A mixed-methods exploration of the nursing associate role, programme experiences and future career pathways.

This article reports on a small mixed-methods research project undertaken with trainee nursing associates (TNAs) in the south of England. AIM: The aim was to gain insight into the motivation behind undertaking the nursing associate (NA) programme, how the NA role is perceived by service users and the wider healthcare team, and the future career pathways of NAs. METHODS: Online questionnaires (n=14) and online focus groups (n=6). FINDINGS: The results suggested undertaking the NA programme increased the TNAs' confidence and ability to use evidence to support their practice; that the role of the NA is not well understood. Some TNAs perceived the NA role as a distinct professional role, whereas others saw it as a way into registered nurse training. CONCLUSION: Role confusion still exists. Research is needed to capture how professional identities in new health and social care professional groups become established.

"From schoolboy to counsellor: An autoethnography of deconstructions and reconstructions of the self as a learner".

WHAT IS KNOWN ON THE SUBJECT: Autoethnographic methods can explore key learning experiences and significant occurrences over a particular lifespan. In this paper, the author has explored and employed these methods to examine the constructs of the self and how such learning may enrich the lifespan of a trainee counsellor. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: These findings will add to the research literature in the field that is limited in relation to identity formation, impact of education on learners and men becoming therapists. Key themes emerged, "He's a sensitive boy"-learning to hide, help through others-I can learn and re-construction-restoration and healing. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Despite the introspective nature of autoethnography, findings from this narrative have a bearing on the importance of inter-dependant relationships and support and how they can impact on learning and how people are viewed and labelled by communities and societies. These findings also illuminate the understanding of the construction and re-construction of the self and inform how a person, in therapy, can rebuild their lives by considering more than the negative narratives about themselves?

Patient perspectives of helpful risk management practices within mental health services. A mixed studies systematic review of primary research.

WHAT IS KNOWN ABOUT THE SUBJECT?: Risk in psychiatry involves harm to self or others owing to mental health difficulties, for example iatrogenic effects of treatment, self-harm, suicide and violence. Risk management is a framework to minimize risks, comprising of risk assessment, generation of risk management plans and evaluation of interventions. Literature has extensively explored risk management and presented a critique that its practices can lead to patient harm. However, there is a paucity of literature about what patients identify as helpful risk management practices, despite the potential for such patient views to ameliorate harm and improve mental health care. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: Interpersonal relationships with clinicians, and communication that keeps patients involved and informed of management processes, were found to be central to beneficial risk management practices, while patients having agency and autonomy to influence their participation was also important. Beneficial interpersonal relationships and connectivity in the form of patients' wider community of support were found to be influential in aiding risk management. Meaningful relationships, and particularly peer support, that maintained personal and collective identities were prevalent in the literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Rendering risk management more visible and accessible in practice might cultivate an openness that promotes patient participation. This includes drawing on a wider network of support, for example the patient's friends and family, as well as having advocacy utilizing peer support. Abstract Introduction Minimizing the harm that patients pose to themselves and others, due to mental health difficulties, is a central component of risk management in psychiatry. However, risk management itself can cause patient harm, but despite this and the potentially informative value of lived experience, little is known about what patients want or expect from risk management. Aim To review research and explore what patients consider beneficial in risk management practice. Method A mixed studies systematic review utilizing PRISMA guidelines, alongside a convergent qualitative design to categorize findings. Results Twelve papers were identified, generating two categories of beneficial practices: interpersonal relationships and communication with clinicians; coupled with patient agency in their own risk management. Discussion Connectivity appears important. Particularly patients feeling involved, and their voices being heard in both the identification of risks and then shaping risk management practice. Moreover, this included involvement of friends, family and peers to widen input and supportive networks beyond clinical relationships. Implications for Practice Risk management needs to be an accessible part of care, which is more inclusive of patient views and needs. The latter might also be aided by drawing on the patient's wider community in order to provide more effective support and risk management.