Category: Nursing

The 876 Group

When I upload blog posts to this site I use tags to help group items together. Today, having looked at the tag cloud created by WordPress I see that ‘Mental Health Nurse Academics UK’ appears in larger size than any other single word or phrase. This tells me that this is my single most-used tag, and I’m not surprised.

This week, over at the Mental Health Nurse Academics UK website, we’ve announced the election of Jim Turner as the group’s Vice Chair and Chair-elect. Jim will first be working in support of Fiona Nolan, who steps into the Chair position at the beginning of the new year following the conclusion of my term of office next month.

I was at the first-ever meeting of the group now calling itself ‘Mental Health Nurse Academics UK’, which took place on April 29th 2003 hosted at City University and convened by Len Bowers, Julie Repper and Mary Watkins. I’ve attached to this post the agenda for the meeting, which reveals how the group began its life linked to organisational arrangements in England, uniquely. That changed once those present determined that the group should simultaneously become both UK-wide and independent from any other organisation or government department.

Very briefly, as I recall, we referred to ourselves as the ‘876 Group’, which was the sum of the ages of all those present at the inaugural meeting. On the naming front, ‘Mental Health Nurse Academics Forum’ was toyed with, and my copy of a draft set of our first-ever terms of reference speaks tenatively of the ‘Assembly of Mental Health Nurse Academics’.

As ‘Mental Health Nurse Academics UK’ our group has grown as time has passed. Membership now includes people from over 70 UK higher education institutions, plus colleagues from other organisations sharing our interests and concerns. We have a number of Standing Groups, principally leading work in the three fields of Education, Research, and Policy and Policy. We’ve always aimed to be proactive, producing (right from the start) independent papers and statements, as well as taking opportunites to respond to consultations. Our first position paper was on post-registration education, and on our website we now have a long list of pieces we’ve produced over the years including evidence submitted to the House of Commons, editorials and journal articles, responses to the NMC, and a whole lot more. An often-referred to piece, written by Steven Pryjmachuk, introduces mental health nursing to people considering making applications for pre-registration degree entry.

I’ll continue getting to meetings once my term as Chair ends, and know that our next meeting (and possibly more) will again be convened online. Our last two meetings, in June and October 2020, were our most-attended: something no doubt related to the fact that they happened using videoconferencing software. For the future, Fiona and Jim are going to be a super combination leading the group onwards, and I’m wishing both all my very best and my support as they press ahead with their work.

Mental health policy, services and nursing in Wales

The COVID-19 pandemic has drawn attention to the existence of devolved government in the UK. Here in Wales we’re used to hearing from Mark Drakeford, but my guess is that it’s only in recent months that most people in other parts of the UK will have become actively aware of his role as First Minister, and indeed the authority held by the Welsh Government to create policy and to legislate. For a helpful discussion on all things Wales and COVID-related, here’s a link to an episode of The Bunker podcast on the same.

In a Wales-themed episode of #mhTV held in October 2020 I joined a discussion panel alongside Hazel Powell (Nursing Officer for Mental Health and Learning Disability in the Chief Nursing Officer’s team) and Michelle Forkings (Associate Director of Nursing/Divisional Nurse for Mental Health and Learning Disability in Aneurin Bevan University Health Board) to talk about policy, power and mental health health nursing. Here’s a link:

International Mental Health Nursing Research Conference 2020

This year’s International Mental Health Nursing Research Conference (#MHNR2020) happened over two weeks in September, as planned through #mhTV and with a whole lot of help from Dave Munday, Nicky Lambert and Vanessa Gilmartin. Along with everyone else who values this annual event I’m indebted to all three for the work they’ve put in over the months to make #mhTV happen, and to do so as an entirely free offering open to anyone with use of an internet connection.

