Gerald A. Farrell

Emotional rescue: the role of emotional intelligence and emotional labour on well-being and job-stress among community nurses.

AIMSnTo investigate the extent to which emotional labour and emotional intelligence are associated with well-being and job-stress among a group of Australian community nurses. The moderating role of emotional intelligence was evaluated as a key factor in the rescue of healthcare workers from job-stress, thus increasing job retention.nnnBACKGROUNDnAlthough emotional labour has been broadly investigated in the literature, the contribution of emotional labour and emotional intelligence to the well-being and experience of job-stress in a community nursing setting requires further exploration.nnnDESIGNnThis study used a cross-sectional quantitative research design with data collected from Australian community nurses.nnnMETHODSnAustralian community nurses (nxa0=xa0312) reported on their perceived emotional labour, emotional intelligence and their levels of well-being and job-stress using a paper and pencil survey in 2010.nnnRESULTS/FINDINGSnResults from structural equation modelling support the hypothesis that both emotional labour and emotional intelligence have significant effects on nurses well-being and perceived job-stress. Emotional intelligence plays a moderating role in the experience of job-stress.nnnCONCLUSIONnThese findings provide additional evidence for the important effects that emotional labour and emotional intelligence can have on well-being and job-stress among community nurses. The potential benefits of emotional intelligence in the nurses emotional work have been explored.

Workplace aggression, including bullying in nursing and midwifery: A descriptive survey (the SWAB study)

BACKGROUNDnWorkplace aggression remains an important source of distress among nurses and midwives and has negative effects on staff health, patient care and organisations reputation and fiscal health.nnnOBJECTIVESnTo report on the nature and extent of workplace aggression, including bullying experienced by nurses and midwives in Victoria, Australia.nnnDESIGNnA descriptive study design was chosen.nnnSETTINGS AND METHODSnThe Nurses Board of Victoria posted 5000 surveys to the randomly selected registered nurses and midwives in Victoria, Australia, in 2010. The participants were asked about their experiences of violence (from clients) and bullying (from colleagues) within their most recent four working weeks. In addition, the study investigated staff actions following incidents, staff training and safety at work, and what staff believe contribute to incidents. Data analysis involved descriptive statistics, including frequencies and percentages. Chi square tests and P value were used to assess differences in categorical data.nnnFINDINGSn1495 returned questionnaires were included in the study (30% response rate). Over half of the participants (52%) experienced some form of workplace aggression. Thirty-six percent experienced violence mostly from patients or their visitors/relatives and 32% experienced bullying mostly from colleagues or from their managers/supervisors. Significant differences were found between those who experienced aggression from patients and those who were bullied in respect to handling of incidents; factors thought to contribute to incidents; and organisations handling of incidents.nnnCONCLUSIONnThe study suggests that staff are less worried by patient initiated aggression compared to bullying from colleagues. For all types of aggression, respondents clearly wanted better/more realistic training, as well as enforcement of policies and support when incidents arise.

Mental health content of comprehensive pre-registration nursing curricula in Australia

In 2008 the final report of the Mental Health Nurse Education Taskforce was released. This paper presents the findings of the report’s survey into the mental health content of generic pre-registration nursing curricula in Australia. A questionnaire was sent to all nursing schools providing pre-registration curricula. Results indicate curricula contained a wide range of mental health theory and clinical hours. While the majority of universities incorporated most of the 20 key topics recommended by the Mental Health Nurse Education Taskforce in their courses, few addressed issues such as Indigenous mental health. There was considerable competition for placements between universities, and concern about the quality of some placements. Nurse academics with formal qualifications in mental health and specialist clinical mental health nurses were mainly involved in teaching theory. Specialist mental health clinicians and clinical educators were the key groups engaged in students’ clinical education, and preceptorship was the most common form of clinical supervision. Consumers and carers had limited involvement in the development or provision of mental health content of pre-registration curricula. Greater attention is needed to increasing the mental health content in pre-registration curricula. Furthermore, initiatives should be developed to increase access to clinical placements and reduce competition for places between universities.

The characteristics, management and outcomes of people identified with mental health issues in an emergency department, Melbourne, Australia

Although the number of mental health presentations to emergency departments is increasing as a result of the integration of psychiatric services with general services, few studies have explored the characteristics of mental health patients presenting to emergency departments in Australia. This study investigated the characteristics of, and outcomes in relation to, people presenting with a mental health problem to one large metropolitan emergency department. Data were collected from the emergency departments electronic records system for adult patients aged 18-65 years old with an emergency department discharge diagnosis of a mental health disorder, including substance abuse and psychosocial crisis, for two months. Mental health patients totalled 5.3% (n= 290) of adult presentations to the emergency department. Over half were male; mean age 37.4 years; 49% were allocated triage category 3/urgent; 45% arrived by ambulance; 39% were overdosed/intoxicated and 55% received one or more diagnostic investigations. Patients who were intoxicated, those who arrived after hours, or patients admitted to a mental health ward were more likely to wait longer than 8h. Findings are broadly in line with that reported for other Australian studies, although the present findings suggest that patients had significantly more routine investigations and there were higher rates of presentations for intoxication.

