A model to facilitate the mental health of student nurses working with mentally challenged individuals

D.Cur. (Psychiatric Nursing Science)The researcher was involved in the clinical accompaniment of student nurses working with mentally challenged individuals during their psychiatric nursing practical training. In her role as advanced psychiatric nurse educator, she noticed that student nurses experienced working with mentally challenged individuals as a challenging working context. It created intense emotional discomfort for the student nurses, especially during their initial exposure to the relevant individuals. During the student nurses' last day of working with these individuals, they reflected with the advanced psychiatric nurse educator on their emotional growth and enrichment and how this experience had changed their views of life. Ineffective management of emotional discomfort may lead to emotional exhaustion or burnout and reflect negatively on a person's mental health. The main purpose of this research was to explore and describe the experiences of student nurses working with mentally challenged individuals. Subsequently, to develop, describe and write guidelines to operationalise and evaluate a model for the advanced psychiatric nurse educator to facilitate the mental health of student nurses working with mentally challenged individuals. A qualitative, explorative, descriptive, contextual and theory-generating research design was utilised to achieve the abovementioned purpose. The development of the model comprised four steps. Step one consisted of a concept analysis including identification and definition of central concepts in the model. A concept analysis was done by exploring and describing the experiences of student nurses working with mentally challenged individuals. Two focus groups, naive sketches, reflective journals, a reflective letter and field notes were used to explore their experiences. Focus groups were audiotaped as well as videotaped. Verbal consent was given by the student nurses to be videotaped and a letter of consent was signed to give permission for audiotaping of the focus groups. The audio tapes were transcribed verbatim. The video tapes were only used by the transcriber when she could not hear the sound on the audio tapes clearly. An independent coder utilised Tesch's method of open-coding to code and analyse the data. A consensus was reached between the researcher and the independent coder with regard to the themes and catogories represented by the data. During the concept analysis, engagement on a deeper emotional level was identified as the central concept. Step two consisted of the relationship statements of the model. During step three, a model for the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals was described. The structure of the model clarified the purpose, assumptions and context. The central concepts were defined and the relationship statements between the central and essential concepts were explained. The structure of the model focused on the relationship-, workingand termination phases within the process of engagement on a deeper emotional level. In step four guidelines were described to operationalise the model in practice. The model, as framework of reference for the advanced psychiatric nurse educator, focused on the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals. The process description of the model differentiated between three phases: the relationship phase, the working phase and the termination phase. Guidelines for the operasionalisation of the model focused on the objective of each phase as well as the strategy of actions for each different phase