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Steve Hemingway presents findings of a study exploring how mental health nurses implement medicines management
Abstract
Aim: This study aimed to ascertain registered mental health nurses' perceptions of their role involving medication management interventions with clients and their carers. Medicine-related interventions include administration, assessment of therapeutic effect potential side-effects, education, liaison with service users and influence in prescribing decisions.
Design and methods: The study used a qualitative design. Ten registered nurses were interviewed.
Findings: Three themes were identified all related to the nurse context of work, role and client and carer need: improved dialogue. information and education, and adherence issues. Practice implications: Nurses use their clinical expertise in medication management to help achieve optimum therapeutic outcomes.
Key words
Medication management, role, mental health nursing, carers, service users
Introduction
Mental health nurses' medicine management interventions have the objective of addressing the needs of the person who is prescribed medication, including effect and side-effect assessment, management and information exchange (White, 2004).
Whether the mental health nurse prescribes or includes medicine management in their role, the aim is ensure the service user (and carer) receives the optimal therapeutic effect of the medication while minimising any potential adverse reactions (Snowden, 2010).
Psychotropic medication remains a leading intervention despite opposition to it claiming its use is for the social control of people with symptoms of mental distress (Cutliffe and Happell, 2009; Gray et al, 2009).
There are questions about the longterm efficacy of psychotropic medication, for example antidepressants (Moncrieff, 2007) and antipsychotics (Leiberman et al, 2006, National Institute of Health and Care Excellence, 2008).
Indeed, rather than increasing wellbeing and life expectancy, antipsychotics (DeHert et al, 2010), some mood stabilisers and antidepressants can increase morbidity and subsequent mortality (McCloughen and Foster, 2011; Hemingway et al, 2014). This also applies to younger (McCloughen et al, 2012) and older people (Baker et al, 2008) diagnosed with a mental illness.
There have been calls to minimise the use of psychotropic medication as their supposed benefits in treating mental health conditions have been described as mythical (Barker and Buchanan-Barker, 2012). Other commentators have suggested mental health nurses need to be at least more critical of psychotropic medication they might administer and prescribe (Harris and Shatnell 2012).
More than 90% of people...