Mental health nursing in emergency departments: the case for a nurse practitioner role

AIMS AND OBJECTIVESnThis paper aims to explore the effectiveness of the mental health nurse practitioner role in the emergency department in the context of the growing use of special units or segregated areas to manage particular kinds of mental health presentations, often complicated by substance use.nnnBACKGROUNDnIn recent years, there has been a significant increase in mental health presentations to emergency departments, often complicated by substance abuse. Emergency departments have introduced a variety of mechanisms to address this growing problem. With the introduction of mental health nurse practitioners, opportunities arise to reconsider these mechanisms.nnnDESIGNnDiscursive paper.nnnMETHODSnIn this discursive paper, contemporary practices are described in relation to special care areas, psychiatric emergency centres and short-stay units. The mental health nurse practitioner role in training and capacity building is also explored and the notion of locational processes described. Rather than being presented as an alternative to short-stay units, the mental health nurse practitioner role is explored in its potential to enhance mental health nursing practice in a sometimes difficult clinical environment.nnnRESULTSnThe paper provides evidence from literature and practice that the clinical outcome for consumers is enhanced through the mental health nurse practitioner role.nnnCONCLUSIONSnIt is argued that the introduction of the mental health nurse practitioner role in the emergency department leads to increased staff competence and confidence in interacting with those presenting with mental health issues. The mental health nurse practitioner role also addresses the serious problem of stigma associated with those with a mental health issue.nnnRELEVANCE TO CLINICAL PRACTICEnIt is expected that those presenting with mental health issues to the emergency department will benefit through the increased assessment and management skills of staff.

Mental health content of Australian pre-registration nursing curricula: Summary report and critical commentary

BACKGROUNDnConcerns have been expressed about inadequate mental health content in generic pre-registration nursing curricula in Australia. These have led to claims new graduates are inadequately prepared to care for patients with mental health issues. The Mental Health Nurse Education Taskforce set up for the purpose of the project by the Australian Health Ministers Advisory Council, carried out a national exploration of mental health content in pre-registration nursing curricula in order to develop a framework for including mental health in future pre-registration courses. This paper summarises the Taskforces report, and presents a critical commentary on several aspects, of the Taskforces report.nnnMETHODSnThe project comprised a literature review, a national survey, national consultations, and advice from an Expert Reference Group.nnnRESULTSnThe report sets out a framework, which included the core values underpinning learning and teaching, learning outcomes, learning and teaching principles, and benchmarks for inclusion of mental health content in curricula. It recommended that a national approach needed to be taken to accreditation of curricula. This, together with greater collaboration between universities and clinical agencies, and the adoption of innovative strategies to secure clinical places, will help ensure a consistent adoption of the framework in each state and territory.

Patient and visitor assault on nurses and midwives: An exploratory study of employer ‘protective’ factors

Most Australian public health-care services have established a range of initiatives designed to help protect nurses and midwives from patient and visitor assault (PVA); however, few studies have specifically examined their effectiveness. The present study is part of a larger survey that explored nurses and midwives experiences of PVA using the Department of Human Services, Victoria (2007) definition of occupational violence and bullying. Participants were asked about the presence of protective factors in their workplace and the importance of having these factors to prevent and manage workplace aggression. Binary logistic regression was applied to ascertain the association between protective factors and the occurrence of PVA, with adjusted odds ratios and their reported 95% confidence intervals for ascertaining the significance of the associations. The study found more protection from assault when there was a high standard of patient facilities, sufficient staffing, effective enforcement of policies, and when staff were provided with personal protective equipment. Working in private health care, and being a registered nurse, also conferred protection. A higher occurrence of staff assault was associated with specific clinical settings, and being on rotation and on night duty. Findings point to important insights into factors associated with protection for PVA.

Challenging behaviour : An action plan for education and training.

Abstract Nurses and other health care staff frequently encounter a range of aggressive and other ‘challenging behaviours’ at work from clients and colleagues. In response to staff concerns, an abundance of state and national policies are now available but it is left up to individual employers to decide how best to implement them at a local level. In this paper we offer an education and training model which is conceptually sound, practical in application, and suitable for health care staff at different levels in the organisation. The importance of understanding challenging behaviour from an interactional perspective, and the educational principles on which training should be founded, are discussed. Finally, the cost of training and the need for program evaluation are considered.