I enjoyed my chance to join Mick McKeown as a co-host of #MHNR2020’s evening panel discussions, and the format of inviting guests to pre-record and upload their presentations ahead of bringing them together in themed groups worked well. Every pre-recorded presentation and panel conflab can be viewed on the conference webpage, and will remain there as a resource for the future. As it happens, I pitched up as a panel member on the evening of September 25th, speaking about findings from the MENLOC evidence synthesis in the area of end of life care for people severe mental illness.  As a shortcut, here’s a link to my pre-recorded presentation summarising our main findings:

Specialist practice in the community

For many years I led a Nursing and Midwifery Council (NMC)-approved post-qualification degree course for mental health nurses working in, or wanting to work in, the community. I wrote about the curriculum we developed in Cardiff, and was involved in two surveys of course leaders of programmes of this type which went on to be published here and here. Our Cardiff course, like others of its type, was recognised by the NMC (and by the NMC’s predecessor, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting) as preparing qualified nurses for ‘specialist practice’. Linked to a set of UK-wide standards, specialist practice was designated as practice beyond that expected at initial registration.

Most programmes of this type have long since disappeared, ours in Cardiff included, but the regulatory standards against which they were validated remain. The specialist practice qualification (SPQ) was first introduced in the 1990s, with the standards for SPQ in community nursing (including community mental health nursing) not being updated since the early 2000s. In 2019 the NMC commissioned an independent review into SPQ, with the final report from this exercise making clear how poorly understood these long-outdated standards had become and how much a root-and-branch review was needed.

A debate can be had on the extent to which standards for practice beyond those linked to professional registration should be prescribed by a regulatory body such as the NMC. For the professions of nursing and midwifery, however, no UK-wide bodies able to definitively set standards of this type exist other than the NMC; this is partly because we have no equivalents to the royal colleges, which exist to set and maintain standards for doctors preparing for post-registration practice in the various fields of medicine.

The NMC’s ongoing programme of work developing its standards has so far included the publication of an education framework, the Future Nurse standards of proficiency for registered nurses and new standards for student supervision and assessment. Now, following receipt of its independent evaluation of SPQ the NMC is embarking on a post-registration review. In August, through my membership of the All Wales Senior Nurse Advisory Group for Mental Health I took part in an NMC webinar and discussion on specialist practice in the community, convened as part of this wider post-registration programme of work. With work already happening in parts of the UK to more closely specify ‘advanced’ practice, such as through Health Education England’s Advanced Practice Mental Health Curriculum and Capabilities Framework, the NMC is stepping into an already-crowded space. It is in this context that consistency and joined-up policy and standards will surely be needed: which is something members of Mental Health Nurse Academics UK (me included) will continue to say as this programme of activity continues to progress.

#MHNR2020 joins #mhTV

Back in pre-pandemic January 2020, the idea that a couple of hundred curious mental health nurses and their friends might gather together to share their research, practice development, educational and related projects seemed quite unremarkable. At that time, with the aim of enouraging a gathering of this sort, I published a short post on this site promoting the call for abstracts for the 2020 edition of the International Mental Health Nursing Research Conference.

#mhTVHow much has changed since then. As an organising committee we made a relatively early decision to call off the face-to-face conference originally scheduled for June 11th at Middlesex University. Now, in May 2020, #MHNR2020 is being brought into a new initiative called #mhTV.

#mhTV owes its existence in no small degree to the energy of Dave Munday from Unite/MHNA and Nicky Lambert from Middlesex University and the first episode launched on May 21st 2020 as a collaboration between Unite/MHNA, the WeMHNurses Community, Mental Health Nurse Academics UK and the Centre for Coproduction in Mental Health and Social Care:

 

The #MHNR2020 scientific committee will be reviewing all abstracts submitted for the intended June 11th conference, and once this work is done we’ll be in touch with invitations for authors to consider turning their presentations into a format suitable for #mhTV. We’ll identify episodes selected in this way as part of #MHNR2020 and publish details on the MHNAUK website. In the meantime, more on #mhTV and on how to submit new ideas can be found here.

Catch-up post 3: research under lockdown

One of the consequences of NHS resources being mobilised so decisively towards meeting the threat of the novel coronavirus has been the cessation of much face-to-face nursing and health services research other than that connected with COVID-19. A response in March 2020 from the NIHR included the instruction to delay the setting-up of new non-COVID projects, and to pause ongoing studies, in order that the infrastructure supporting NHS research be brought to bear almost exclusively on efforts to tackle the pandemic.

