The Nursing
Contribution
Up to 80% of direct NHS care is
provided by nurses, working in all settings, and across all age
ranges. In mental health, nurses are the largest occupational group
both in relatively new services, such as assertive outreach,
community forensic, criminal justice and crisis teams, as well as
in established services such as inpatient units, community mental
health teams, specialised drug and alcohol services and child and
adolescent mental health. Nurses work across the plurality of
service provision and hence provide professional continuity
throughout the entire patient pathway. Nurses frequently play key
roles in the non-statutory and independent sectors as well as
within the NHS.
In inpatient, and increasingly in
community settings nursing is provided 24 hours a day, 365 days of
the year. For the vast majority of such "out of hours" services;
nurses are the major direct care providers. Such extended and close
contact with service users leads to an intimate knowledge of the
individual and their significant others.
95,000 nurses are able to practice as
registered nurses in mental health across the UK (NMC March 2003),
however many do not currently work in mental health settings or
within the NHS. In England, there are now 47,000 registered
nurses within the speciality in the NHS. The ratio of women to men
is nearly 2:1.
The title "nurse" is legally
protected, however, definitions of nursing tend to be broad and do
not clearly distinguish a unique role as compared to other
professions:
The personal concept of
what nursing is, what it is for and how do we do it is rarely put
into words, and cannot therefore be easily communicated… Nursing is
the use of clinical judgement in the provision of care to enable
people to improve, maintain, or recover health, to cope with health
problems, and to achieve the best possible quality of life,
whatever their disease or disability, until death. (RCN 2003).
Mental health nursing can potentially
provide truly holistic care, with a range of interventions, from
intimate physical care to formal psychological approaches, and from
directly applying constraints under the Mental Health Act to
spending extended periods of unstructured time with service
users. Additionally, the two-thirds of qualified nurses who
work in inpatient care areas also have direct health and safety
responsibilities and responsibility for managing the
environment.
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