Passionate about
Psychiatric and Mental Health Nursing
In Canada, about ten years ago, the
national psychiatric and mental health nursing community chose to create
and participate in a specialty certification program. Psychiatric and
mental health nursing was described as a specialized area of nursing which
has as its focus the promotion of mental health, the prevention of mental
illness, and the care of clients experiencing mental health problems and
mental disorders (CNA, 1993). Benner’s
(1984) domains of nursing practice frame the process. While no one theory
is prescribed, it is expected that nurses will use a theoretical
framework/nursing model to guide their practice. We support our nurses to
gain this important credential The ©Tidal Model with its emphasis on
collaboration/partnerships, empowerment, interdisciplinary teamwork and
narrative interventions, celebrating narrative knowledge and stories is
our choice.
National
trends to evidence-based practice - and what is better evidence than the
person’s own perception/words! - and best practice guidelines are
expressed and supported through the Tidal Model. Indeed, the Registered
Nurses Association of Ontario (RNAO) has developed Best Practice
Guidelines for Client-Centred Care [www.rnao.org]
and even the language of the Tidal Model is echoed in these guidelines.
For example, recommendation one clearly shares Tidal language and values:
Nurses embrace as foundational to Client Centered Care the
following values and beliefs: Respect; human dignity; clients are experts
for their own lives; clients as leaders; clients’ goals coordinate care
of the health care team; continuity and consistency of care and
caregivers; timeliness; responsiveness and universal access to care.
At the Royal Ottawa Hospital, we had
just articulated a vision for nursing to become an internationally
recognized centre of excellence for psychiatric and mental health nursing
which has at its core committed, person-centred professional practice and
scholarship when the Perspectives Tidal article was published.
Reading the article was an ah-ha experience. It was a
gift to find our beliefs and values echoed in The Tidal Model. Not only
did it address the need for nursing and the proper focus of nursing but it
came complete with a documentation system. What a blessing!
We joined the international Tidal
community, the first North American site, within weeks of our acquaintance
with the model. Using the multimedia education program, we introduced the
model to three programs, mood and anxiety, forensic, and substance use and
concurrent disorders. A research project evaluating the implementation of
the model using the criteria developed by the Newcastle group is in
progress.
The concept of engagement resonates
with us. We have incorporated this across our facility in our work on
creating healthy, healing environments and in our observation policy.
Security assessments and plans are now an integral part of our
hospital-wide constant observation policy. One outcome is that the number
of hours for Constant Observation has significantly decreased.
Our
passion is psychiatric and mental health nursing. The Tidal Model
has fanned the fires of (affirmed) our passion, and provided us with
language to speak our practice.
