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In the recent years, concerning need of mental health nurses is seen in the UK due to the increasing number of mental health problems in the country. It is reported that 1 in 4 people in the UK are currently suffering from mental health problems each year in England for which they require care and hospitalisation (mentalhealth, 2022; Chapman et al., 2018). In 2019, it was reported that a number of adults aged 18 years and above with clinically significant distress raised from 20.8% in 2019 to 29.5% in 2020 (Gov, 2022). This indicates that a sharp rise in mental health problems is seen in the UK which is able to be managed by mental health nurses as they have expert knowledge and skills to accomplish the care. Mental health nurses work in varied environments and their role is determined based on their position at work (Greenberg et al., 2020). Moreover, the work schedule along with different patients determines the specific role to be played by the mental health nurse in supporting care for the patients (Greenberg et al., 2020).
The understanding of the role played the mental health nurses in supporting the recovery of individuals with severe mental illness is essential because it helps the service users determine the extent to which they would be assisted in the care for the promotion of their health (Chicoine et al., 2022; Poghosyan and Maier, 2022). It makes the family members of the patients suffering from severe mental illness understand the purpose of supporting the inclusion of effective mental health nurse in the care of the service users (NHS, 2022). Slade et al. (2019) inform that severe mental illness makes individuals unable to execute their everyday actions. This is because of the deteriorated cognitive condition which hinders them to perform effective thinking and execute everyday actions (Peter and Jungbauer, 2019). It makes the patients become burden of care for the family who intend to arrange care in secondary care placement to promote the health condition of patients. In this context, the understanding of the role of the mental health nurses in supporting patient recovery is important to lead the family members to understand the extent to which they would be relieved from the care burden and the other arrangement to be made in better health improvement of the patient (Bambra et al., 2020; Jones et al., 2022). Thus, the current study is essential to understand in detail the role of mental health nurses in supporting the recovery of severely mentally ill patients.
In this study, the electronic search strategy is followed in gathering required articles and journals to present valuable information regarding the topic. This is because electronic searching helps in the selection of valid articles about the raised problems in the study within minimum time and effort leading to save the researcher ample amount of time to be used in its critical review and presentation (Demmler et al, 2019). Moreover, the electronic search assists in exploring focussed topics from journals across the world to develop enhanced idea regarding the study. It assists in selection of freely available articles for the study in turn saving money to be spent in formulating the research. The platforms used for electronic search are CINHAL, PubMed and Google Scholar. The CINHAL is used as the platform because it contains highly reliable studies free of charge related to the medical and nursing topic to be easily accessed by the researchers (ebsco, 2022). PubMed is used because it contains link to full-text articles related to various biomedical topics making it a reliable platform to be used in executing the research (pubmed, 2022). Google Scholar is used because it provides direct citation of potential articles along with support identification of complied full-text studies from all biomedical fields to be used in critically presenting information in any study (scholar, 2022).
The search terms used in formulating the search on the platforms are “mental health nurse”, “psychiatric nurses”. “severe mental health”, “acute mental health”, “role”, “nursing responsibility” and others. The Boolean operators used in linking the search terms in developing a meaningful search are AND and OR. In the study, the inclusion characteristics followed in selecting articles are articles published on and after 2018, related to mental health nursing, contain primary qualitative information, fully accessible, academic and written in English language. The exclusion characteristics followed in selection of research articles are articles published before 2018, related to physical care, contain secondary information, only abstract is available, non-academic and grey literatures and not written in English. The articles published in the last 5 years are included and other excluded because within the time limit adequate new researches are made regarding the topic to present advanced and updated data. The use of backdated articles would result in the presentation of unreliable data which would tarnish the quality of the study.
The articles related to mental health research are included as the topic is related to exploring the role of mental health nurses in promoting the health of patients with severe mental illness. It did not focus on exploring both physical and mental health care and so the selection is being made. The qualitative articles are included because they present well-descriptive information to instruct the way mental health nurses play their role in promoting health of the patients with severe mental illness leading us to identify their potential impact in managing the care. The articles with secondary information such as systematic reviews and others are excluded because they may contain data which are presented based on the beliefs and analysis of the researchers that are beyond the actual perspectives of the participants in the original research. The articles written in English ae included and other are excluded as it is the main language spoken and understood in UK. Therefore, articles written in English would help the researchers and readers to refer them to understand the way information from them are currently presented in the study which would leave little space for confusion regarding the credibility of the study.
