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  • Subject Name : Mental health

National Safety and Quality Health Service Standards

This journal is intended to reflect on the scenarios that took place during my placement in the hospital's Mental Health Clinic unit. That reflection of the essay design based on the Gibbs Reflective Cycle (1988). The Gibbs reflection model consists of five stages process which enhances my ability to continually develop my clinical practice and to learn from the mistakes for better future practices. The Gibbs cycle starts with a description about the scenario, an assessment of the feelings, an assessment of the experience, and analysis of situation, a conclusion and last phase is an action plan to develop if the problem occurs again (Husebø et al., 2015). The model helps us to develop the skills to determine and navigate through the process of reflection and identify areas of weakness or susceptibility, and layout a platform to improve strategy to address these shortcomings. The reflective process also includes an interpretation of national competency requirements for registered nurses by the Australian Nursing & Midwifery Council (AMNC). Reflection, coupled with evidence-based theory and practice, will help me to become a more competent nurse having good communication skills and professional development(Babiker et al., 2014).

Description of Mental Health Clinic

During my 6 weeks of clinical placement in Unit 3, I was able to complete my medication competences. I learned to communicate with nurses, patients, and other multidisciplinary staff. I alsogained experience in preventing and monitoring healthcare-associated infection rates, developing comprehensive care practices, communicating with safety standards, designing detailed individualized treatment plans (Kourkouta&Papathanasiou, 2014).I performed urine analysis for the patients along with a temperature checks at regular intervals.I also learned to carry out mental state examination of the patients by communication with them personally. I also gained knowledge about how drugs are planned in Australia and administration of various psychiatry drugs. In this pandemic situation of COVID- 19 infections we were made to be extra cautious with patients. I had learned the practice standards in theory as a nursing student, but I practiced using these standards in the unit gave me more confidence.

Feelings of Mental Health Clinic

In the beginning, I was very reluctant to pursue duty in the mental health unit, and as I had very less experience working with patientsof mental health problems or illnesses. In the theoretical course of mental health, I had gained information and understanding of the range of the medical problems of mental health including pathophysiology and clinical diagnosis. The mental health facility, however, caused a spectrum of anxiety that generated negative feelings inside me.I got anxiousin helping patients as I had a negative outlook on interacting with patients with mental wellbeing.

I was very keen to see how the nurses perform routine work from the first week and I used to compare if they communicate with the practice standards. I exercised hand hygiene before and after any operations, among other precautionary measures, to minimize patient damage as the situation with the COVID infection worsens (Odor et al., 2020). The unit also carries out therapy session for the patients. I was disappointed as I could not attend any of the sessions due to COVID infections. I also felt bad that we couldn't take patients with OCD, as the chances of infection spread is more with such patients. I engaged with staff in developing a patient care plan during the screening processes and evaluations. Being responsible I handover using ISOBAR to ensure that important patient information is transmitted to staff. For every shift, the nurses have helped me to achieve these competencies very smoothly. I felt bad when I came to know that I cannot access the medication room.

Evaluation of Mental Health Clinic

The nursing students entering mental healthunits are filled with thoughts of common myths and misconceptions about mental health (Choudhry et al., 2016). I also faced the same dilemma of a natural fear of the unknown and the conflict towards the patients with mental illness. The negative perception regarding mental wellbeing is dependent on several causes, mainly misunderstanding and misconceptions. Stigma leads to delay in the recovery process and affects almost every aspect of the life of a person with a mental illness. These stigmas and negative feelings have varying ways of affecting patients with mental health. Individuals reported alienation from their parents, lose romantic spousal and child relationships, encounter aggression, lose people and endure feelings of isolation.

The nurses were really helpful and taught me to handle the patients in the unit and help me overcome my misconceptions. I was able to witness and attend admission and release processes during my shifts. Because it's my first mental health admission process, this was easy for me since my clinical educator had prepared us to take MSE's, do risk analysis, and write treatment plans.I am also aware that the Melbourne clinic is fully accredited to the NSQHS Standards. Before I started my placement and during my placement, I have to complete the infection control training, and also with the current COVID crisis they have been very strict and cautious. Initially, I was hesitant in discussing and approaching the nurses for the patient care plan. I understand the importance of ISOBAR is to avoid any miscommunication in the handovers (Porteous at al., 2009). So, I started communicating with the other team members slowly.Later on, I learned about the various ways to communicate within the unit, which was writing a progress note, communications book, and ISOBAR handover. I recognize the value of communication in nursing as it has a direct influence on patient care and feedback (Bramhall, 2014).As a student nurse, I am being monitored for my critical thinking and communication skills to ensure that I am a safe and competent nurse practitioner. I also learned that the nurse administering medication must adhere to the eight rights to medication (Smeulers et al., 2015).

