Category Archive Values based practice mental health nursing


Values based practice mental health nursing

Values-based education is believed to improve interpersonal relationships between staff and patients and carers. Two Scottish health boards set up training courses. A pilot programme successfully engaged large numbers of people in discussing and challenging the competing values that underpin mental health nursing practice. This was followed by a recommendation that using a values-based approach to mental health nursing improved interpersonal relationships between staff and patients and carers.

values based practice mental health nursing

Nursing Times ; 15, A values-based approach to nursing involves taking into account values as well as the evidence base when making decisions about care. A recent recommendation proposed that taking this type of approach to mental health nursing would help develop interpersonal relationships between nurses and patients Hewitt, These relationships have been described in the literature as the core of practice in mental health nursing Dziopa and Ahern, The Scottish Executive Health Department undertook a review of mental health nursing with the aim of improving experiences and outcomes of care for service users and carers.

The review consisted of a five-year action plan, made up of 24 action delivery points. The first of these action points is to ensure all mental health nurses have undertaken values-based training, and that mechanisms are in place to include values-based practice in personal development plans and clinical supervision.

The focus on values-based practice came from an evaluated pilot programme based on the 10 Essential Shared Capabilities ESCs Brabben et al, Box 1. Spanning both values-based and evidence-based practice, the ESCs provide an explicit benchmark of the core attitudes, skills and knowledge needed for the entire mental health workforce. It was expected that the ESCs would be incorporated into staff appraisals and personal development plans and with all types of pre and post qualification training for people working in mental health services.

An ESC Learning Pack for Mental Health Practice was developed and piloted as part of an overarching implementation plan to introduce the mental health workforce to the ESC core skills, attitudes and knowledge needed to deliver best practice. The pilot successfully engaged large numbers of people in discussing and challenging the competing values that underpin mental health nursing practice. A nine-day training for trainers course was delivered to mental health nurses by a voluntary sector alliance Penumbra and Health in Mind.

Both trainers felt it was important to deliver the training away from the clinical environment to encourage participants to feel valued and more able to reflect on their work environment away from clinical disruptions. The trainers created an environment where discussion was used to acknowledge and challenge attitudes in the workplace openly. Discussion was at times difficult to facilitate; the training was mandatory for mental health nurses in both boards and not all who attended were willing to share their values.

The majority of the participants were able to share good practice, network and improve their understanding of the 10 ESCs. A variety of training styles were used, including working in both small and large groups, role play, PowerPoint presentations and reflection on lived experiences.Metrics details.

Professional values of nursing students may be changed considerably by curricula. By using the stratified random sampling method, nursing students were included in the study. In light of the low importance of some values for nursing students, additional strategies may be necessary to comprehensively institutionalize professional values in nursing students. Peer Review reports. Values are goals and beliefs that establish a behavior and provide a basis for decision making [ 1 ].

In a profession, values are standards for action that are preferred by experts and professional groups and establish frameworks for evaluating behavior [ 2 ]. Nursing is a profession rooted in professional ethics and ethical values, and nursing performance is based on such values. Core values of nursing include altruism, autonomy, human dignity, integrity, honesty and social justice [ 3 ].

The core ethical values are generally shared within the global community, and they are a reflection of the human and spiritual approach to the nursing profession. However, the values in the care of patients are affected by cultural, social, economic, and religious conditions dominating the community, making it essential to identify such values in each country [ 4 ].

Professional values are demonstrated in ethical codes [ 5 ]. In fact, ethical codes clarify nursing profession practices, the quality of professional care, and professional norms [ 2 ]. Advances in technology and expansion of nursing roles have provoked complex ethical dilemmas for nurses. Such dilemmas, if not dealt with properly, negatively affect the ability of novice nurses to make clinical decisions [ 6 ].

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With the ever-increasing number and complexity of ethical dilemmas in care settings, promotion of professional values has become more crucial in nursing education. The acquisition and internalization of values are at the center of promoting the nursing profession [ 2 ].

When values are internalized, they will become the standards in practice and guide behavior [ 7 ]. Values can be taught, modified and promoted directly or indirectly through education [ 8 ]. Each student enters the nursing school with a set of values that might be changed during the socialization process [ 9 ]. Purposeful integration of professional values in nursing education is essential to guaranteeing the future of nursing [ 1011 ].

