Masters of Advanced Nursing Practice students flourish under pressure in Emergency Department
Although the 2020 International Year of the Nurse and Midwife has not been the celebration we were expecting due to COVID-19, now more than ever communities are leaning on the knowledge and guidance of our incredible nurses to keep us safe.
The pandemic and its associated restrictions are having a serious impact on people experiencing psychological distress. As a result, Emergency Departments are experiencing an increasing number of people who are in need of urgent mental health care and support. While battling these new challenges brought on by the pandemic, MSHS Masters of Advanced Nursing Practice students have spent their time studying mental health nursing skills and knowledge remotely at UoM, while also working at the Royal Melbourne Emergency Department.
Juggling long shifts, home life, pandemic stresses and university assignments is no small feat. Dr Cathy Daniel and Elizabeth Currie from the mental health teaching team are proud to say that this year's cohort have done particularly well with their studies despite the challenging circumstances surrounding them. 2020 is the first year in which mental health education has been incorporated into the Masters curriculum, with the aim of equipping nursing students with the right skills to provide comprehensive and collaborative mental health care in a complex and fast-paced Emergency Department (ED) environment. For example, incorporating Safewards strategies into student practice has been embraced by nursing staff. The Safewards model aims to reduce containment and conflict, and increase a sense of safety and support between people seeking help , their family and carers, and health care professionals.
"Liz and I are really impressed with the students level of engagement in their learning and how they have adapted the assessment tasks to a make them relevant for the ED context," remarks Dr Daniel.
"They have been engaged in restraint reduction and incorporated Safewards language into their practice. They have also worked alongside the mental health clinicians in the Emergency mental health team to gain a deeper understanding, which is really positive".
Dr Daniel and Professor Marie Gerdtz recognised a workforce need for Behavioural Assessment Unit (BAU)/Crisis hubs where people receive care for the first 24-28 hours by ED nurses who did not have the same access to mental health nursing education. In collaboration with the ED nursing leadership team, the Masters of Advanced Nursing Practice curriculum was adapted to address this clinical need and ED nurses are completing post graduate education in mental health assessment, psychopharmacology and mental health nursing skills.
"We cannot expect to have consumers cared for in the most acute time of their presentation by nurses who have not completed any formal mental health skills or qualifications," explains Dr Daniel.
"We are supporting and upskilling ED nurses to provide a more comprehensive and holistic nursing assessment and care. These nurses are role models and leaders in the department for junior staff who are developing mental health nursing skills".
Scott Woolard is a Clinical Nurse Educator at the Royal Melbourne Hospital (RMH) and a current student of the Masters of Advanced Nursing Practice at MSHS. As part of the RMH leadership team, Woolard has been working hard educating nursing staff on new COVID protocols and the development of eLearning resources. He has also been assisting the ED splitting into two separate sections, the Normal ED (NED) and the Respiratory ED (RED), all while achieving fantastic grades and becoming a father for the second time. Acknowledging that studying this year has been both a challenging and rewarding experience, Woolard explains how the circumstances have unusually been beneficial to his learning.
“I think of all the times to undertaken further study in mental health, the current pandemic has strangely proven to be a good time,” he says.
“Few people recognised the potential impact the pandemic and associated state-wide restrictions would have on consumers with acute or chronic mental health problems. We have seen increasing numbers of mental health presentations with ranging acuity, so being able to consolidate skills, utilise new strategies, and develop rapport while dressed head to toe in PPE has been invaluable”.
During their studies, the students have worked closely with Emergency Mental Health clinicians at the Royal Melbourne ED, building relationships and learning from their professional experience. The Masters of Advanced Nursing Practice has benefitted greatly from a strong working relationship between the University of Melbourne and the Royal Melbourne ED, while Dr Daniel and Currie have stepped into the role of mental health nurse educators. Both would like to thank the ED leadership team for supporting students to flourish under pressure this year and take the time to prioritise their reflective practice.
"Regardless of where people are when they are unwell with mental illness or in a crisis, or experiencing intoxication withdrawal from substances, they should have nurses with the right skill set caring for them," agrees Currie.
"If crisis hubs and presentations continue to increase in emergency departments, which we know they will, we need to have nurses there who are clinically prepared and have access to supervision and support to develop these skills and practices".
Learn more about studying the Master of Advanced Nursing Practice at the University of Melbourne.