Mental Health Nursing E-Portfolio: Literature Review & Reflection

This e-portfolio assignment for a BSC Mental Health Nursing student encompasses three key components: an annotated bibliography of five sources related to mental health nursing topics, a literature search exploring the history of mental health nursing in the UK, and a reflection on a practice visit, focusing on medication administration and the challenges faced by nurses in mental health settings. The annotated bibliography summarizes key articles on emotional labor, resilience, supporting young people's mental health, the role of social media, and community mental health care. The literature search provides a historical overview of mental health nursing in the UK, highlighting key developments, funding changes, and evolving approaches to patient care. The reflection details observations made during a practice visit, focusing on effective communication, medication administration processes, and the challenges nurses face, including issues related to dosage calculation and dealing with patients with swallowing difficulties or aggressive behavior. The assignment demonstrates the student's understanding of key concepts, research, and practical aspects of mental health nursing.

BSC MENTAL HEALTH NURSING 1ST YEAR
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Table of Contents
1. Annotated bibliography..........................................................................................................3
2. Literature search.....................................................................................................................4
3. Reflection...............................................................................................................................5
Reference list..............................................................................................................................7
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1. Annotated bibliography
i) Citation: Edward, K.L., Hercelinskyj, G. and Giandinoto, J.A., 2017. Emotional
labour in mental health nursing: An integrative systematic review. International journal
of mental health nursing, 26(3), pp.215-225.
Summary: Emotional labor (EL) can be identified as an effort, which is given by suppressing
one's emotions for providing care to others. Nurses of mental health (MH) need to be
engaged in therapeutic interactions during any emotionally intense stage. This article is a
systematic review, which is done with the aim of investigating emotional labor during work-
related with MH. For conducting the research, systematic reviews and meta-analysis
methodology has been followed (Edward et al. 2017). Different factors like emotional
exhaustion, emotional intelligence, and EL contributed burnout of caregivers and contributed
to attrition. Results also show that EL can impact the growth of intelligence in MH nurses.
ii) Citation: Foster, K., Roche, M., Delgado, C., Cuzzillo, C., Giandinoto, J.A. and
Furness, T., 2019. Resilience and mental health nursing: An integrative review of
international literature. International journal of mental health nursing, 28(1), pp.71-85.
Summary: It can be seen that nurses in MH work in a stressful environment. Different
stressors like family, job environment, the context of service receiver and employee
interpersonal relationships. Stress can cause different impacts like burnout, professional
challenges, and others. Resilience is essential, which can help nurses to get adapted to a
stressful environment (Foster et al. 2019). The methodology of systematic screening and data
extraction was followed in this article. Resilience was found low in nurses who have job
satisfaction, self-esteem and hardiness. If resilience level is high among nurses, they face a
tough environment in job and burnout. Self-efficacy of MH nurses to build resiliency can be
increased by organizing resilience programs.
iii) Citation: Arnold, J.L. and Baker, C., 2018. The role of mental health nurses in
supporting young people’s mental health: a review of the literature. Mental Health
Review Journal, 23(3), pp.197-220.
Summary: MH issues among adolescents are increasing day by day and depression is a
major issue. The main aim of this paper is to identify the role of nurses to provide support to
adolescents facing MH problems. It was found from the study that professionals in MH must
provide knowledge about MH issues to adolescent right from the school (Arnold and Baker,
2018). Mental health education must be provided by professionals, which can help young
people to assess different services related to MH. Moreover, nurses and other professionals
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need to work with families of young patients in collaboration. This can help them to establish
an emotional attachment with the patient.
iv) Citation: Naslund, J.A., Aschbrenner, K.A., Marsch, L.A. and Bartels, S.J., 2016.
The future of mental health care: peer-to-peer support and social media. Epidemiology
and psychiatric sciences, 25(2), pp.113-122.
Summary: In this paper, it has been mentioned that social media has an important role in
effective communication between patients of mental illness. According to Naslund et al.