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One of the significant consequences of teaching ethics and professional values to students is increasing their capacity for autonomous ethical decision-making [ 12 ]. Nursing students acquire professional values initially through the teaching of their school educators and the socialization process.

Professional socialization is the method of developing the values, beliefs, and behaviors of a profession [ 13 ]. In their study, Seda and Sleem reported a significant relationship between professional socialization of students and improvement of professional values [ 9 ]. Through professional socialization, which results in the complete acquisition and internalization of values, nursing students should acquire necessary skills and knowledge in cognitive, emotional, and practical dimensions.

Presently, however, less attention is paid to the emotional dimension in the formation of values compared to the other two [ 14 ]. At this level, stabilization of values requires passage of time [ 15 ]. Studies have shown that education causes differences in the formation of professional values, and that nursing educators have significant influence on the stimulation of professional values [ 8141617 ].

In addition, the ability to make ethical decisions was reported to be stronger in students who had passed an ethics course compared to those who had not [ 18 ]. Therefore, nursing educators play a key role in determining the future way in which nurses grow professionally and are prepared to confront new, unavoidable challenges [ 9 ].

Aesthetics in Mental Health Network (AiMH)

Students may increase their commitment to professional values directly through role playing and indirectly through observing behaviors related to professional values [ 14 ]. Nursing educators are effective role models because of their clinical skills, sense of responsibility, professional commitment, and personal characteristics such as kindness, flexibility, and honesty. Nursing educators enhance creative learning by encouraging critical thinking and decision-making, establishing a supportive learning environment, having technical and ethical knowledge, and providing opportunities for fair evaluation and feedback.

Nursing educators should teach nursing students effective strategies to confront ethical dilemmas [ 12 ]. Therefore, nursing educators are able to educate graduates who are ready for decision-making and can effectively deal with daily ethical challenges.

This study is a part of a larger study. The results of the first part was published in previous study [ 21 ].Gemma Stacey is a lecturer in mental health; Kirsty Johnston is a research associate;Theo Stickley is associate professor, all at University of Nottingham, division of nursing, Nottingham; Bob Diamond is a clinical psychologist, Nottinghamshire Mental Health Trust. Stacey G et al How do nurses cope when values and practice conflict?

Nursing Times ; 5, early online publication. Background A lack of opportunity to express values in nursing practice and a conflict of ideals with organisational constraints are associated with low job satisfaction and high attrition rates.

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Aim To explore the stories of mental health nurses in inpatient settings to find how values influence their experience of nursing practice.

Participants described values that were consistent with a commitment to person-centred nursing care and professional and ethical principles expected by external governing bodies. Conclusion Mental health nurses are aware of the dissonance that arises when there is a conflict between their values and their practice. They respond to this in a variety of ways, notably through acceptance, rejection or innovation. Having to cope with conflict over values may affect capacity to work with people in distress.

Conflict over values could explain the high levels of stress and attrition in mental health nursing. Values have a major influence on the actions of practitioners and are integral to socialisation and the consequent development of professional identity Woodbridge and Fulford, ; Fagermoen, It is unsurprising, therefore, that the significance and role of values in mental health practice has gained momentum in UK policy Department of Health, a; However, a lack of opportunity to express values in nursing practice and a conflict between values and organisational constraints have been strongly associated with low job satisfaction and high attrition rates Forsyth and McKenzie, ; Takase et al, While there has been much commentary on the low morale and disillusionment of the nursing workforce in general DH,there is less on mental health nursing.

Nurses often experience conflict between the values they hold and develop during their education and their ability to apply them in the workplace Kelly, Instrumental to this is the process of professional socialisation.

This has been frequently criticised as it does not adequately recognise the influence of the values and assumptions about the profession held by students when they start training Fitzpatrick et al, ; Du Toit, This involves nurses internalising the values, norms and expectations of the profession. Simpson and Back suggested that socialisation has three stages. It begins with pre-socialisation, where values are shaped by societal groups and public perceptions of nursing.

This is followed by formal socialisation, where students learn to behave in an appropriate professional manner. The process is completed during post-socialisation, where the outcomes of formal socialisation are applied to practice.

