A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities.

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.

Nurses are background actors in medical reality television: A character network analysis and call for authentic action.

AIM: The aim of this study was to describe how nurses' dialogue compares with that of doctors in the Australian reality television program Emergency and to explain how this dialogue and the use of narration and direct-to-camera monologues contribute to the portrayal of nurses. The final aim was to outline how these findings can inform the actions of nurses, nursing organizations and writers and journalists. DESIGN: A descriptive study conducted in 2021 and 2022. METHODS: Character network analysis was used to describe the verbal interaction of nurses and doctors and identify major, minor and background characters. Narration and direct-to-camera monologues were analysed through frequency counts. Cultivation theory was used to interpret the results. RESULTS: Fifty-four characters were identified, with 19 of these being nurses. Doctors spoke 87.9% of the dialogue. Most of the dialogue (43%) was monologue by doctors directly to the camera. All major characters were doctors, and only one nurse was a minor character. The mean number of mentions by the narrator of a nurse per episode was 4, and 30 for a doctor. CONCLUSION: The portrayal of nurses in Emergency is inaccurate and the production methods are used to privilege the role of doctors. This finding comes after decades of research showing inaccurate images of nursing in television. Drawing on recent Australian inquiries and the challenges experienced by mental health and aged care nursing, several approaches for collaborative action to improve these images are suggested. IMPACT: This is the first study of the portrayal of nursing in reality television. These results suggest that much effort is still required even in contemporary reality television to accurately reflect the work and contribution of nurses. It is the shared responsibility of individual nurses, nursing organizations and writers and journalists to accurately portray nurses in the media. NO PATIENT OR PUBLIC CONTRIBUTION: This network analysis of a postproduction television program did not allow patient or public involvement in the design or analysis.

Restrictive Practices and the 'Need' for Positive Behaviour Support (PBS): A Critical Discourse Examination of Disability Policy Beliefs.

BACKGROUND: Few studies have considered policies which underpin the promotion of positive behaviour support (PBS). The present study examined policy beliefs about PBS and their relationship to restrictive practices. METHODS: Discourse network analysis (a combination of critical discourse analysis and social network analysis) was used. RESULTS: A total of 11 policies were examined from which 38 belief statements were coded. One cluster was identified which promoted 13 dominant beliefs. Dominant discourses related to law, safety and the environment were evident. A conceptual representation of the shared PBS beliefs demonstrated contradictions in PBS policy. CONCLUSIONS: There is evidence that PBS policies have become informal rules for using restrictive practices, not reducing them. They are also acting as surrogates to debate conflicts between political, personal and bureaucratic interests. Three recommendations for improved PBS policy are provided.

Mental health nursing in bushfire-affected communities: An autoethnographic insight.

There is no literature to guide mental health nursing in bushfire-affected communities. Using autoethnographic methods, the author reflects on his experience of mental health nursing during the Australian bushfires of 2019-20 and the challenges of identifying existing practice guidance. Applying an existing nursing model and insights from gestalt, he analyses his field notes to identify and describe practices which he found important and useful for working with bushfire-affected persons and communities. Eight suggestions are provided to assist mental health nurses to practise in an informed way and promote recovery. This paper makes a contribution to a small body of existing mental health nursing research using autoethnographic methods, and it is the first contribution to the mental health nursing literature about working with bushfire-affected persons and communities.

Cluster A personality disorders: considering the 'odd-eccentric' in psychiatric nursing.

Psychiatric nurses are familiar with the concept of personality disorder because of their contact with persons with the most common personality disorder in clinical settings - borderline type, who frequently engage mental health services. Perhaps it is this familiarity that has focused research and clinical attention on borderline personality disorder compared with the other personality disorders. The significance of cluster A personality disorders for nursing is multifaceted because of their severity, prevalence, inaccurate diagnosis, poor response to treatment, and similarities to axis I diagnoses. Despite this, literature reviews have established that relatively few studies have focused on the treatment of the cluster A personality disorders - paranoid, schizotypal, and schizoid - resulting in a dearth of evidence-based interventions for this group of clients. A discussion of these disorders in the context of personality disorder and their individual characteristics demonstrates the distinctive and challenging engagement techniques required by psychiatric nurses to provide effective treatment and care. It is also strongly indicated that the discipline of psychiatric nursing has not yet begun to address the care of persons with cluster A personality disorders.