New Ways of Working for nurses
| Pages | 4-9 |
| Published date | 24 September 2009 |
| DOI | https://doi.org/10.1108/17556228200900019 |
| Date | 24 September 2009 |
| Author | Neil Brimblecombe |
| Subject Matter | Health & social care |
4The Journal of Mental Health Training, Education and Practice Volume 4 Issue 3 September 2009 © Pier Professional Ltd
New Ways of Working for nurses
Abstract
An enormous amount of change has occurred in
the last six years for the mental health system in
England and the workforce within it. We have seen
the 10-year National Service Framework for Mental
Health (Department of Health, 1999) gradually
make its impact felt in the form, in particular,
of new community mental health teams and
structures for delivering care in the community.
We have also, most recently, experienced the
Government, 2007), after many turbulent years of
controversy and argument, extending to nurses
and non-medical practitioners who have been
given statutory powers to act as approved mental
health practitioners and approved clinicians.
Alongside these important developments has
been a gradual revolution in traditional ways of
working, in the form of the New Ways of Working
initiative. This article cons iders the impact of
New Ways of Working on mental health nursing
– the single largest professional group within the
mental health workforce – and the continuing
implications for the profession. The development
of nurse prescribing is used as an illustration of the
challenges and opportunities that have commonly
arisen when new roles and skill sets have been
introduced in mental health settings.
Key words
New Ways of Working; mental health nursing;
nurse prescribing; interprofessional relationships
Mental health nursing in England
Mental health nurses (MHNs) are found in virtual ly every
service area in mental health. In many areas, such as in
inpatient settings, they form the bulk of the workforce,
but they are also found working in specia lty areas such
as psychothera py services. Num bers have grown steadily
over the years. The most recent census data show a 14.8%
increase, from 48,877 in 1998 to 56,117 in 2007 (NHS
Information Ce ntre for Health and Social Care, 2009) .
In order to understand the way in which New Ways of
Working (NWW) has be en embraced, or not, by MHNs,
it is i mportant to understand the historical context of
the profession. There is a direct occupational ancestry
that evolved i n Victorian asylums, where the first formal
training progr ammes and qualifi cations were esta blished
at the end of the 19th century. Importantly, medical staff,
in the form of t he medical superintende nts, retained
direct managerial control over mental health nurses until
the 1960s. The two profes sions of psychiatry and nursing
have thus been intertwined since their births. Even when
most of psyc hiatry’s formal ma nagement responsibility
for nursing came to an end, implicit influe nce over many
nursing activities was slow to fade (Brimbl ecombe, 2005).
However, the steady growth of more independent nursing
roles outside the hospital setti ng, the increase in more
specialist and s enior roles (such as nurse consultants a nd
nurse practitioners) and acquisition of advanced skills
(such as psychosocial interventions) has supported the
profession to belatedly assert its i ndependence.
So, in the last few years, mental health nursing has
joined the interpr ofessional jostling for ‘space, attention
and independ ence’ (Coppock & Hopton, 2000 p48) in the
mental hea lth arena. Many MHNs want their profession
to become more confident and autonomous, and also
to have improved relationships with other professions
(Gowodo & N olan, 2008). Yet , recently, mental health
nursing has had to c hallenge thr eats to its s urvival
as a separate and distinct branch of nurs ing from its
own nursing regulatory body. The outcome, following
much vigorous lobbying by men tal health n urses, was
a continued commitment to hav ing separate branc hes,
rather than follow the model of generic nursing as the
basic qualificat ion for all areas of practice, as followed in
most of the rest of Eur ope.
Neil Brimblecombe
Director of Nursing, Research and Development
South Staffordshire and Shropshire Healthcare NHS Foundation Trust
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