European Festival of Psychiatric Nursing, Malta 07.11.2008

Mgr. TOMAS PETR

BLANKA NOVOTNÁ

Psychiatric Nursing in Czech Republic

Who are we?

Tomas Petr (MSc, BSc, RN)

- BSc General Nursing- MSc Management in Health

Care- Currently Manager of

Psychiatric Intensive Care Unit, Central Military Hospital, Prague

Blanka Novotná (RMN)MN)

- Registered mental health nurse

- Currently manager of nursing care, Psychiatric Hospital Prague

Overview

IntroductionHealth care system in Czech Republic General information about mental health Structure and organisation of servicesNurses training, registration, professional bodiesSpecific issues, challenges

Czech Republic

Population:

approx. 10 mil.Nationality:

95% Czech

5% Slovak, Polish,

German, Vietnamese,

UkrainianOfficial language:

CzechCapital: Prague

Prague

Health care system in The Czech Republic- main features -

Social health insurance system- Compulsory contribution – 13,5 % from salary (4,5%

employee, 9% employer)- State – contribution for unemploeyd people, children,

retired people, women on maternity leave- 9 insurance companies- Since 1.1.2008 – regulatory fees (a doctor´s

appointment – 30 CZK, 1 day at hospital – 60 CZK, prescribtion of drugs – 30 CZK = 1,2 EU etc.)

- Expenditure on health services – 7,3 % of GDP

Percent of GDP spent on health care (OECD, 2004)

UK 7,7

France 9,7

Germany 10,9

Sweden 9,2

Czech Republic 7,3

Spain 7,6

Lack of nurses (deficit of 1000 nurses in the system)

Re-defining competences of nurses (higher education, but the same competences)

Low salaries

Changes in education - 3 900 nurses completed study

- 200 started working in hospitals

- 1 180 carried on with study on higher level

- rest of them dissapeared

Main challenges in nursing in Czech Republic

Mental health care

Cinderella between medical disciplinesLack of interest from politicians and publicRetaining stigma of psychiatry (media, movies etc.)Insufficient funding (mental health – only

3,5 % from health care budget)

% of health care budget

Zdroj: MHEEN, 2004

Expenditure on mental health care

3.5% from health care budget

STIGMA OF PSYCHIATRY representative sample of 1248 respondents, 1999

0 1 2 3 4 5

cardiology oncology GP ophtalmology psychiatry

1 – the best, 5 – the worst

SO

CIA

L P

RE

ST

IGE

Choosing a job ???

Jobs with the highest prestigeJobs with the highest prestige Jobs with the lowest prestigeJobs with the lowest prestige

Physicians – 88Scientists – 82University teachers –

77Nurses – 72

Secretary - 41Member of Parliament

- 34Priest - 40Cleaner - 30

CVVM 9/2008

Prestige of nursing job99 – the highest prestige, 0 – the lowest prestige

On the way to becoming a psychiatric nursestep 1

age of 18finished secondary education

A. 3 years study on nursing school

general nurse

B. 3 years on university (bachelor degree)

general nurse

On the way to becoming a psychiatric nursestep 2step 2

general nurse diploma general nurse diploma 12 months of field experience 12 months of field experience 3 years postgradual study 3 years postgradual study

640 hours - 50% theory, 50% practice640 hours - 50% theory, 50% practice

psychiatric nursepsychiatric nurse

Less then 30% of nurses working at psychiatric Less then 30% of nurses working at psychiatric hospitals have got specialization at psychiatric hospitals have got specialization at psychiatric nursing.nursing.

Where to work, if you are psychiatric nurse?

Asylum-like hospitals

2068,8% of hospitalisations happens

within asylums average length of hospital stay – 79,4

days 2,5% of clients longer then 1 year

number of nurses - 2 899

Psychiatric wards

32 average length of hospital stay – 20,9

days

number of nurses - 700

Ambulatory care providers

number of them is growing up (in 2005 – 24,4% more then in 2000)

private, paid by insurance companies

number of nurses – not known

Community care

poor network mainly concentrated in big cities problems with funding

number of nurses - 6

Structure of services - main issues -

Most of the care happens within hospitalsLack of community servicesLong hospitalizationFrequent rehospitalizationHigh cost of care/low effectivenessPoor conditions within inpatients settings

Psychiatric nurse

What your job will be like?

- 12 hours shifts- 1 nurse – group of 20 clients- Increase of paperwork- A lot of stress- Average salary – 1000 EU/month

Compulsory since 2004

Registration term lasts 6 years

Condition for renewing:- 40 credits - clinical practise- CRB- good state of health

Registration of nurses

Professional bodies

CNNA – Czech National Nurses Association

- Member of ICN, PCN, WENR

- Divided into 69 sections- 21 000 members- Membership is voluntary

CNNA

Psychiatric section

700 members full member of Horatio

Main activity: Organizing conferences, congresses,

workshops Working on clinical guidelines Participating in clinical research Publishing study materials

Horatio congress in Prague - 2010

Conditions within psychiatric hospitals- contrasts -

TOMAS_PETR@HOTMAIL.COMTOMAS_PETR@HOTMAIL.COM

BLANKA.NOVOTNA@PLBOHNICE.CBLANKA.NOVOTNA@PLBOHNICE.CZZ

Contacts: Contacts:

QUESTIONS