Analysis of Mental Health Clinic

The duties I have been doing in my unit adheres to the NMBA standards of comprehensivequality nursing practice. For any health care system if it is a requirement to abide by the NSQHS standards in order to provide safer care to the patients and reduce risk of the patients from infections. Medications are excessively used in hospitals and it’s the nurse responsibility to manage patient’s drug safely and accurately. The nurse should have a detailed medication plan for the patients.As a mental health nursing student, the main thing to keep in mind was to have therapeutic communication skills. It is demanding that in healthcare system promoting effective communication is essential despite the workplace being often unpleasant and pressurizing (Bramhall, 2014).

However, the NMBA practice standards require nurses to provide suitable care, covering ethical and cultural issues (Eren, 2014). High rates in nursing education have shown that they can positively affect students’ attitudes towards mental health. Such emotions and the resulting problem are natural processes and many student nurses and more seasoned nurses face them. Nurses are always expected to act in a way that protects and promotes their patients' wellbeing. During care for psychiatric patients, nurses face difficulties in taking control of their negative feelings. By acquiring knowledge and skills, recognizing moral problems and implementing ethical understanding, nurses and health care providers can address ethical issues (Pachkowski, 2018).

Conclusion on Mental Health Clinic

Personal evolution and coordination of care is a procedure which nurses are compelled by, as provided in the code of ethics. The primary responsibility of nurses is to take care of patients and to make them ready for their activities in life. A nurse should know to evaluate the moral dilemmas objectively and deal with them effectively. Despite being initially irritated, I felt I had a responsibility to look after these patients. I thought that I was professionally trained and fulfilled my obligation by demonstrating the ability to provide a high standard of patient care.Knowing the standards of practice in nursing career is very important for being a more professional and providing the patient with safe care. So, I was extra careful with the hand hygiene and PPE in dealing with patients. Additionally, learning about medication is very important to ensure safe and effective medication administration. Communication in nursing is a key component for effective working with the multidisciplinary team and providing patients with efficient care.

Action Plan on Mental Health Clinic

My action plan will be about the knowledge I want to gain. I have come to realize and comprehend that mental health care patients have a right to nursing care, and it is of paramount importance that I recognize and understand the mental health patients needs. I will put an end to the misconceptions related to mental health and serve them with my best of abilities. I will follow the standards of practice and will gainknowledge about psychiatrylegal and ethical issues (Aydin & Ersoy, 2017).For the professional development and patient care, I would like to know more about the medications and their adminstrations, given to patient with mental illness. Also, I would like to enhance my communication skills for better work output in a multidisciplinary team. I will do more scheduling research and try to minimize the errors while administering medicines.

References for Mental Health Clinic

Aydin Er, R., & Ersoy, N. (2017). Ethical problems experienced by nurses who work in psychiatry clinics in Turkey. Journal of Psychiatric Nursing. 8(2),77-85.

Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., Assiri, A., Al Saadi, M., Shaikh, F., & Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese journal of paediatrics, 14(2), 9–16.

Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard. 29(14), 53-59. doi: 10.7748/ns.29.14.53.e9355

Choudhry, F. R., Mani, V., Ming, L. C., & Khan, T. M. (2016). Beliefs and perception about mental health issues: a meta-synthesis. Neuropsychiatr Dis Treat. 12, 2807‐2818. doi:10.2147/NDT.S111543

Eren N. (2014). Nurses' attitudes toward ethical issues in psychiatric inpatient settings. Nurs Ethics. 21(3),359‐373. doi:10.1177/0969733013500161

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.

Odor, P. M., Neun, M., Bampoe, S., Clark, S., Heaton, D., Hoogenboom, E. M., Patel, A., Brown, M., & Kamming, D. (2020). Anaesthesia and COVID-19: infection control. British journal of anaesthesia, S0007-0912(20)30200-2. Advance online publication. https://doi.org/10.1016/j.bja.2020.03.025

Pachkowski, K. S. (2018). Ethical competence and psychiatric and mental health nursing education. Why? What? How? Journal of Psychiatric and Mental Health Nursing, 25(1), 60–66. https://doi.org/10.1111/jpm.12439

Porteous, J. M., Stewart-Wynne, E. G., Connolly, M., & Crommelin, P. F. (2009). iSoBAR--a concept and handover checklist: The National Clinical Handover Initiative. Med J Aust. 190(S11), S152‐S156. Husebø, S. E., O'Regan, S. &Nestel, D. (2015).Reflective Practice and its role in simulation. Clinical Simulation in Nursing. 11 (8) 368-375

Smeulers, M., Verweij, L., Maaskant, J. M., de Boer, M., Krediet, C. T., Nieveen van Dijkum, E. J., & Vermeulen, H. (2015). Quality indicators for safe medication preparation and administration: a systematic review. PloS one, 10(4), e0122695. https://doi.org/10.1371/journal.pone.012269

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