In this context, I have also observed how the online survey has become the method of choice for researchers wanting to immediately understand the effects of the COVID crisis on wellbeing and work. In April 2020, a team led by Chris Bundy from the School of Healthcare Sciences in Cardiff University launched a coping during coronavirus survey, whilst a team including Healthcare Sciences’ Danny Kelly invited nurses to take part in the first of three planned surveys reporting experiences during the crisis. The Mental Health Policy Research Unit, meanwhile, has opened its programme of COVID-related research with a survey for people working in mental health services.

WCEBCMeanwhile, one type of research relatively unaffected by the coronavirus outbreak is the evidence synthesis. In Cardiff we have the Wales Centre for Evidence Based Care and, in the early months of 2020, I joined a team led by Nicola Evans and Wales Centre colleagues to start work on a synthesis of the evidence in the areas of service organisation, effectiveness and experiences for children and young people in mental health crisis. Our plans include database searching plus online searching for grey literature, policies and guidance. More to follow as the project unfolds, which in April saw us deep in title and abstract screening.

Catch-up post 2: Mental health matters in the pandemic

MHNAUK covidHere’s a belated catch-up post (the second of three), produced largely with the aim of revitalising this blogsite and summarising recent happenings. This one I’ve dated to March 2020, and the period in which UK was first locking down in response to the COVID-19 pandemic.

Towards the end of the month, Mental Health Nurse Academics UK (which I chair) published this statement on mental health nursing in the coronoavirus crisis. It addressed a number of areas: learning from people with early experience of caring for people with mental health problems and coronavirus infection; looking self and others; service responses and guidance for practitioners; the work of mental health nurses; supporting students; and research. I reflect how, in March 2020, relatively little was being said about mental health in the context of the pandemic. That’s changed, more recently, which I’ll perhaps return to in a later short post.

#MHNR2020 call for abstracts

NPNR 1The first Network for Psychiatric Nursing Research (NPNR) Conference took place in 1996, and the picture at the left is the front cover of the delegate’s handbook. My first visit to the NPNR conference, as a non-presenting delegate,  was not until a few year’s later and I’m grateful to Russell Ashmore (the conference’s unofficial historian) for sharing this scanned document. The first presentation I gave at the event was during its seventh running, in 2001 (there having been one year previously in which two events took place); this went with the title Tales from the field: using ethnographic methods to investigate the provision of community mental health care. A glance at my records suggests that, to date, I’ve been involved in 27 papers delivered at the event over the years, as presenter, co-presenter and/or co-author. It’s the single conference I always aim to be at.

The NPNR became the International Mental Health Nursing Research (MHNR) Conference for 2017, and this year’s 26th running takes place over one day, June 11th 2020, at Middlesex University. A call for abstracts has been published on the Mental Health Nurse Academics UK website, and is reproduced here:

MHNR2020

Celebrating Mental Health Nursing

Past, Present and Future

26th International Mental Health Nursing Research Conference

11th June 2020

Middlesex University

The Burroughs, London NW4 4BT

Call for Abstracts

Follow us on Twitter: @MHNRconf and join in using the hashtag: #MHNR2020

This event represents a collaboration between Mental Health Nurse Academics UK (MHNAUK) and Middlesex University School of Health and Education.

Diversity of presenters, participants and topics will be a priority therefore all presenters will be offered one free place in addition to their own paid attendance which should be used to invite a student, service user researcher, carer, newly qualified nurse or a colleague who hasn’t previously attended a conference.

Abstracts are invited for work based in clinical practice, teaching, activism or research.  Those looking at mental health more generally are also welcome, and options for presenting will be in the form of concurrent papers, symposia, workshops or posters under the following topics:

  1. Advanced practice: To include examples of expanded roles, skills and responsibilities for nurses in healthcare services.
  2. Celebrating mental health: To include any activities addressing the history of mental health work or professional identity.
  3. Building communities: To include examples of work to promote community resilience, mental health and diversity and to reduce stigma and discrimination
  4. Creative approaches: To include any examples of creative approaches to promoting wellbeing and mental health.
  5. Activism and social justice: To include examples of rights-based approaches such as addressing restrictive practices, upholding human rights and achieving equality of access and resource allocation for mental and physical health services.
  6. Working across professions and disciplines: To include examples of inter-professional and cross-organisational projects or services
  7. General mental health: Those which do not fall into any of the above can be grouped here

