How the Mental Health Nurses Masterclass can Enhance Your Practice.

The very first Psych Scene training event for mental health nurses was held in Melbourne in March this year, with a passionate and motivated group of nurses attending from across the Australian states. The aim of this new Masterclass is to impart knowledge that positions the nurse as an important bio-psychosocial strategist within the multidisciplinary team. After all, nurses spend a lot more time with the patients than consultant psychiatrists; and their observations, opinions and synthesis can be a valuable addition to the overall picture in management. The second event is now scheduled in Sydney for November 30th 2013.

The first half of the training day started off by focusing on the practical aspects of neurobiology of psychiatric disorders relevant to clinical practice – e.g. for clues that would differentiate schizophrenia from fronto-temporal organic brain involvement, examining the brain through clues from mental state exam, physical behaviours, cognitive examination and investigations. This was then linked to the psychopharmacology, covering antipsychotics, antidepressants and mood stabilisers. The course stressed that antidepressants and antipsychotics cannot be clumped into one category, and that by understanding the unique receptor potential of each of the medications one could tailor medications to patient symptomatology. This was followed by the key elements of cognitive examination and brief physical examination with signs that can provide important clues to a physical illness.

After the morning coffee break, the hypothesis based interview and formulation models were covered. Psychiatric interviewing is based on an iterative model where the questioning is based on the data and evidence generated, resulting in a time efficient and high yielding interview.

Sir William Osler’s statement “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” has been a long-standing motto of the Psych Scene training. Hence, whilst the diagnosis is an essential aspect of management, it is also important to go beyond the label, teaching techniques to devise a comprehensive bio-psycho-social formulation. This is based on the same structure provided in the Psych Scene courses for Psychiatry Trainees and Consultants.

The formulation models encompass bio-psycho-social models which, when incorporated together, provide a comprehensive and sophisticated understanding of the patient that goes beyond the diagnosis. This article provides you with a glimpse. By incorporating neurodevelopmental models, hormonal and vascular hypotheses, dialectical behavioural models, interpersonal models etc. a complete picture of the patient emerges.

Techniques to devise a structured management plan were also discussed, empowering the nurse to present in a structured, sophisticated manner taking into account risk, bio-psycho-social elements, prioritisation and prognosis.

Later on, a quiz and 2 case studies helped to reinforce all the earlier discussions.  Overall, the patients in the cases discussed would have been in good hands as the attendees nutted down the specifics and looked at the person as a whole. At the end of the training day, the latest advances in psychiatry were covered, spanning from the role of hormones, psychoneuroimmunology, new medications and receptor profiles.

As part of the training, participants received a hard copy course booklet and access to the course presentation online, along with the certificate of completion accredited for 7 CPE points by the ACMHN.

Positives from the course:

• 100% of the candidates would recommend the course to others.
• The overall usefulness of the training day was marked 4.69 (1 = poor, 2 = adequate, 3 = average, 4 = good, 5 = very good).
• The overall course content was marked 4.61 (1 = poor, 2 = adequate, 3 = average, 4 = good, 5 = very good).

Attendee Comments:

“It was good to have someone speak to nurses in a way that presumed and even demanded that we step up and let our observations be heard knowing they have meaning.”

“Thought provoking – makes me want to investigate issues with patients further.”

“I can use all of the knowledge and skills learnt today, hopefully with improved outcomes for consumers using new models.”

And also need for improvement:

~   “Breaking up the day more would be better.”

~   ”Lots of information for one day.“

~   “Better to spread over two days.”

~   “More case studies required.“

Overall, it was a great day with lots of learning. The Psych Scene team are already planning for the next training day for mental health nurses, which will be held in Sydney during the second half of this year. Changes made, based on the received feedback, will include the addition of another expert speaker and more case studies. The next course will deliver an enhanced program and benefit the new attendees greatly. Stay tuned…

The second Mental Health Nurses Masterclass is being held on 30th November 2013.

The Psych Scene team thanks the participating Mental Health Nurses for their valuable input in program quality improvement.

This article is written by Dr Sanil Rege. Sanil is a Consultant Psychiatrist and co-founder of psychscene.com. He is pursuing an MBA at the Melbourne Business School.  You can follow him on Google+