The perceived psychological stressors and coping behaviours in university students, on a pre-registration programme.

The purpose was to investigate perceived stressors and coping behaviours in student nurses on a pre-registration programme of study. Stress in student nurses has been identified with decreased emotional well-being and poor academic achievement. The significance of stress and coping behaviours in students during training has implications for education and practice. The present study recruited eighty seven pre-registration student nurses in a cross sectional design. Bivariate and multivariate analyses assessed the differences in field and year of study and the students’ perceived stress and coping behaviours. The findings showed that stress is a significant issue in nurse training. Fifty-three percent of the participants had levels higher than the mean. Interestingly, the present study found that high perceived stress was associated with avoidance behaviours. The most common type of perceived stress and ranked by highest factor were from written assignments and a lack of professional skills and knowledge. Their peer group and everyday life activities were shown as potential ways of coping with stressors. Thus, it seems reasonable to focus support on decreasing avoidant and enhancing stress-reducing behaviours. Psychological stress and coping behaviours must be considered together as perceived stress is bound by the ability to ameliorate stress by managing helpful and unhelpful behaviours. The findings may suggest that a potential benefit could come from the provision of helpful strategies such as peer group support and reduction of avoidant behaviours. Also, there seems to be a need for greater mental health literacy in dealing with stress during training

Perinatal mental health : preparing the future nursing workforce

Perinatal mental health (PMH) problems occur during pregnancy and up to a year after giving birth. They can have a significant effect on the mother and family, and can affect the social, emotional and cognitive development of the child. PMH nursing is gaining increasing recognition in national policy; additional funding has been announced to align national perinatal services with agreed standards and the perinatal workforce has been identified as an area of growth. The PMH competency framework published by Health Education England and the Tavistock and Portman NHS Foundation Trust, London, is aimed at training staff to deliver high-quality care to women who experience mental health problems during the perinatal period. However, the framework does not address the competencies required from the emerging workforce: nursing students. The pre-registration nursing curriculum must align with PMH competencies to ensure that nursing students become competent practitioners who are adequately prepared to care for the PMH needs of the mother and family

Should I stay or should I go? Stress, burnout and nurse retention.

Janet Scammell, Associate Professor (Nursing), Bournemouth University looks at problems retaining nurses

Implementing an Integrated Acute Response Service: Professional Perceptions of Intermediate Care

Purpose: The purpose of this study is to examine the implementation, care processes and sustainability of an integrated, intermediate Acute Response Team (ART) service. The primary aims of the service are to enhance the level of health and social care integration across a range of organisations, to ensure a timelier and appropriate service for people in the community at risk of admission to hospital. Design/methodology/approach: A qualitative methodology was employed in order to gain a deep understanding of the experiences of staff members within the ART service and external stakeholders. Twenty-one professionals took part in a focus group or one-to-one interviews. Data were analysed thematically. Findings: The key to successful implementation was that the service was co-created from the “ground-up” with support from local provider organisations. The inclusion of general practitioners (GPs) as part of the team was instrumental in setting up and maintaining the service and seems to be unique in intermediate care settings. Referrals into the ART service were dependent on awareness of the service at the interface with mainstream services. Transitions out were sometimes delayed due lack of availability of social care packages. To ensure sustainability of the ART and other integrated intermediate care services, continued resources, especially skilled staff members, are necessary. Originality/value: This study adds to the intermediate care and acute response service literature by offering insights into “what works” from a professional perspective in terms of service implementation, care processes and sustainability, in an integrated care system

Response to the article by Mitchell, P., Nightingale, J., and Reeves, P. (2019). Competence to capability: An integrated career framework for sonographers. Radiography

We would like to congratulate Mitchell, Nightingale and Reeves for their article on ‘Competence to capability: An integrated career framework for sonographers’ for providing a suggested framework for skills escalation for sonographers.1 This is particularly relevant to the current work being undertaken by Health Education England (HEE) to attempt to address the sonographer shortages in England2 and challenges faced by the introduction of a wider range of entry points to ultrasound practice

