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Tex-Nex
A Texan Nursing Exchange
Amy Barry, Betsy Conlon and Nathalie Mills
• Created in 1948 following WWII
• The general principle is ‘health service will be
available to all and financed entirely from taxation
which means that people pay into it according to
their means’
• Private healthcare does exist but it is quite
unaffordable for most
• Currently the NHS is a hot topic in politics and
financial cuts are causing a huge strain
Mental Health Care Services
• Community – covers all ages
• Inpatient - ranging from Psychiatric Intensive
Care (PICU), Acute, Rehabilitation, Elderly,
Child and Adolescent (CAMHS)
• Since the recent cuts in funding we have seen
a dramatic shift from inpatient services to care
in the community
Multidisciplinary teamwork
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On a typical ward there will be:
Registered Nurses
Health Care Assistants (HCA’s)
Consultant Psychiatrist
Occupational Therapist
Social Worker
Music Therapist
Advocate
Animal Therapist
Physiotherapist/Dietician
Admission for Treatment
• The Mental Health Act works in conjunction with
the Mental Capacity Act
• Patients will be brought to a ward on a section or
informally
• The common sections that are used are
• Section 2
• Section 3
• Section 136
• Patient’s can appeal their sections if they wish
Post Graduate Diploma in Mental
Health Nursing
• We all have a previous degree in Psychology
• The course is two years as apposed to 3
because of our previous degree
• The second year is Masters level
• We all have previous experience in working
with vulnerable people
• When we graduate in February we will be
Registered Mental Health Nurses (RMN’s)
Post Graduate Diploma in Mental
Health Nursing
• 40% of the course is theory and 60% is made
up in practice hours
• Theory involves being in university and is in
the form of lectures and practical's
• So far we have had placements in: Elderly,
Rehabilitation, Acute care and Community
Settings
Placements
• A placement ranges from 6 – 14 wks working 37.5
37.5 hours per week
• We shadow a registered nurse
• We have a ‘placement book’ which has to be
filled in at the end of the placement showing that
we have adequately completed competencies
required to qualify as a nurse
• On placement you are expected to work as part
of the team – dispensing medications,
coordinating shifts, managing the ward
Challenges facing Recovery in Mental
Health
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Funding cuts from government
Stigma and discrimination
Families
Recovery vs medical model
Challenging old school thinking
Theory
• The first semester covered an introduction to
basic nursing skills and medication management
• Core aspects of the course have been:
• Care planning
• Clinical Skills
• Leadership and Management
• We also complete Mental Health ‘simulations’
http://www.youtube.com/watch?v=uPurxufCj_Q
Substance misuse
• We haven’t had the opportunity to gain any
experience in this as yet but from what we
understand in the UK:
• Substance misuse is mainly treated in the
community
• Some people have a short stay in a unit where
they have access to 24 hour medical care if
necessary
Places we have visited in Texas!
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Recovery Resource Council
Serve Denton
SARC
Solutions
Maggie’s House
Our Calling
Denton County Juvenile Detention Centre
Enterhealth talk
Kristin Farmer Autism Centre
TAAP
Centre for Neuro Skills
Epilepsy talk
Stewpot
Presbyterian Hospital
Sante
Terrell State Hospital
Denton Juvenile Detention Centre
How do things differ?
• As we are much more familiar with inpatient
wards we have chosen to compare what we have
seen of the hospitals here
• Daily routine
• Leave
• Modern Technology
• Grouped according to disorder
• Restraint
• Follow up care
• State funded care has more similarities to the UK
Suggestions for future exchanges
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Advise that it is necessary to rent a car
Advise to make a blog
CRB
Outline beforehand what the objectives of the
exchange are and what would be beneficial
• A schedule in advance
• Would be beneficial to attend some lectures if
possible
Things we really enjoyed
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Having a guide (Amy)
Being given enough downtime to explore
The weather
The Detention Centre
Terrell Hospital
Presbyterian Hospital
Stewpot
Maggie’s House
How hospitable everyone has been
The expertise of everyone who we have spoken with
What we all have in common is a desire to care for
others and ultimately that is all that matters.
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