Key dates and registration information

  • Call for abstracts opens: 28th January 2020
  • Deadline for receipt of abstracts: 28th February 2020
  • Confirmation of acceptance: 20th March 2020
  • Programme announced: 6th April 2020
  • Registration fees: £130 (for attenders, where this fee includes a place for an attender’s guest)/£70 for students and mental health service users
  • Please register early as places are limited

Guidance for preparing abstracts

  • Title: Should be clear, with appropriate use of capital letters that is, at the start of the title and when using abbreviations (RCN not Rcn).
  • Theme: Abstracts will be considered for one theme only, so please select the one most suitable for your submission (see above).
  • Word limit: Please adhere to the word limit given below.
  • Abstracts for concurrent sessions and posters should be no more than 350 words.
  • Concurrent sessions will be 15 minutes in length, with a further 5 minutes for questions.
  • Posters should be visually stimulating. Presenters will be expected to make themselves available to speak with delegates during identified poster viewing times.
  • Abstracts for concurrent and poster presentations MUST adhere to the following criteria:
  • Abstracts reporting on the results of quantitative research studies must be structured: background, aim(s), method(s), results, discussion and conclusions.
  • Statistics including sample size and sampling method used must be supplied.
  • Relevant contextual information must be given (e.g. research setting).
  • For qualitative studies the abstract must be structured: background, aim(s), sampling method, method(s), specific analytical approach or approaches, main findings, discussion and conclusions.
  • Theoretical/methodological abstracts and practice and/or education developments must be structured: background, aim(s) of the paper, discussion and conclusions.
  • For all abstracts authors must specify how the paper contributes to mental health nursing research, education, policy or practice.
  • All abstracts must be written in English. NB All accepted abstracts will be published ‘as submitted’. It is therefore incumbent upon the author to ensure that the spelling, grammar and syntax are of an academic publishing standard.
  • Workshop (350 words) will be 70 minutes in length. The abstract should include the aim(s) and proposed outcome(s), content, rationale for delivering the session in this format, how it relates to the conference themes, and description of any activities in which delegates will be invited to participate.
  • Recommended reading lists: Provide up to five references relevant to your abstract. These should be cited in full using the Harvard referencing system, that: Author, I. (year) ‘ Article title’. Journal name in full, vol #, no #, pp 101-107.
  • Biography: Maximum of 100 words, written in the third person.
  • Presenter details and authorship: Please include author details as you would like them to appear in a conference abstract book: forename, surname, qualifications, job title, and place of work. Please put an asterisk (*) next to the presenting author(s).

All abstracts should be submitted using this form:

https://forms.office.com/Pages/ResponsePage.aspx?id=iHvjOKGjz0ifBWU3Qn_tJCry0moWADJGn573rM2pLp5UM1JPQzNHQkg5QkJITTI3RzNLT1FCQkNTWi4u

With this being the Year of the Nurse and Midwife #MHNR2020 is aiming to be the place for mental health nurses to share what they do, and to say why it’s important. I’ll be there, as always, and am looking forward.

Year of the Nurse and Midwife

yonmMarking the 200 years which have passed since the birth of Florence Nightingale, the World Health Organization (WHO) has designated 2020 as the International Year of the Nurse and Midwife. In this toolkit the WHO describes these two professions as ‘the cornerstone of the strong, resilient health systems needed to achieve universal health coverage’, and estimates a global nursing workforce of 22 million. That’s a big number, but according to the WHO is still nine million registrants short if sustainable development goals are to be met.

Many people within nursing are already using the WHO’s initiative to channel efforts to promote the profession, and to press the case for investment and expansion. This is excellent, but events to celebrate and advance nursing in the next 12 months must reflect the diversity of the profession, and do more than concentrate only on the (excellent) contributions made by physical health care nurses. Here in the UK we formally recognise four fields of nursing, of which mental health is one, but in the WHO’s toolkit referred to above there is no mention of nursing work in this area.