An exploration of the factors influencing career choice in mental health

Aims and objectives: To identify the factors that are associated with considering a career in mental health. Background: The mental health specialty is facing a recruitment crisis in the United Kingdom but there is limited evidence about which factors encourage and discourage people from considering a career in mental health. Design: Quantitative, observational, online survey using a multiple ordinal logistic regression model to identify if there were any significant predictors of the extent to which participants would consider a career in mental health. The design and write up of the study were guided by the STROBE checklist. Method: We gathered the views of 231 participants (female = 188, 81.7%) aged between 16–65 (mean = 22.7, SD = 8.9), using an online survey, the majority of whom were studying on, or graduates of, psychology/social studies degrees. Information was gathered about the extent to which a range of factors influenced consideration of a career in mental health. Results: The majority (71.2%) of participants reported that they would definitely or probably consider undertaking a career in mental health, and over half (51.4%) would consider a career as a mental health nurse. The ability to help others and receiving appropriate training required for the role were important career choice factors. Being female, having a mental health condition and greater knowledge of mental health were associated with a significantly greater likelihood of considering a career in mental health, while having had experience of working with people with mental health difficulties was significantly negatively associated. Conclusions: Students and graduates of psychology and social studies degrees appear to be a large, untapped recruitment pool for mental health services. Relevance to clinical practice: The results can inform more targeted recruitment strategies and development of suitable career pathways for those interested in a career in mental health

Solution Orientated Learning to build resilience in mental health nursing students and recently qualified nurses

With concerns about nursing students’ mental health and the retention crisis facing nursing, it is essential that staff working in nurse education develop effective responses to enable nursing students to acquire the skills, strategies and confidence that will sustain them throughout their education and beyond. The principles and interventions of solution-focused brief therapy can be applied in nurse education. The authors outline a solution-oriented learning (SOL) model and argue that it has the potential to build intrinsic motivation, promote deeper learning, strengthen support networks and empower nursing students. The SOL approach can be incorporated into a range of active learning experiences so that, over time, nursing students learn the SOL strategies and can use them independently to address broader personal and professional learning needs. The ability to take a positive, optimistic and structured approach may contribute to building resilience and sustaining nurses post-qualification, therefore contributing to nurse retention

An evaluation of a short course in mindfulness for Health Visitor Practice Teachers

Practice Teachers (PTs) participated in an 8 week course, Mindfulness Based Cognitive for well-being and resilience. The evaluation was undertaken using three (3) evidenced based questionnaires: Perceived stress(PSS) (Cohen et al 1983), Self-Compassion Score SCS (Neff 2003) and Five Facet Mindfulness Questionnaire (FFMQ) (Baer et al 2006) to identify outcomes for the mindfulness training. Findings indicate the impact on personal wellbeing and professional practice with recommendations for retention of students & Health Visitor (HV) workforce. Summary Mindfulness skills to support top performance and good mental health were offered in eight two-hour sessions to 18 Practice Teachers from September- December 2014 and was evaluated. The course drew on the approach of Mindfulness Based Cognitive Therapy, where participants learn to focus their attention and develop the possibility of creating the space for reflection and response rather than reacting to life’s difficulties. Participants had the opportunity to develop self–care and self-compassion in the sessions as well as in between sessions and which research has shown can have a positive effect on others. Compassion is a contemporary theme in the CNO’s strategy to return to the fundamentals of nursing; mindfulness enables the foundation of practising compassion on self and ultimately to practice compassion with others we work and care for. The attendees were encouraged to review and refresh their practice through with the ultimate planned outcome, to reduce student attrition and prevent breakdown of the practice placement. However, this is a the complex area of adult learning and the nature of student attrition from courses as well as from the workforce cannot necessarily be reduced to one factor. The practice of mindfulness can have an influential effect on health, well-being and resilience, as shown by scientific and medical evidence. This experiential course was neither therapy nor religious instruction but an effective means of helping to alleviate stress and promoting well-being, resilience and flourishing. The course was delivered at a time when practitioners, including PTs were experiencing an increase of student numbers and service delivery changes with associated imperative data collection. The perception of practitioners about the declared increase in the HV workforce (DH 2011) to support and implement these changes was not evident and the evaluation indicates the need for self-care and resilience in the workforce which includes students and practitioners. The project outcomes make recommendations based on the impact of this mindfulness training with PTs to inform future developments within the programme and practice education as well as the HV workforce where a number of interventions call for 'mindfulness' with infants, children and families

The transition to ‘patienthood’, the contribution of the nursing assistant: a grounded theory study

The face of nursing is changing, as health-care organizations are looking to new assistant roles to support the registered nurse and potentially provide a source for apprenticeship toward registration. These developments are within a context of an existing assistant staff group, delivering much of the bedside care. Few studies have explored the dyadic relationship between nursing assistant and patient, despite the potential for their interactions to contribute to the patient experience. This study aimed to gain an understanding of patients’ perceptions of the nursing assistant role using constructivist grounded theory. Constant comparison guided data collection and analysis, and 4 core categories emerged: expectation, observation, meaningful connections, and adaptation. Within these core categories, we suggest the assistant plays a part in how participants adapt from the known self to a self of patienthood and the overall patient experience. We conclude that there is a necessity to understand more fully the dyadic relationship between patients and nursing assistants