Changing Nurses Attitude towards Electroconvulsive Therapy

RUNNING HEAD: PRACTISE PROPOSAL
PRACTISE PROPOSAL
Name of Student
Name of University
Author note

1PRACTICE PROPOSAL
Assessment – Practice change proposal
Changing nurses attitude towards the practice and knowledge of ECT
Applicant’s details:-
As a mental health nurse with an experience of more than 10 years and working as a
mental clinical nurse consultant, I have observed many changes in the interventional
approaches of mental health care – in order to manage many acute and chronic condition in
an evolved way. My qualifications are B.Sc and M.Sc in nursing. My good and bad
experiences with clinical practice of mental health has pushed me to take up a project on
practice change in negative or awkward attitudes in nursing practice towards the application
of electroconvulsive therapy.
Overview of Project:-
This practise development project will be aimed at improving the attitude of nurses
towards the knowledge and practise of electroconvulsive therapy in mental health care. The
project uses an evidence based practise change model to address the aim and methodology of
the study. The model uses explanatory (Nardi 2018) and analytic methods (Hirschi and Selvin
2017) to analyse the rationale to bring in a purposeful change. The project focuses on
understanding the covert social and cognitive mechanisms (Dahl, Lutz and Davidson 2015)
leading to the development of negative or frantic behaviours (Sinclair, Seydel, and Shaw
2017) in nurses when asked to relate to electroconvulsive therapy. The project also extends
its framework to analyse the perceptual blocks (Witt, Tenhundfeld and Bielak 2017) in many
nurses about the ‘experience’ of electro convulsive therapy in patients, they had been treating
for a long time and has developed a therapeutic bond with. The project uses varied data
collection and data analysis methods in order to inter – relate with ongoing perceptions about
the clinical practise of electroconvulsive therapy and how ethically correct – the therapy is.

2PRACTICE PROPOSAL
Hence, the study will explore into many areas of ethical dilemmas related to the use of
‘electroconvulsive therapy’ (Joshi et al.2016) in the modern clinical environment and how
does it affects the other patients in the wards and professionals working closely with them.
The methods that will be used in the research design should be able to analyse the
deficiencies of mental health nursing (Brown 2015) in regards to managing acute
behavioural, cognitive, personality and neuropsychological cases. The deficiencies would be
investigated from different perspectives like –
a) inadequate nursing education (Barton, Bruce and Schreiber 2018)
b).non-adherence to clinical guidelines (Arts et al. 2016)
c). incoherence in multidisciplinary approach planned around an acute mental condition
d). Lack in nursing training programs (Douglas and Affoo 2018).
e) knowledge gap(Démeh and Rosengren 2015)
f) missed areas in clinical mental nursing (Orthwein 2017).
The study will be aimed to an understanding of nurses' attitude and knowledge towards
electro-convulsive therapy and to explore whether this knowledge and the previous
experiences of electroconvulsive therapy can be correlated with a gradually developed
positive attitude towards the ‘controversial’ treatment (Sadowsky 2016) that has question
logic, reasoning and ethical dilemmas (Doherty & Purtilo 2015) over the decades. The
practice change will also focus on immediate and long term goals to be achieved within an
organizational framework for sustenance of the ‘attitude change’ and how this ‘acquired
knowledge’ can be blended with the learning of future nurses (Glegg et al. 2017). Of course,
that would take a standardization, quality check and a ‘drastic’ change in the practice
perception in accordance with usage of electroconvulsive therapy. As to cater to the practice

3PRACTICE PROPOSAL
change model that is to be used in the proposed research would be will act by knowledge
transformation process (Pham & Nguyen 2017), knowledge exchange (Tjoflåt et al. 2017)
within the professional and organizations social and cultural framework, ‘synthesis of
application and inquiry’ (Moran, Burson and Conrad 2016) organizational change theory to
adopt to new practice setting and the pace in uptake of the new clinical environment and
practice modifications. The project methodology will be determined on studying the nurse –
patient collaboration in a mental health setting and to what extend a pact is feasible, given the
behavioral and personality distortions resulting in aggressive, indifferent or extremely
unexpected patient behaviors. A mixed methods procedure will be incorporated with research
design to achieve the desired results with any personal bias from the researcher’s side. The
analysis and interpretation techniques will keep in check, any sort of patient irritation or
digression from the main aim of the project.
Background and Need for Project:
For a therapeutic relationship to take place - the nurse has to generally work inside the
emotional loop of the patient. Nurses tend to spend most of the therapeutic time that a patient
spends in the hospital. Hence, nursing knowledge complemented with a positive attitude to
electroconvulsive therapy is vital because through the therapeutic bond, the nurses will be
able to transfer the same knowledge to the patients. The history of electroconvulsive therapy
runs back to 1930s when it was first devised and administered as a therapeutic method in the
psychiatry world. Slowly with randomized and regular practices – Electro Convulsive
Therapy proved to a life-saving intervention in extreme depression, as it acted on the neural
circuits acting on behavioral planning to reduce suicidal ideations and attempts. Some studies
indicated Electro Convulsive Therapy for depression while in majority of the western world
especially in Europe, ECT was primarily indicated for schizophrenia. It was thought that
electro convulsive therapy might cause brain tissue damage, functional circuit breaks,