Tex-NexA Texan Nursing Exchange

Amy Barry, Betsy Conlon and Nathalie Mills

• Created in 1948 following WWII• The general principle is ‘health service will be

available to all and financed entirely from taxation which means that people pay into it according to their means’• Private healthcare does exist but it is quite

unaffordable for most• Currently the NHS is a hot topic in politics and

financial cuts are causing a huge strain

Mental Health Care Services

• Community – covers all ages• Inpatient - ranging from Psychiatric Intensive

Care (PICU), Acute, Rehabilitation, Elderly, Child and Adolescent (CAMHS)

• Since the recent cuts in funding we have seen a dramatic shift from inpatient services to care in the community

Multidisciplinary teamwork

• On a typical ward there will be:• Registered Nurses• Health Care Assistants (HCA’s)• Consultant Psychiatrist• Occupational Therapist• Social Worker• Music Therapist• Advocate• Animal Therapist• Physiotherapist/Dietician

Admission for Treatment

• The Mental Health Act works in conjunction with the Mental Capacity Act

• Patients will be brought to a ward on a section or informally

• The common sections that are used are • Section 2• Section 3• Section 136• Patient’s can appeal their sections if they wish

Post Graduate Diploma in Mental Health Nursing

• We all have a previous degree in Psychology• The course is two years as apposed to 3

because of our previous degree• The second year is Masters level• We all have previous experience in working

with vulnerable people• When we graduate in February we will be

Registered Mental Health Nurses (RMN’s)

Post Graduate Diploma in Mental Health Nursing

• 40% of the course is theory and 60% is made up in practice hours

• Theory involves being in university and is in the form of lectures and practical's

• So far we have had placements in: Elderly, Rehabilitation, Acute care and Community Settings

Placements

• A placement ranges from 6 – 14 wks working 37.5 37.5 hours per week

• We shadow a registered nurse• We have a ‘placement book’ which has to be filled

in at the end of the placement showing that we have adequately completed competencies required to qualify as a nurse

• On placement you are expected to work as part of the team – dispensing medications, coordinating shifts, managing the ward

Challenges facing Recovery in Mental Health

• Funding cuts from government• Stigma and discrimination• Families• Recovery vs medical model• Challenging old school thinking

Theory

• The first semester covered an introduction to basic nursing skills and medication management

• Core aspects of the course have been:• Care planning• Clinical Skills• Leadership and Management• We also complete Mental Health ‘simulations’

http://www.youtube.com/watch?v=uPurxufCj_Q

Substance misuse

• We haven’t had the opportunity to gain any experience in this as yet but from what we understand in the UK:

• Substance misuse is mainly treated in the community

• Some people have a short stay in a unit where they have access to 24 hour medical care if necessary

Places we have visited in Texas!• Recovery Resource Council• Serve Denton• SARC• Solutions• Maggie’s House• Our Calling• Denton County Juvenile Detention Centre• Enterhealth talk• Kristin Farmer Autism Centre• TAAP• Centre for Neuro Skills• Epilepsy talk• Stewpot• Presbyterian Hospital• Sante• Terrell State Hospital

Denton Juvenile Detention Centre

How do things differ?

• As we are much more familiar with inpatient wards we have chosen to compare what we have seen of the hospitals here

• Daily routine • Leave• Modern Technology• Grouped according to disorder• Restraint• Follow up care• State funded care has more similarities to the UK

Suggestions for future exchanges

• Advise that it is necessary to rent a car• Advise to make a blog• CRB• Outline beforehand what the objectives of the

exchange are and what would be beneficial• A schedule in advance• Would be beneficial to attend some lectures if

possible

Things we really enjoyed

• Having a guide (Amy)• Being given enough downtime to explore• The weather • The Detention Centre• Terrell Hospital• Presbyterian Hospital• Stewpot• Maggie’s House• How hospitable everyone has been• The expertise of everyone who we have spoken with

What we all have in common is a desire to care for others and ultimately that is all that matters.

www.tex-nex.com