emergency department of a Melbourne metropolitan hospital. The results indicate a high level of satisfaction, particularly with the availability of staff with psychiatric qualifications and experience to provident treatment, support and care. The major areas of dissatisfaction identified by patients included: lengthy waiting times, lack of privacy in the triage area and negative attitudes of general staff. These findings support the argument from the literature for psychiatric consultancy services to be available in the emergency department, and further identifies the need for triage guidelines to be tailored to the needs of mental health patients and for emergency department triage staff to be appropriately educated to adequately triage these patients.

An overview of the role and functions of a psychiatric consultation liaison nurse: an Australian perspective.

The role of the psychiatric consultation liaison nurse (PCLN) has increased substantially in popularity over the last few years. Despite the growth of this position, a paucity of literature regarding the role, functions and effectiveness of psychiatric consultation liaison nursing continues to exist. The current study was undertaken as part of the Victorian Nurse Practitioner Project. A significant aspect of this study concerned collection of data on the activities of the PCLN. This approach enabled an extensive and detailed profile of the PCLN to be formulated. The findings indicate that the PCLN provided a service to nursing, medicine and allied health in relation to patients experiencing mental health problems in the general hospital setting. Patients referred to the PCLN presented varied clinical features in terms of medical, surgical and mental health disorders. The PCLN performed a range of interventions. The results of this study make a significant contribution to address the current paucity of literature.

Consumer participation in mental health services: looking from a consumer perspective.

Widespread changes to the structure and delivery of mental health services have effected considerable change in the role of the service user or consumer. The view of consumers of mental health services as passive recipients of care and treatment is gradually undergoing a significant shift, in light of an increasing expectation that consumers be provided with opportunities to become actively involved in all aspects of their care. Consumer participation is now broadly reflected in government policy; however, to date there has been little exploration of the extent to which the policy is being realized in practice. To provide a greater understanding of these experiences and opinions, in-depth interviews were conducted with consumers of mental health services (n = 15). The interview transcripts were analysed through the identification and explication of major themes. The findings reinforce the need to view consumers as heterogeneous and respond to individual needs and interests regarding consumer participation. Despite variations in experience there is a clear need to develop mechanisms to support consumer involvement and to influence the attitudes of health professions to become more valuing of a consumer perspective. Nurses are in an ideal position to lead this process.

The mental health nurse: contributing to improved outcomes for patients in the emergency department.

Fundamental changes to health-care policy in Australia have led to an increase in the extent to which emergency department staff come into contact with patients experiencing mental health problems. This has been problematic for nurses, many of whom perceive themselves as lacking the skills and expertise to provide appropriate care and treatment to this client group. Psychiatric/mental health consultation-liaison nursing within the emergency department is becoming established as a means to overcome some of the problems identified. Despite this growth there is a paucity of literature evaluating the effectiveness of this position. This paper presents the results of an evaluation of the mental-health consultation-liaison nurse role in an inner city teaching hospital in Sydney Australia. The survey involved a three stage approach to data collection. The data collected at the commencement of the position included focus groups to ascertain the needs of emergency department nurses and a questionnaire designed to measure the skills, confidence and perceived knowledge of emergency department nursing and medical staff. An evaluation of the satisfaction of nurses and doctors was conducted towards the end of the three month pilot programme. The results confirmed the need for positions of this type and suggested a high level of satisfaction with the service provided.

The triage of psychiatric patients in the hospital emergency department: a comparison between emergency department nurses and psychiatric nurse consultants.

The triage of patients in the hospital emergency department (ED) has developed as an efficient method to determine the level of urgency and provide appropriate care and treatment. The triage process has been found to be less effective for patients presenting with mental health related problems. Triage guidelines specifically tailored for mental health needs have been introduced in the attempt to overcome existing problems, however, the effectiveness of these guidelines has not been extensively tested. This paper presents the findings of a study conducted in a large metropolitan hospital in Melbourne, Australia. All presentations to the ED for psychiatric problems (n = 137) were triaged using the mental health guidelines over a 3-month period. The same presentations were triaged by psychiatric nurse consultants employed in the ED and the results compared. The results indicate a high level of difference in the triage ranking by the two groups of nurses, with emergency nurses tending to classify presentations as more urgent than their psychiatric nurse colleagues. These findings suggest that mental health education for emergency nurses is necessary if the guidelines are to be used effectively and improve outcomes for patients presenting with psychiatric problems.

Problem-based learning: providing hope for psychiatric nursing?

Problem-based learning has been recognised as an educational method designed to facilitate student motivation and interest in clinically-based situations in order to increase their problem-solving capabilities. This paper describes the author's experience with the development and implementation of problem-based learning for the study of psychiatric nursing. The results of student evaluation suggest that this approach has been successful in fostering the interest of students in the skills and knowledge of this field of practice. More specifically, a stronger interest in pursuing psychiatric nursing as a career has emerged. This is particularly important in view of the negative image which the majority of undergraduate nursing students appear to hold towards psychiatric nursing as a career option.

Can educational methods influence the popularity of psychiatric nursing?

The ongoing difficulty of attracting sufficient numbers of undergraduate nursing students to a career in psychiatric nursing has been acknowledged. Limited available research suggests that education can produce a more positive view of psychiatric nursing. Despite these findings, research into the impact of educational methods upon the popularity of psychiatric nursing has not been undertaken. This paper reports the findings of a quasi-experimental research project, which examined the relationship between the study of, and the popularity of, psychiatric nursing. The results propose that through undertaking the psychiatric nursing program, psychiatric nursing as a future career option became more popular. The greater significance of the results of this study than had been found in previous studies suggests that problem-based learning is an educational method capable of influencing the development of more positive attitudes.

Student interest in perioperative nursing practice as a career.

Perioperative nursing is in crisis because of the difficulty recruiting sufficient numbers of graduate nurses and the threat of nonnursing employees performing traditional nursing duties. The relative unpopularity of perioperative nursing as a career choice for graduate nurses is commonly attributed to little exposure to the specialty's theory and practice in undergraduate nursing education programs. This article discusses results of a longitudinal study's first phase to ascertain career preferences of undergraduate nursing students. Findings suggest that when students begin nursing programs, they consider perioperative nursing a favorable career option. Few studies regarding student nurses' attitudes toward perioperative nursing exist, making these results significant.