The PRISMA tool is used in reporting the results of the way research articles related to the current study are identified. It helps in demonstrating the traits considered in the selection of the articles (Page et al., 2021). The CASP tool is used to critically analyse the articles because it helps in determining the quality of the study, strength and limitation of the methods used in the study and the feasibility of use of the study in formulating any current research (CASP, 2022). On the basis of exclusion and inclusion criteria, a total of 6 qualitative related to the study are included in presenting the discussion. The ethical consideration in the study is ensured by presenting the original information from the articles in paraphrased form while referring the original author and year of publication of the study from which the information is taken for presentation. Moreover, no articles which are not ethically approved are included in the study to maintain effective ethical consideration.
In promoting the recovery of severely mentally ill patients, mental health nurses are found to have important role and purpose for the action. Nash et al. (2021) aimed to investigate the role of the mental health nurse in supporting improved physical and mental health recovery of patients with severe mental illness. The study used a qualitative approach with a semi-structured interview in gathering potential information. 9 general practitioners, 10 psychiatrists and 4 mental health nurses are included in executing the interview. The use of semi-structured interviews is beneficial because it helped in gathering detailed ideas regarding the role to be played by mental health nurses in supported enhanced health recovery of severely mentally ill patients (Matthes et al., 2020). The ethical consideration in the study is effectively followed which ensured moral actions are taken and legally approved methods are used in formulating the study. The results inform that mental health nurses have the role to working in collaboration with the general physicians and psychiatrists to deliver effective care and promoting health improvement in patients. The mental health nurse also has the role to monitor the physical health of the patient and make necessary changes in care to ensure their good health. The limitation of the study was that 4 out of 53 mental health nurses participated in the interview process indicating small sample of nurses are used to gather ideas regarding their role in care.
In comparison, the study by Hassan et al. (2020) aimed to explore the role of the mental health nurse in supporting the healthy behaviour of people with severe mental illness. The study design used is a secondary qualitative analysis of 30 mental health carers and patient interviews. The method is effective to be used because it helped in gathering critical overview of the topic. The ethical consideration in the study was effectively followed. The results inform that mental health nurses have the role in motivating patients to effectively use psychological, social and physical opportunities in care. Mental health nurses also have the role of observing health benefits of the patients along with promote knowledge and social support for the mentally ill patients in influencing their enhanced recovery. The mental health nurse has the role to create physical opportunities for the patients in developing routine behaviour required in managing their severe mental health condition.
In contrast, McAllister et al. (2021) aimed to execute a theory-informed complex intervention to understand the role of the nurse to be improved in making therapeutic engagement of the patients in the acute mental health ward. For this purpose, a theory-described approach is undertaken to integrate and adapt Behaviour Change Wheel and Experience-based Co-design. This is beneficial as it helps in gathering an effective understanding of the causal mechanism of treatment and effects along with contribution of mental health nurses in caring for acute mentally ill patients (Bielinska et al., 2022). A total of 14 service users, 2 carers and 12 clinicians in mental health environment are interviewed through semi-structured questionnaires to gather information. The ethical consideration in the study is effectively maintained and the semi-structured interview was beneficial approach. This is because it helped in gathering descriptive data regarding the study topic (Fritz et al., 2020). The results informed that mental health nurses in supporting recovery and developing effective therapeutic communication with acute mentally ill patients has the role of empowering the service users in taking their own care, improve team relations, ward culture and develop increased self-confidence in providing care. The roles can be developed with effective training, restriction in care, persuasion, education and others. The limitation of the study is that it is executed in a single ward due to the generalisation of the results is hindered. The study by Oates et al. (2021) aimed to investigate the perspectives of mental health nurses and psychologists in effectively playing their role to act as a responsible clinician to provide advanced care to the patient. The study used qualitative research approach in gathering information. It was effective because qualitative study approach assists in gathering subjective and objective information required in resolving the raised question. The study supported execution of 12 semi-structured interviews with four sub-themes being emerged. The thematic analysis of the facts in the study is beneficial as it helped in systematic presentation of data without duplication (Shanahan et al., 2019). The results reveal the mental health nurses have the role to present their best skills and experiences in meeting the needs and demands of the patients in supporting their recovery. The role also included expressing increased confidence in deciding and delivering care, working in collaboration with multi-disciplinary teams, dividing challenges in delivering care with professionals to be resolved and other things. The limitation faced in the study is that it reflects the opinions of few of the mental health nurses who are working at the same time due to which longitudinal data to determine the way their role changes with time for promoting recovery of severe patients remains unidentified.
