To start our third day with BCU, we had a talk with Samantha Parry who is an educated school nurse. In the United States we say that school nurses help students within our school systems when they are sick throughout their day and make sure that students are taken care of. In the United Kingdom, school nurses are community and public health based. School nurses focus on children and young people that are school age and support their families. This type of nurse provides care for patients up to the age of 25 and try to maintain a seamless transition of care from birth to adulthood. The goal of school nurses is to make overall health better for children which corresponds with their education and focus which will create overall better health outcomes. As a school nurse, they don’t technically have a protected title. Having a protected title means that nobody else can say they’re a nurse until they go through the training, and as of now a lot people can say they’re a nurse without the proper education. The role of school nurse includes support with exam stress, dental and hand hygiene, puberty awareness, development checks, immunization checks, safeguarding, and advocating on different levels. These types of nurses are based in health centers and hubs and are actively emerging within the community. School nurses rearrange and connect their services to fit the needs of the community and exert socioeconomic awareness. Resources and people are allocated to where certain communities and areas are struggling. When assigned a different area of the community, school nurses conduct what they call community profiling. This is a screening for the community which entails walking around the area and looking at locations and access. They find in these profilings that areas of deprivation have higher amounts of fast food access which results in lower life expectancy. I think that this statement can also be applied to less fortunate communities within the United States. The cost of living and screening for high risk financial status is just a little part of the jobs of a school nurse within the community while taking socioeconomic into consideration.
From our talk with the school nurse I also learned a lot about the mental health aspect of this category of nursing. School nurses also have mental health support roles for their children that are within their course load. Through the work of school nurses they offer many different care and support groups. All the nurses have went through specific first aid mental health training so they are well versed in what to do in specific crisis situations. There is a section of the mental health service called Tier One Service. This is used for the most basic mental health cases like helping a child deal with panic attacks or when a child first starts to self-harm. If the situation is more major then the child will be referred to CAMHS, which stands for child and adolescent mental health services. This is apart of the National Health System and involves trained mental health nurses. Sometimes children have to be put onto a waitlist for an appointment for at least 2 years. If a child or parent does not want to wait that long for a specific service, they can go private. Private services, like child psychotherapy, is quite expensive and not accessible for everyone. Schools also have counseling available. There can either be individual talk sessions or group sessions that students can attend. The downside to counseling is that a certain counselor is only allowed to have a certain amount of students within their service, so there is also a waitlist for these services. Through these mental health services the main goal is to build resilience. Mindfulness techniques and meditations are just a few of the tools given to students. These techniques are also similar to counseling techniques that are used in the United States. The difference within the States is that we aren’t able to access these services for free like the United Kingdom. Also within the mental health realm for school nursing is the burnout rate and resilience of these nurses. Within the past couple of years there has been a 35% decrease of school nurses due to retirement. This massive decrease allows for increased burnout rate and decreased mental health of these nurses. I learned how school nurses begin to cope with these problems. These nurses try to adapt the tools they give to their patients and reframe these ideas for themselves. They also use the idea of a stress bucket. They ask themselves what fills their bucket or what has been weighing on their mind. They then begin to make holes within their bucket to try and relieve these stressors. There is informal and formal supervision that is also offered. Informal supervision is sharing with peers and formal supervision is sessions with team leaders and managers. An effect of the decline of mental health for nurses is the health promotion decreasing. The nurses themselves don’t have the capacity to offer or promote to others because they need to help themselves to help others.
Within our talk we also talked about in person and virtual services. The virtual services have increased since having the pandemic and from this increase came a tool called chat health. Chat health is a text number given to a child to text a health professional for advice which is usually a trained school nurse. The current records for school nursing are mainly paper but are starting to shift to electronic. Different people within the child’s care have different access rights. Also, different areas of the country have different systems which make it difficult to transfer records. Overall, from the school nurse discussion I learned about the major differences in how we use our school nurses and how the United Kingdom uses theirs.
We then had a lunch break after the school nursing lecture and then we switched to talking about mental health nursing in Birmingham. We began hearing from Jonathan Gadsby and a third year nursing student. We learned that Jonathan switched from adult nursing to mental health nursing which is not encouraged. After his introduction we began to learn about the history of the British government. We started to talk about the relationship with Hong Kong, Pakistan, and India. After reviewing this history we learned about how history or outside experiences can create the condition and category we call mental health.
The first author we began to talk about is Joanna Moncrieff, who is a practicing British psychiatrist. Her main focus is the use, misuse, and misrepresentation of psychiatric drugs. It deals with how we misunderstand the drugs we use and how we overestimate or underestimate their effects. She talks about the 2 separate models: the drug centered model and disease centered model. The drug centered model focuses on the psychiatric drugs and the mind altering effects that come along with them. She says that rather than correcting chemical imbalances, they cause one. Sometimes these effects are therapeutic to patients but other times the effects are negative. The disease centered model says that the psychiatric drugs work by reversing underlying illnesses. For example, depression used to be seen as a person not having enough serotonin and we would take SSRIs (selective serotonin reuptake inhibitors) to reverse these effects of deprivation of serotonin. The takeaway from this author is trying to move away from seeing a patient in the medical point of view but rather as a whole person with different life influences that cause these problems. Nurses need to try and support interventions and also reduce stigma. The next author we talked about was Lucy Johnstone who is a critical writer about psychiatry. She tends to talk about how diagnosis gets made and where this framework comes from. She focuses on the power imbalance rather than a chemical imbalance as a cause. The last author we talked about was Freya Collier-Sewell who is a nurse herself and just started writing. Her key arguments focus on the services nurses facilitate and how they keep getting rocked by scandal of poor care, neglect, and actual abuse. She is basically talking about the stigma around mental health nursing and the reputation history has given them. She says that we are trying to grow independence but we doubt that the independence is a good way of thinking about mental health.
After this talk, we were joined by the Black Heritage Walking Tour. From this we were greeted by a nurse who worked in 1960s in the United Kingdom. She told us about her experience through the different ages of nursing over here and how she was impacted by changes. She went from general nursing to psychiatric nursing to midwifery. We were informed that along with black people being discriminated against, Irish people were also discriminated against. We then went on a tour throughout Birmingham with the Black Heritage Walking Tour until dinner time, where we ate at a Jamaican restaurant.
I learned a lot from our lectures today, especially with reference to my research topic of mental health. I was very excited to learn more on this topic and found that I was very intrigued. I’m excited for the next day and all the information it has to bring!
