The Work of Child and Adolescent Mental Health Nurses: A Conceptual Framework

Author: Philippa Enid Rasmussen

Rasmussen, Philippa Enid, 2013 The Work of Child and Adolescent Mental Health Nurses: A Conceptual Framework, Flinders University, School of Nursing & Midwifery

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Recent changes to national nursing legislation in Australia have resulted in the removal of a separate register with regulatory authorities for the specialty of mental health nursing. Aspects of mental health nursing are not easily defined with some characteristics of the work being tacit. Child and Adolescent Mental Health (CAMH) nursing is a specialty area of mental health nursing. Developing a deeper understanding of the contribution that CAMH nurses bring to an inpatient setting through their work was the focus of this research. The purpose of the research was to: Identify the specific knowledge and skills that CAMH nurses use in an inpatient unit; Explore and interpret the role (e.g.. nursing practice, beliefs and attitudes) of mental health nurses working in a CAMH inpatient unit; Provide a comprehensive understanding of the role and function of mental health nurses in an acute child and adolescent mental health unit; Explore the relationships within the multidisciplinary team. The expected outcomes were: the development of a comprehensive understanding of the role and function of mental health nursing within a child and adolescent mental health inpatient unit; and recommendations in relation to the significance of the unique knowledge and skills that the mental health nurse brings to a child and adolescent mental health inpatient unit. The research question was 'What is the work of CAMH nurses in an inpatient unit?' The epistemological framework was social constructionism which is concerned with the making of meaning and the social processes involved. The methodology was interpretive enquiry, as it allowed for the interpretation of multiple realities. This resulted in a rich description of the work of CAMH nurses. There were three stages of data collection each with a different method; document analysis, focus groups interviews and individual interviews. The participants included current and previously employed nurses from the inpatient unit as well as staff from other disciplines. The documents were analysed using iterative and thematic analysis. The focus group and individual interview data were analysed using an adaptation of the six phase thematic analysis process. The findings of the research led to the development of a holistic conceptual framework that explained the work of the CAMH nurse in an inpatient unit. The holistic conceptual framework identified the knowledge and skills that CAMH nurses needed and considered how knowledge development assisted them in moving through the five developmental stages of becoming a specialist CAMH nurse. The findings were supported via elements of role theory and patterns of knowing. The conceptual framework was found by practitioners in this specialty to be reflective of their practice, useful for the education of colleagues and had potential for further research in other settings in which CAMH nurses worked. How CAMH nursing knowledge and skills are generated and sustained was identified. The five stages of understanding the role and developing an individual perspective of the nature of the work were also supported by the elements of role development and the patterns of knowing. Implications for practice and further development of the role through education and research were identified. This research led to two publications in refereed journals (Rasmussen, Henderson & Muir-Cochrane 2012; Rasmussen, Muir-Cochrane & Henderson 2012).

Keywords: child and adolescent mental health nursing, conceptual framework, social consturctionism, qualiatative methodology

Subject: Nursing thesis

Thesis type: Doctor of Philosophy
Completed: 2013
School: School of Nursing & Midwifery
Supervisor: Unknown