Du Toit said that values change through the professional socialisation process. Bradby maintained that, when student nurses qualify, they go through a process of change to move from having one social status to another.

This early role conflict has been observed in some depth and it is acknowledged that the transition to qualified nurse is ill defined Holland, Kelly suggested that, if newly qualified nurses believed they were not living up to their moral convictions, this could lead to moral distress and self blame.

Here, they become aware of the discrepancy between their perception of what constitutes good nursing and what they observe in practice, and they cope with this by redefining their perceptions of their role. Several studies recognise the danger of newly qualified nurses becoming desensitised to poor nursing practice habits and adopting them as their own Mackintosh, ; Holland, It has been suggested that this can lead to a willingness among students to shift their self-identity to justify the loss of ideas and become proficient in their new role Mackintosh, Denzin described a narrative as a story that tells a sequence of events.

These events are significant to both the narrator and audience. Narrative inquiry is a research method used to understand how people think through events and what they value.Should you need additional information or have questions regarding the HEOA information provided for this title, including what is new to this edition, please email sageheoa sagepub. Please include your name, contact information, and the name of the title for which you would like more information.

For assistance with your order: Please email us at textsales sagepub. This is an extememly useful and readable book that enables students on the AMHP programme to revisit their knowledge and understanding of values and ethics in mental health practice and to reflect on how they apply them to their own practice as mental health professionals.

It covers current issues in mental health practice particularly the concept of positive risk taking and the issue of values and ethics in mental health law which are particlarly relelevent to the AMHP role. Skip to main content.

September pages Learning Matters. Download flyer. Description Contents Reviews Preview This book draws on both the historical context and contemporary research evidence to present the roles of the Mental Health Social Worker, the Approved Mental Health Professional and Best Interest Assessor, within an ethical framework.

Codes of practice and statutory legal requirements, such as the Mental Health Act, Mental Capacity Act and the Human Rights Act, are all considered and linked to a competency-based approach that will assist both those in training and those in practice to understand the dilemmas, complexities and conflicts that are evident in the practice environment. A clear and informative guide to understanding the complexities of values and ethics.

Mr Gary Souter. March 10, Report this review. Mrs Karen Wild. School of Nursing and Midwifery, Keele University. March 17, Helpful text. Mr Stefan Brown. June 21, Mrs Mary Macdonald. April 19, For instructors.

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Values Based Practice: the theory

Select a Purchasing Option Electronic version. ISBN: Related Products. Demystifying Mental Capacity. Practising Quality Assurance in Social Care.Metrics details. Multiple electronic databases were searched using comprehensive terms.

Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative, narrative synthesis of study findings was conducted.

Fifty-one papers covering studies from 41 unique samples including mental health nurses in 14 countries met inclusion criteria. Forty-two Eleven were intervention studies; 40 were cross-sectional. Observational and qualitative studies were generally of good quality and establish a baseline picture of the issue. Intervention studies were prone to bias due to lack of randomisation and control groups but produced some large effect sizes for targeted education innovations.

Comparisons of international data from studies using the Physical Health Attitudes Scale for Mental Health Nursing revealed differences across the world which may have implications for different models of student nurse preparation. Contemporary literature provides a base for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes.

At the same time, developments are needed which are congruent with the needs and wants of patients. Peer Review reports. People with a mental disorder diagnosis are at more than double the risk of all-cause mortality than the general population.

Most at risk are those with psychosis, mood disorder and anxiety diagnoses. Median length of life lost by this group is While risk of unnatural causes of death, notably suicide, are greatly increased in this group, it is death from natural causes that remains responsible for the vast majority of mortality.

In people with schizophrenia, for example, cardiovascular disease accounts for about one third of all deaths and cancer for one in six, while other common causes are diabetes mellitus, COPD, influenza, and pneumonia [ 2 ]. A relatively high rate of tobacco smoking in this group is implicated in significant increased mortality [ 3 ], as is obesity [ 4 ], exposure to high levels of antipsychotic pharmacological treatment [ 5 ], and mental disorder itself [ 1 ]. Accordingly, the physical health of patients with mental disorder has been prioritised, becoming the focus of guidelines for practitioners in general [ 6 ] and for mental health nurses and other clinical professionals specifically [ 789 ].