(2016), patients are developing online communities to share their issues with people with
similar mental states. This study has proposed a conceptual model that can help; to
understand the effect of this social communication on the lives of patients in terms of
mitigating challenges and deal with stigmas. As a result, it has been found that peer-to-peer
communication on social platforms is helping people to overcome challenges and stigmas
through continuous empowerment and accessing interventions.
v) Citation: Thornicroft, G., Deb, T. and Henderson, C., 2016. Community mental
health care worldwide: current status and further developments. World Psychiatry,
15(3), pp.276-286.
Summary: In the article by Thornicroft et al. (2016), it has been mentioned that there are
many people with mental disorders, who do not get sufficient treatment and support from the
community. Instead, they face social isolation, stigmas, and other challenges. This paper has
evaluated the meaning of community healthcare for mental illness and a framework to
improve its quality. Moreover, they have discussed possible platforms other than hospital
settings that can support the improvement of MH. The process of implementing MH practices
has been mentioned in this study. These approaches can help many people to get access to
mental healthcare services and support from all community levels.
2. Literature search
History of mental health nursing
Before the Second World War, mentally ill people were sent to Victorian asylum for a long-
term stay. In the United Kingdom, lower funds were available for the research on this field.
In the year of 1949, Dr. Derek Richter has mentioned that there must be a specific amount of
funds allocated for the research on MH. Humphreys (2018) have contradicted that, the quality
of care for mentally ill patients were improving gradually. However, in the year of 1954, the
number of this kind of patient has reached approximately 140,000 (Digital.nhs.uk, 2019).
During the time between 1955 and 1970s, the trend of mental asylums has been reduced and
healthcare sector has taken the initiative to provide care to these patients from psychiatric unit
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of hospitals. Many organizations have started spreading awareness about MH and some
positive media coverage were gradually changing the visibility of public regarding MH. In
the 1970s, health expenditure has been cut due to the economic crisis. However, Turner et al.
(2015) have argued that there was slow progress in the sector of mental healthcare in the
1970s.
In the 1980s, the nursing service for mental patients has been improved as the evidence of
research works was showing the link between the mental and physical health of people. At
this time, approximately 49 psychiatry professorships were there in the medical schools and
universities in the UK. At this phase, people get to know about the impacts of stigma on this
issue and the social challenges of people with mental disorders. As mentioned by Coffey and
Hannigan (2013), nursing staff got influenced by the sufferings of mentally ill people and
they started providing the best care to them. In the 1990s, the government of the UK has
taken initiatives to allocate more funds to the general projects on MH than the research
works.
In 1999 national service framework was established and raised the issue of MH as a public
agenda. In the early 2000s concerns for the safety of drug treatments, other non-medical
approaches get started. However, at that time funding levels were low (Digital.nhs.uk, 2019).
The foundation of MH also got its independence in 2000. This organization has increased its
interconnectedness, which has helped to increase the intensity of mental illness. Analyzing
the history of mental health, it was found that, with time the facility of MH services has
increased. In addition, different systems have been improved for providing support to the
sufferers of different MH issues (Coffey and Hannigan, 2013). Recently, different non-
medical approaches like talking therapies have been improvised to provide relief to the MH
patients.
A care program approach has been started, which is a package that can be used for planning
regarding MH care. Proportion of people who have approached CPA for gaining assistance
has reduced in the last few years. In the year 2016-17, it was 11.7% in the UK. However, this
percentage has reduced to 11.5% in the year of 2017-18 and 10.5% in 2018-19
(Digital.nhs.uk, 2019).
3. Reflection
From the practice visit, I have learned that it is important for nurses to have effective
communication skills. According to Alteren (2018), these skills help to communicate with
doctors and nurses get the right information about medications. Moreover, I have seen that
doctors and senior nurses guide other nurses while administering medication. It is important
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to administer the right drugs to the right patient at the right time (Odberg et al. 2019). During
the practice visit, I have noticed that nurses check details about the physical condition of
patients before administering a medicine. They ensure that they are providing the right dose
of medicine to patients through the right route. Understanding the dosage and timing is very
important in terms of administering medicines. I feel that nurses are liable to patients in this
regard. One of the nurses mentioned that they need to make decisions about medication in
terms of emergency cases. However, it is important for them to involve maximum seniors and
experts while making major decisions regarding the medication before administration. I have
observed that nurses are checking blood pressure and pulse rate before administering a higher
dose of medicine. In terms of patients with mental illness, nurses communicate with them to
gain their trust. This aspect helps them to administer medication as instructed by concerned
healthcare professionals and they successfully ensure speedy recovery of patients.
