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Implementing cultural safety to enhance the care of mental health service users
Culture plays an important role at every level of healthcare and in every healthcare encounter. Cultural factors significantly affect the interactions between mental health nurses and service users, the experience of mental health service users and ultimately their health-related outcomes. The concept of cultural safety originates from the work of Maori nurse leaders in New Zealand. It builds on concepts such as transcultural nursing, intercultural competence, cultural congruence and cultural competence, enabling a deeper exploration of the underlying issues of inequality affecting people from minority groups. Implementing cultural safety in mental health nursing practice can enhance the quality of care by promoting culturally sensitive communication and prompting nurses to better accommodate the needs of service users.This article discusses the concept and benefits of cultural safety in the context of mental health nursing and explains how mental health nurses can use cultural safety to enhance the experience and health-related outcomes of service users with diverse cultural backgrounds.
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The Me first communication model
This article explores communication and decision-making with children and young people in healthcare. Children and young people report that healthcare professionals are good at explaining and helping them to understand what will happen to them, but that they do not feel involved in decision-making about their care or treatment. To improve communication with children and young people, they need to be involved in decision-making about their care and treatment. In partnership with children, young people and healthcare professionals Common Room Consulting, Great Ormond Street Hospital for Children NHS Foundation Trust and Health Education England have co-produced a communication model, Me first, to support decision-making with children and young people in health care. This article introduces the Me first model and explores how it can be applied in clinical practice.
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Supporting people who are experiencing domestic abuse
Supporting the health, well-being and safety of people who are experiencing domestic abuse can be a life-saving intervention and is an important part of the mental health nurse’s role. This article details best practice in safely assessing and supporting these people, and outlines the associated indicators and the potential effects that domestic abuse can have on health. The article also details the actions that mental health nurses can take to improve the care of victims, and explains the importance of effective communication skills, risk management and record-keeping.
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Identifying and managing patients with disease-related malnutrition in primary care
Disease-related malnutrition can be challenging to treat. A disease, its treatment or the consequences of treatment can cause patients to experience a reduction in appetite and the desire to eat, resulting in an inability to consume sufficient food and drink to maintain or improve nutritional status. This article summarises a four-step approach to identifying and managing patients with disease-related malnutrition, and details how community and primary care nurses can effectively identify and manage the underlying causes of malnutrition and assist in advising on dietary modifications to enable enhanced patient outcomes.
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Supporting women’s sexual safety in acute mental health settings
Sexual safety in mental health settings is being increasingly recognised as a complex issue and a crucial aspect of organisational and practice responsibilities. However, concerns have been raised in relation to sexual safety for service users admitted to mental health inpatient wards in the UK. While sexual safety is a concern for everyone, the experiences and nature of concerns may vary across different groups and between individuals. It is also acknowledged that although interest in sexual safety is increasing, there remains limited evidence available from the perspectives of those who use mental health services. This article defines sexual safety and discusses its various components, and discusses a project that was undertaken to explore women’s perspectives and experiences of sexual safety in inpatient mental health settings. It also provides recommendations for maintaining sexual safety in clinical practice.
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Nurse prescribing: developing confidence, autonomy and collaboration
Nurse prescribing has been introduced in many countries with benefits for patients, prescribing clinicians and healthcare systems. However, nurse prescribing is not without challenges and the role of nurse prescriber has been debated. Some nurses may be reluctant to take on the role because they are concerned about making prescribing errors, acquiring sufficient knowledge and skills, or having to give up some of their other nursing roles. This article discusses the fundamental requirements for nurses to become effective and safe prescribers, a process underpinned by developing confidence, autonomy and collaboration – in particular with prescribing mentors. This article is written from the combined perspectives of the Australian and UK contexts.
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Sexual violence: a trauma-informed approach for mental health nurses supporting survivors
It has been recognised that there is a likely high prevalence of trauma originating in sexual violence among people who receive care in inpatient mental health settings. Mental health nurses working in inpatient settings are therefore highly likely to encounter, knowingly or not, survivors of historical and/or recent sexual violence in their practice. This article enhances mental health nurses’ understanding of the effects of sexual violence on survivors, explains the principles of trauma-informed care, and outlines strategies that nurses can adopt to promote the recovery of service users who have experienced sexual violence.
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Management of indwelling urinary catheters for people with learning disabilities
The insertion of an indwelling urethral catheter is a considered, invasive intervention that places the patient in a position of increased vulnerability. It requires the nurse to have the knowledge, skills and understanding to prepare and perform the procedure while supporting the patient. Such a procedure may evoke a range of emotions and responses in a person with a learning disability. It is important that nurses address the needs of the individual and tailor the care to their needs in a sensitive and respectful manner.
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Supporting people with dementia who mobilise excessively around and outside of the home
Family carers of people with dementia often report that the person they care for appears to ‘wander’ around or wants to leave the home. Community nurses are in an ideal position to offer guidance and support to carers who may not understand this behaviour. This article discusses the potential reasons why people with dementia may be increasingly mobile and/or walk with purpose. It provides information for community nurses on how they can support and advise family carers. It also details practical measures that can be taken to ensure the safety of people with dementia, in a person-centred and compassionate manner.
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Using team formulation in mental health practice
Formulation is a process of developing an understanding of what is happening for a person and why, and therefore what might be helpful for them. It involves gathering information, drawing from personal meanings and theoretical understandings to develop a coherent narrative. Traditionally, formulation is undertaken by a practitioner and a service user on an individual basis, but it can also be undertaken in a team context.This article explores team formulation, outlining its ideas, implementation and potential effects. It describes some of the evidence, outlines some techniques that can be used and reflects on team formulation in practice. However, it is not a systematic review of the evidence. It is hoped that this process will enable readers to develop an enhanced awareness of the concepts and issues involved, feel more confident engaging in team formulation and recognise the challenges and value that it can bring to clinical practice.