However, while policies and guidelines are necessary prerequisites of change they must also be implemented in practice if they are to have a positive effect; one of the key barriers to change implementation for mental health nurses has been identified as lack of confidence, skills, and knowledge [ 10 ].

Robson and Haddad [ 11 ]: p. Since then, there has been a tangible and growing response among mental health nursing academics and practitioners. There has also been an upsurge in the amount of related empirical research. Further, studies about the effectiveness of interventions designed to improve their delivery of or attitudes to routine physical healthcare have not been systematically appraised. A systematic review of the literature following the relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [ 21 ].

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Since the review scope encompassed questions about experience and effectiveness a dual literature search strategy was developed. For studies of the effectiveness of interventions to improve or change mental health nurse-related outcomes a Population Intervention Comparator Outcome PICO structure was implemented Population: mental health nurses; Intervention: any intervention including physical health-related education, policy or guideline change; Comparator: any or none; Outcome: any [ 22 ].Medicine is replete with emotive images and processes.

These occur in everyday practice, from small day-to-day interactions as well as more pronounced issues of life and death. People immersed in healthcare environments can be deeply moved and respond in aesthetic ways.

All groups concerned with healthcare — service users, service providers and those working at an organisational level — share experiences of encounters with each other and with their environments. Developing an aesthetic awareness in and through such encounters may enhance reflection on values and steer thoughtful, empathic care-giving to re-humanise practice. This is nowhere more important than in the context of mental healthcare. Aesthetics in Mental Health AiMH is a lively new trans-disciplinary network that seeks to extend and enhance aesthetic responsiveness in the context of healthcare and thus to improve mental health and wellbeing among both service users and service providers.

Arising from the concluding discussion in our first meeting the AiMH Network has the following objectives:. We seek to advance these objectives through networking and with regular meetings to share developing ideas and experience. For further details please click here.

values based practice mental health nursing

The AiMH Network was set up to act as a focus for the growing number of people and groups drawing in different ways on aesthetics in mental health. Network members are working in a variety of trans-disciplinary ways between the arts and humanities that raise aesthetic awareness in the clinic. The Network seeks to build strong links between theory and practice. Members include academics and both service users and service providers. Although based in the UK and Austria our members come from many other parts of the world representing a wide variety of both research and service development projects.

For a list of current members please click here. If you are interested in joining the Network please contact us.

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New research on developing arts practice-based ways of enhancing reflection on empathic understanding in health care education. Helena Fox Co-Lead of the Aesthetics in Mental Health [AiMH] Network is looking for students or practitioners from any area of health or social care to help with her zoom-based research. The study now has ethics approval. Click here for further information. Home Who Are We? Aesthetics in Mental Health AiMH is a lively new trans-disciplinary network that seeks to extend and enhance aesthetic responsiveness in the context of healthcare and thus to improve mental health and wellbeing among both service users and service providers Objectives Arising from the concluding discussion in our first meeting the AiMH Network has the following objectives: Bring people together to explore, share and define experiences of working in an aesthetic mode in relation to mental wellbeing and health.

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Develop ideas that broaden knowledge about the complexities of subjective human experience through deeper sensory connection with self, each other, community and environment in the clinic.If ethical principles are insufficient to guide good healthcare, how should we respond to the conflicting values often present? It is the practical counterpart of the analysis of values in medicine proposed by Bill Fulford and discussed in Conceptual Issues in Nursing.

The main emphasis in VBP is that clinical decision making is not sufficiently guided by a framework of ethical rules and regulation, important as such a framework is, but depends also on learnable clinical skills to respond in a balanced way to a far broader range of diverse values. It provides a skills-based approach to balanced decision-making where, as is often particularly the case in mental health, complex and conflicting values are in play. Ten Principles of Values Based Practice.

But is it plausible to replace aiming at the right outcome with simply having a good process of deliberation? Is that merely subjective and if so is that a bad thing? And what of the value of using VBP is the first place? Fulford, K. Ten Principles of Values-Based Medicine.

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Nikoran Posted on10:12 pm - Oct 2, 2012

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