Nurse prescribing in specialist mental health (part 1): the views and experiences of practising and non-practising nurse prescribers and service users.

Non-medical prescribing is a relatively new competency that appears to benefit both service users and health professionals alike. However, little is known about its use in mental health settings. This single case study in one UK National Health Service (NHS) Trust aimed to look at these views and consider how the role can be developed further in light of this. Six service users and two nurses trained in nurse prescribing were individually interviewed. One trained nurse had been prescribing for the last 3 years; the other was trained but had never practised. Service users reported that nurse prescribing was more convenient and less anxiety provoking, an issue of particular importance for optimizing mental health services. Offering choice was deemed important; however, for some service users, information about why medication may be beneficial was highlighted as an unmet need in the prescribing process. The practising nurse prescriber described her experiences and credited a good structure of supervision and support from the team. Reasons why trained nurse prescribers may not be practising are discussed, with suggestions for future developments and guidance. This competence appears to work well in a mental health setting when conducted in a supported and structured way.

Nurse prescribing in specialist mental health (part 2): the views and experiences of psychiatrists and health professionals.

The establishment of working relationships between nurse prescribers and other health professionals, particularly psychiatrists offering supervision, can be a rewarding one. However there remains little guidance in terms of how this can be achieved and the opinions of those from different disciplines in specialist mental health teams. This study aims to look at the views and experiences of psychiatrists and other mental health professionals regarding nurse prescribing. Nine health professionals from a multidisciplinary mental health team attended a focus group; and two psychiatrists were interviewed, both with varying degrees of supervision experience. Psychiatrists reported concerns about prescribing in terms of themselves needing better support and communication, and perhaps having an involvement in the selection process. Nonetheless, the psychiatrist who had experience of supervision reported that this was highly positive. Overall, health professionals stated that nurse prescribing enhanced team working; however, most had limited knowledge about the role. Further training for teams, and the establishment of a good supervisory relationship and an agreed working structure are required to fully integrate this competency into specialist mental health services.

'Building a new normality': mothers' experiences of caring for a child with acute lymphoblastic leukaemia.

BACKGROUND: Treatment of childhood cancer occurs over a 2- to 3-year period, with initial intense phases of chemotherapy followed by less severe treatment periods. From first diagnosis, families are encouraged by healthcare professionals (following government guidelines) to try to maintain a normal life. The aim of this paper is to contribute to our understanding of how 'normal' family life is compromised from the perspective of the families themselves during this period of extreme stress and concern for the health and well-being of their child. METHODS: This study was longitudinal and involved a cross section of 32 mothers of children recently diagnosed with acute lymphoblastic leukaemia (ALL) currently participating in the Medical Research Council ALL-97 randomized control trial. Mothers were interviewed at three time points (3-4 months post diagnosis, 15 and 27 months) using a semi-structured format with open-ended questions. A qualitative methodology was employed to analyse interview data using Thematic analysis. RESULTS: Mothers reported understanding the importance of achieving normal life, but described how this was difficult to realize. At first interview, mothers were optimistic that they could achieve the 'normal life' as advised by healthcare workers. At 12 and 24 months, although all mothers reported that life was not back to normal, there were differences in how they perceived this lack of normality. Whereas some families experienced frustration and disappointment, others had adjusted and managed to accept the new order. CONCLUSIONS: Families felt encouraged on diagnosis to be told that despite the severity of the disease and treatment regime, a normal life was possible and should be pursued. Our findings indicate that over time, more concrete information is needed to guide parents through the treatment process in order to help them achieve this.