| Summary: | In British Columbia, people with mental handicaps are moving from
institutions to living in the community and the British Columbia government has
recently hired nurses to supervise the health care needs of these people. A
body of knowledge on which to base the specific roles for nurses working with
this client population is virtually non-existent. The purpose of this study was to
explore and describe nurses’ perceptions of their role in working with individuals
with severe mental handicaps in the community.
This was a qualitative, descriptive study. Sampling was theoretical and
twelve respondents were conveniently chosen. Data were collected through
tape recorded, semi-structured interviews which were transcribed verbatim and
analyzed using a process of inductive content analysis.
Three distinct categories of nurse functions (with subcategories) emerged
from the data: Collaboration, support, and teaching/learning. Collaboration
included activities where the nurses worked with others and was divided into
components of consultation, liaison, and team participation. Support included
activities related to maintaining the health of or meeting the needs of clients
and maintaining caregivers in their roles; it was comprised of advocating,
assessing, documenting, planning, providing direct care, and relationship building. Teaching/learning encompassed activities related to teaching others
and self-learning.
Collaboration and teaching/learning were stated to be major roles by all of
the nurses. The support components deemed to be important were advocacy,
assessment, planning and relationship building. Most nurses were doing case
management activities and saw this as their future focus. Travelling and
documenting consumed much time and observation; communication, time
management, and interpersonal skills were important for each aspect of the
nurse’s role.
The most difficult part of the job for most nurses was advocating for
clients while collaborating with caregivers at the same time. A major frustration
was expressed when nurses identified the clients’ health to be at risk but felt
they were not listened to by caregivers.
Nurses with advanced educational qualifications and experience working
with individuals with severe mental handicaps appeared to be the most
comfortable in the collaborative and teaching roles. Ongoing inservice
education and support are required for nurses working with this client
population and it is realistic to consider a baccalaureate degree as a minimum
requirement for this job.
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