The weight of “the keys”: two autoethnographic accounts of how mental health nurse training has changed over the decades
| Date | 24 October 2023 |
| Pages | 811-820 |
| DOI | https://doi.org/10.1108/MHSI-09-2023-0097 |
| Published date | 24 October 2023 |
| Subject Matter | Health & social care,Mental health,Social inclusion |
| Author | Barrie Green,Jake Stanworth |
The weight of “the keys”: two
autoethnographic accounts of how
mental health nurse training has
changed over the decades
Barrie Green and Jake Stanworth
Abstract
Purpose –This paper aims to criticallycompare the impact and preparedness for practice of two types
of mental health nurse training in the UK. One being a hospital-based apprenticeship model from the
1980s;the other a university-based and moreacademically focussed approachfrom this millennium.
Design/methodology/approach –This autoethnographicreflective commentarydescribes and reviews
the effectivenessof two training curricula for Registered Mental Nurse (RMN) training.The first being the
certificate-level1983 syllabus of the UK Central Council for Nursing, Midwifery and HealthVisiting, which
was replaced in the late 1990sby diploma and degree-level Project 2000 training of the GeneralNursing
Council. Usinga reflective narrative approach to describethe lived experience of two qualified nurses,it
compares,reviews and critiques both initiatives.
Findings –The author/researchers found both benefits and negatives inherent in each model. These
were grouped into fivekey headings, which are a sense of belonging/identity; exposure to clinical
practice; differences in training modality; development of clinical management skills and clinical
preparedness; and academic merit. The older curriculum lacked an academic or research base,
whereas the more recent approach encouraged and enhanced this element. However, with regard to
preparingthe clinician/registered nurse to feel confidentin addressing a range of clinical and managerial
challenges,the older style training seems to deliver better outcomes.They conclude that a move towards
a ‘‘middleground’’ between the two models may beof benefit to future RMN preparation.
Research limitations/implications –This study reports on the experience of two registered nurses.
Therefore, the sample sizeis small. However, autoethnography is acknowledged as an effectivemeans
of delivering qualitative research; in addition, the authors access and use material from the wider
literature to triangulate and critique their approach. This paper addsto the literature but also allows for
duplicationby others to further test the findings.
Practical implications –This type of study providesan opportunity for others to review, compare and
contrast nursingor other multi-discipline changesin training/curriculum. The researchmethod is one that
is transferable and canbe used within areas of practice, which have resourcelimitations. It provides an
opportunityto replicate it in other servicesor jurisdictions.
Social implications –Nursingin the UK has experienced significant changeover the past four decades.
For RMNs, the move from hospitals into the community has been transformational. In addition, the
influence of higher academic standards and the influence of the recent pandemic have challenged
the profession and individuals within it. This study demonstrates positive and negative elements of the
dilemmafaced by nurses and offers a further contribution to this area.
Originality/value –There are a number of academic papers, media stories, statutory reports and
guidance that explore the impact of changes within nurse training. This paper uses a first person
autoethnographicstudy of the impact and effectiveness of thesechanges at a human level, the nurse on
the ground. It uses the ward medicinekeys as the vehicle to represent the huge responsibility that newly
qualifiednurses must face; this is not widely represented elsewherein the literature!
Keywords Autoethnography, Historical account, Mental health nurse training, Preparation for practice
Paper type Research paper
Barrie Green and
Jake Stanworth are both
based at the Department of
Psychology, University of
Bolton, Bolton, UK.
DOI 10.1108/MHSI-09-2023-0097 VOL. 28 NO. 5 2024, pp. 811-820, ©Emerald Publishing Limited, ISSN 2042-8308 jMENTAL HEALTH AND SOCIAL INCLUSION jPAGE 811
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