Innovation
We developed personal and professional development (PPD) groups to facilitate mental health student nurses processing the emotional challenges experienced in education and practice. The 90-minute groups meet weekly throughout the academic year, including when the students are undertaking placements, and last for the entire length of the course. Each group has two facilitators who commit to facilitating the group for the duration of the students’ course. The facilitators undergo fortnightly supervision from an experienced group analyst.
What prompted innovation?
The groups were developed with reference to Menzies Lyth’s suggestion that nurses need help to confront and address their anxiety (Menzies Lyth 1959). There is evidence that nurses find the exploration of feelings to be a demanding and alien process: nurses talk of having a ‘protective shell’ that blocks exploration (Ashburner et al, 2004). Student nurses in particular ‘appear overwhelmed by a simple invitation to explore self-awareness or group dynamics’ (Gilmartin, 2000). The PPD groups were designed to give students time to learn how to make such explorations. The aim of the PPD groups is to promote understanding about the impact of mental health work on the students as individuals.
A further local reason for establishing the groups is related to the clinical areas in which the students undertake placements. The need for inpatient services in the three inner East London boroughs (Hackney, Newham and Tower Hamlets) is about three times as high as the national average (www.lho.org). Students placed in this geographical area are more likely to be exposed to high levels of disturbance and distress.
References
Ashburner C, Meyer J, Cotter A, Young G, Ansell R (2004) Seeing things differently: evaluating psychodynamically informed group clinical supervision for general hospital nurses. NT research, 9, 1, 38-48.
Gilmartin J (2000) Psychodynamic sources of resistance among student nurses: some observations in a human relations context. Journal of Advanced Nursing, 32, 6, 1533-1541
LPHO (London Public Health Observatory)
www.lho.org.uk/LHO_Topics/Analytic_Tools/MentalHealthScoreCard.aspx accessed March 27, 2013.
Menzies Lyth, I (1959) The functions of social systems as a defence against anxiety. A report on a study of the nursing services of a general hospital. Human Relations, 13, 95-121.
What makes innovation different?
In common with other Higher Education Institutions delivering healthcare education we support students in clinical practice; most of the support is process driven (by reflective practice groups or visits to clinical areas). The PPD groups are different because they promote self-exploration and an understanding of the impact of the work on individual students.
Changes in practice
Students report reduced levels of fear about discussing the clinical work that is causing distress, and increased understanding of their own role and improved confidence in their ability to cope in practice. We anticipate that this will result in reduced attrition and sickness, and increased satisfaction, as well as a long-term positive impact on well-being and performance.
Impact
- This style of learning was commended by the NMC on the validation of the September 2012 pre-registration nursing curriculum at City University London.
- Students report deriving a great deal of support from the PPD groups and increased understanding of the impact of the clinical work (in evaluations).
Dissemination
- A paper has been submitted to an academic nursing journal.
- Lecturers in the School of Health Sciences are currently undertaking research to establish the impact of the PPD groups.