Nurses perceptions of their role working with people with severe mental handicaps in the community

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.Applied Science, Faculty ofNursing, School ofGraduat