Mental health nurses can most definitely use 2020 to take, and make, opportunities to talk about what they do, and to say why this is important. Already-confirmed dates for mental health nurses to showcase their contributions include Mental Health Nurses’ Day on 21st February 2020, and a one-day International Mental Health Nursing Research Conference to take place on 11th June 2020 at Middlesex University. As always, for people wanting an accessible introduction to the work of mental health nurses, and on routes to degree-level preparation, this still-current post on the Mental Health Nurse Academics UK website remains as good a place to start as any.

Learning how to see: industrial action in universities and the nursing workforce

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Photo by @sarawhittam

I take the view that ‘everything is connected to everything else’, to use a phrase I recently learn is attributed to Leonardo da Vinci. More on him later.

Over the past week I’ve been involved in industrial action as part of #UCUStrikesBack. What I’m not going to do in this post is to explain why university staff are currently on strike, largely because this has already been adequately covered elsewhere (for example, see here and here). Instead, I want to share some picket-line reflections linking what happens in universities with what happens in the health service. These are connections which are not being made frequently enough, including by some who should know better.

As a mental health nurse academic I am acutely aware of the perilous position occupied by my profession in the NHS, with reports from earlier in 2019 pointing to a loss of 6,000 mental health nurses in NHS England since 2009. Below is a graph, created using NHS Digital data, which starkly reveals the current situation:

MHN numbers 2019As an aside, data of this type are not published here in Wales. They should be. In any event, quite correctly much concern has been expressed about this startling decline in the workforce, with mental health nursing now singled out as a group needing particular help to improve both recruitment and retention.

Reflecting my position as a health professional academic I hold joint membership of the University and College Union (UCU) and the Royal College of Nursing (RCN). The RCN, along with other health service unions like Unite and Unison, is trying to reverse the crisis facing the nursing workforce. It is campaigning on safe staffing, has published a manifesto to assist nurses wanting to interrogate prospective parliamentary candidates ahead of the December 2019 general election, and through its Fund our Future campaign is lobbying government to reverse the removal of tuition fee and living cost support for students of nursing in England.

These campaigns are important. So far, however, in its public pronouncements the RCN has failed to make the necessary connections between working conditions in universities and the present and future education of student nurses. Put simply, an adequate supply of educated, evidence-minded, person-centred nurses demands an adequate supply of secure, well-supported, fairly paid nurse educators and researchers. Nurse academics typically have career trajectories which are significantly different from those in other fields, with implications for their recruitment, retention and development. The modern norm for historians, physicists and sociologists seems to involve years of precarious, post-doctoral, employment characterised by repeated short-term contracts before landing (if ever) much sought-after full-time academic posts. In contrast, with some exceptions nurses are generally recruited into higher education by dint of their practitioner expertise, their posts linked to the servicing of courses of professional study. This was certainly how it was for me: my academic career commenced with an initial series of short-term employment contracts associated with the leading of a post-qualification course for community mental health nurses. In all universities, nurse academics can soon find themselves carrying major teaching and course management responsibilities, often for programmes and modules of study which run more than once across a single year. Demanding education and education-related workloads can squeeze out time for research, scholarship and wider engagement, in workplaces which traditionally value productivity in these areas for the purposes of career progression.

Expanding the number of nurses to fill the gaps which now exist, for which the RCN and others are rightly campaigning, requires thought and careful planning. In the run-up to the general election both are in short supply as nursing numbers become reduced to political soundbites. More student nurses must mean more nurse academics, but in any future rounds of staff recruitment potential entrants will have their eyes wide open. The erosion of university pensions relative to pensions in the NHS does nothing to encourage those contemplating the leap from health care into higher education (or, at least, into that part of the sector in which the Universities Superannuation Scheme predominates). Very reasonably, those considering future careers as nurse academics will also want to weigh up the appeal of doing work which is undoubtedly creative and rewarding with what they will hear about workloads, developmental opportunities and work/life balance.

I also learn, this week, that Leonardo da Vinci saw the making of connections as necessary in order that we might see the world as it truly is. In my working world, education, research and practice are intimately intertwined. It is disappointing that these connections are being missed by organisations which campaign on the state of nursing and the NHS, but which do not (as a minimum) also openly acknowledge the concerns that nursing and other academics have regarding the state of universities. Right now, some words of solidarity and support would not go amiss.