In contrast, the study by Eldal et al. (2019) aimed to determine the role of mental health nurses in inpatient severe mental health context. The study used a qualitative approach in gathering descriptive information regarding the topic. A semi-structured interview was performed for a year with the involvement of 14 mentally ill patients. The follow-up data helped in determining the way ole of the mental health nurse changes with time. The results informed that mental health nurses are required to play the role of maintain effective therapeutic communication with the patients to determine their needs to be resolved through care in promoting their recovery. The mental health nurses also have the role to make the patients feel safer in care and take responsibility in maintaining their dignity to promote patient’s recovery in care. The barriers faced in delivering care by mental health nurses are lack of closeness with the patients, hindered patient -nurse relationships and others. The limitation of the study is that the participants are selected from a single healthcare unit due to which potential bias may be faced in recruitment of the sample.
In contrast, the study by Berg et al. (2020) aimed to determine the role of mental health nurses in providing safe clinical practice to patients in suicidal crisis as severe mental health conditions. The study used qualitative design with semi-structured interviews to identify the role of the nurses. The role of the nurses is determined from the views of the 18 patients who are admitted in the hospital. The ethical consideration in the study is effectively followed and informed consent from participants are taken. The results mention that mental health nurses have the initial role of making effective assessments of patients in suicidal crisis to determine their risk of being suicidal. The study further informs the nurses have the role to provide tailor-made treatment to the patients who are suffering from poor mental health. The mental health nurses also have the proactive role of developing adaptive practices to protect the suicidal individual from any further harm. The limitation of the study is that the role of the mental health nurse is not explained from the professional point of view and rather from the perceptions of the severe mentally ill patients who may not have effective judgemental decision to effectively mention the roles to be played by nurses in supporting their recovery.
Implication for Practice
The evidence added to the knowledge base to be later implied in practice is understanding ways mental health nurses are to take proactive measures in protecting individuals with severe mental illness from any risk of harm or abuse. It supports in meeting the NMC Code which mentions that the nurses are responsible to protect patients from any harm or risk (NMC, 2018). The implication would be also useful in meeting the aspect of the Care Act 2014 which mentions that the nurses are to work effectively with the local authorities in protecting people from any risk of harm (legislation.gov.uk, 2014). The other evidence gathered to be implemented in practice is that mental health nurses have the responsibility to work collaboratively with the multi-disciplinary team to support recovery of severe mentally ill patients. This is because the collaborative working evidence indicated the way it supports sharing of care ideas and skills in helping mental health nurses develop support from experts in providing quality care to severe mentally ill patients without unnecessary challenges and barriers in accomplishing care. The other implication of the gathered evidence in practice is that it instructs the mental health nurses regarding the expected roles to be played by them as per the severely mentally ill patients. It provides them idea regarding the way satisfactory care can be provided by mental health nurses by meeting the expected roles and responsibilities to be played by them. The further information likely to be known is the expected team roles to be played by the mental health nurses while acting with the multi-disciplinary team in caring and promoting the recovery of mentally ill patients. The gaps identified in the current study is the lack of detailed explanation of role of the mental health nurses in emergency situations of treatment for severely mentally ill patients in supporting their improved recovery. There is also lack of idea regarding the ethical role of mental health nurses while providing care for supporting the recovery of severe mentally ill patients.
The above discussion mentions that understanding the role of the mental health nurses in caring for the severely mentally ill patients is important as there is often confusion regarding the complex rile which hinders effective care delivery. Moreover, the understanding of the role is essential as it would help the mental health nurses determine the actions to be performed in meeting the care goals. The electronic search strategy is used in gathering information regarding the study. The inclusion and exclusion criteria are followed to identify 6 key resources regarding the study. The CASP tool is used to appraise the selected studies to determine their credibility and trustworthiness of use in the current research.
The key information developed from the review is that the initial role of mental health nurses in supporting recovery of severe mental illness is identifying the needs and demands of the patients. They also have the role to act in collaboration with the multi-disciplinary team in caring for the patients. The mental health nurses have the role of promoting patient safety to avoid further risk of harm or abuse towards the patients. they also have the role of modifying the ward culture to ensure a favourable care environment is maintained for the patients as well as for them to work effectively. They also have the role to act with confidence so that no unnecessary error occurs during the care and promotion of recovery of severe mentally ill patients. The gap identified in the study is that it lacked the presentation of effective ideas regarding the ethical aspects of care to be maintained by the mental health nurses while promoting recovery of the severely mentally ill patients.
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