I have also learned the medication process for older patients suffering from mental disease.
Nurses face different problems like the capacity of patients, confusion, and lack of
knowledge regarding elderly psychiatric care (Venables and Gunnell, 2018). These issues
create difficulty during the administration of medication. I have noticed that many elderly
mental health patients have problems with swallowing and crushing tablets. Nurses have
helped them by crushing the tablets manually and dissolve medicines for administering
medications. Moreover, many times nurses have to apply a large number of medicines at the
same time. This creates a problem for nurses as some patients become aggressive while
attempting to administer medicines. Moreover, the layout of clinics or health care settings
also creates problems during the application of medicines (Alteren et al. 2018). I noticed that
inadequate facilities in the healthcare setting and lack of space have created many problems
for the nurse. Calculating the dosage, especially for administering liquid medicines is another
problem that is faced by the nurses. For mitigating this problem, I noticed that nurses
consulted with physicians and gain knowledge about the exact dosage. As stated by Venables
and Gunnell (2018), errors in dosage can create complications in mental health patients
especially older patients. Nurses generally wake up the patient just before the time of
administering medicine because these patients feel drowsy most of the time. This knowledge
about medication to mental health patients can help me in my professional career. I came to
know about different issues and solutions to mitigate those issues. Among the identified
issues, I feel communication problem with other staff is a major issue that can cause an error
in the process of medication.
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Reference list
Alteren, J., Hermstad, M., White, J. and Jordan, S., 2018. Conflicting priorities: Observation
of medicine administration. Journal of clinical nursing, 27(19-20), pp.3613-3621.
Arnold, J.L. and Baker, C., 2018. The role of mental health nurses in supporting young
people’s mental health: a review of the literature. Mental Health Review Journal, 23(3),
pp.197-220.
Coffey, M. and Hannigan, B., 2013. New roles for nurses as approved mental health
professionals in England and Wales. International Journal of Nursing Studies, 50(10),
pp.1423-1430.
Digital.nhs.uk (2019). Mental Health Bulletin annual statistics. Available
at:https://digital.nhs.uk/data-and-information/data-tools-and-services/data-services/mental-
health-data-hub/mental-health-bulletin [Accessed on 15th January 2020]
Edward, K.L., Hercelinskyj, G. and Giandinoto, J.A., 2017. Emotional labour in mental
health nursing: An integrative systematic review. International journal of mental health
nursing, 26(3), pp.215-225.
Foster, K., Roche, M., Delgado, C., Cuzzillo, C., Giandinoto, J.A. and Furness, T., 2019.
Resilience and mental health nursing: An integrative review of international literature.
International journal of mental health nursing, 28(1), pp.71-85.
Humphreys, D., 2018. Family Involvement in Collaborative Adult Community Mental Health
Treatment.mental health foundation, p.p 23-56
Naslund, J.A., Aschbrenner, K.A., Marsch, L.A. and Bartels, S.J., 2016. The future of mental
health care: peer-to-peer support and social media. Epidemiology and psychiatric sciences,
25(2), pp.113-122.
Odberg, K.R., Hansen, B.S. and Wangensteen, S., 2019. Medication administration in nursing
homes: A qualitative study of the nurse role. Nursing open, 6(2), pp.384-392.
Thornicroft, G., Deb, T. and Henderson, C., 2016. Community mental health care worldwide:
current status and further developments. World Psychiatry, 15(3), pp.276-286.
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Turner, J., Hayward, R., Angel, K., Fulford, B., Hall, J., Millard, C. and Thomson, M., 2015.
The history of mental health services in modern England: practitioner memories and the
direction of future research. Medical history, 59(4), pp.599-624.
Venables, R.H. and Gunnell, K.A., 2018. A Practical Guide to Medicine Administration. UK:
Routledge.
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