Matter for Discussion: Future Nurse Standards

Members can view a recording of the debate here (part 1) and here (part 2).

This debate highlights the growing dissatisfaction with mental health nurses on what is perceived to be a dilution of mental health nursing as a distinct specialty.

Prior to the launch of the Nursing and Midwifery Council’s (NMC) Future Nurse Standards in 2018 (Nursing and Midwifery Council, 2018), UK-wide mental health nurse academics raised concerns that although mental health nurses gaining more physical health skills was useful, generic nurse education may harm the mental health provision (Mental Health Nurse Academics United Kingdom, 2016).

Professional communications between mental health nurses, students and academics continue to highlight the increasing genericism of nurse education, arguing that mental health nursing students do not always receive adequate preparation for the job they are registered with the NMC to do, thereby creating implications for care quality and parity-of-esteem (Royal College  of Nursing, 2021), which is a clear RCN priority (Royal College of Nursing Congress, 2017).

No mental health nurse would argue that the profession does not require physical health knowledge and skills to reduce health inequalities (Public Health England, 2018). However, this must be underpinned by the needs of mental health populations and the role of mental health nurses, and (Department of Health and Public Health England, 2016) not stipulated at a generic level, which is most suited to adult nursing.

Mental health nursing students are expected to achieve competencies in physical health skills, which are often underutilised within mental health settings. These students must rely on simulation or adult nursing placements to be deemed as competent. Once mental health nursing students have gained their registration, these skills can remain dormant and unused.

In preparing this matter for discussion, mental health nurse academics have reported that teaching in undergraduate curricula is often dominated by physical health content, with far less attention given to mental health. The dissatisfaction of mental health nurses has potential implications for the recruitment and retention of students, registered nurses, and academics.

Mental health nursing is not generic, and requires technical and non-technical skills, such as psychotherapy, ensuring safety, understanding the utility and limitations of diagnosis, emotional intelligence, advanced communication skills and awareness of power differentials (Hurley et al, 2022).

No three-year generic training can encompass the breath of physical health knowledge and skills of an adult nurse, as well as those required of a mental health nurse if we are to adequately care for, with parity, people with mental health problems.

At the very least, the wording and construction of the NMC’s Future Nurse Standards allows institutions to provide a more generic education curriculum, potentially dominated by adult nursing content.

Reading lists for each agenda item can be found here.

References

Department of Health and Public Health England (2016) Improving the physical health of people with mental health problems: actions for mental health nurses. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/532253/JRA_Physical_Health_revised.pdf (Accessed 20 April 2022)

Hurley J, Lakeman R, Linsley P, Ramsay M and Mckenna-Lawson S (2022) Utilizing the mental health nursing workforce: A scoping review of mental health nursing clinical roles and identities, International Journal of Mental health Nursing, 13 Feb. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/inm.12983 (Accessed 20 April 2022)

Mental Health Nurse Academics United Kingdom (2016) Position paper on the future of mental health nursing. Available at: https://mhnauk.files.wordpress.com/2017/01/position-paper-on-the-future-of-mental-health-nursing.pdf (Accessed 20 April 2022)

Nursing and Midwifery Council  (2018), Standards for pre-registration nursing programmes. Available at: https://www.nmc.org.uk/standards/standards-for-nurses/standards-for-pre-registration-nursing-programmes/ (Accessed 20 April 2022)

Public Health England (2018) Health matters: reducing health inequalities in mental illness. Available at: https://www.gov.uk/government/publications/health-matters-reducing-health-inequalities-in-mental-illness/health-matters-reducing-health-inequalities-in-mental-illness (Accessed 20 April 2022)

Royal College of Nursing (2021) Parity of esteem. Available at: https://www.rcn.org.uk/clinical-topics/mental-health/parity-of-esteem (Accessed 20 April 2022)

Royal College of Nursing Congress (2017) Debate: parity of esteem. Available at: https://www.rcn.org.uk/congress/congress-events/parity-of-esteem (Accessed 20 April 2022)