What skills and expertise are required for mental health nurse roles in acute settings?

Simon Arday has been appointed as Imperial College Healthcare NHS Trust’s first lead nurse for mental health and is currently recruiting a range of mental health nurses to a new outreach team in two acute settings. We asked him what he looks for when he sorts CVs and conducts interviews.

 

What general traits, skills and expertise are needed for those looking to deliver mental health in hospitals?

Most mental health nurses I know, and certainly those already in our team, already have a very diverse skill set. So often what I’m looking for depends on when I’m recruiting and for which team, as I’ll need to recruit nurses who will complement the existing skill sets. I’ll also be looking for dynamic skills that mean they can adapt to fast moving situations.

Mostly though I look for strong values. That has always formed the basis of my own practice and I trust it. The primary values I look for are mirrored in our Trust’s values: kindness, collaboration, aspiration and expertise.

• Kindness should be central to every mental health nurse's practice. It fuels our empathy, and enables us to support someone in distress, while acknowledging them as a ‘whole person’ not just a diagnosis. It means we can appreciate their strengths.
• Working across sites, specialities and settings, collaboration is also key. It is necessary for providing good integrated care with other professionals, as much as it is for working in partnership with patients, their families and carers.
• I think mental health nurses should also aim to be leaders, no matter what level they work at. That means people who aspire to be agents of change, no matter how small that is. For example, can they role model trauma-informed approaches when communicating; can they work autonomously and manage challenging situations; and do they feel confident to help build expertise across an organisation by delivering sessions in our training and education programme?
• The art of our profession is to continually evaluate our practice in response to changing needs and a changing environment. The science is the evidence base that underpins it all, i.e. our approaches to risk assessment, formulation and management. The expertise lies in how we bring those two together and that is key for me.

 

What kind of career and development options do you think mental health nurses should look for when applying for jobs in acute settings?

I can only speak from my perspective but I do think that generally career pathways for mental health nurses aren’t as well developed as they should be. And in acute settings it’s even less clear. In creating my team I’ve also tried to put in place an internal career framework for nurses who want to provide direct mental health care from an acute trust perspective. While it may take some time to establish, there is a real opportunity to nurture and develop the skills required to seamlessly work across the mental-physical health interface.

As a result, I’m very clear that there needs to be a strong support system in place for mental health nurses in acute settings, with guidance aligned to a clear competency framework and personal development plan. Nurses should be able to clearly see the skills and training required for each role and the support each nurse can expect to help them achieve these.

Mental health nurses applying for roles should also ask about how regular supervision is, if there are opportunities to reflect on practice, or any access to coaching and mentoring, as I see this as essential to maintain effective mental health practice. Often this can be more difficult in hospitals.

Overall nurses should be looking to understand what the vision for mental health is in an area and within a trust, as this will help them identify where they can bring most value or where they can develop skills.

 

What’s the reward for mental health nurses who look to progress their career in acute settings?

I think there is a real opportunity to develop your autonomy as a practitioner in this field while still having access to support. I also think this is a great time for all mental health nurses to think of themselves as leaders and partners in developing services.

The NHS generally is moving towards have a greater understanding of mental health and its impact on physical health, and vice versa. Certainly, in our team we practise observing the principle of ‘parity of esteem’, which seeks to care for the whole person and their needs whether mental or physical.

But it’s an area where health leaders are still grappling with how to do that most effectively, so this is a real chance for mental health nurses to help create those systems and approaches.

I’m hoping to create a career framework so we have opportunities for Band 4 mental health practitioners through to Band 6 mental health nurses.

Mental health nurses will also always work in multi-disciplinary teams and that’s exciting for nurses, allowing them to gain diverse experience and develop skills from a wide range of other specialists and experts.

 

Editor’s note

Pay rates for the Agenda for Change bands mentioned

Band 4: £25,147- £27,596, Band 5 £28,407- £34,581, Band 6 £35,392 - £42,618