Annie Altschul Collection

This thesis focusses on nursing within clinical practice and higher education. The work emerges from mental health nursing with one of the most marginalised groups in society, homeless people with mental health problems. The works develop from liminal spaces in clinical practice to the liminal space occupied by nursing in higher education.
Themes: Liminality; professional identity; nursing in higher education; gender and nursing

Survey of undergraduate student nurses and midwives to identify prevalence rates of stress, the sources of stress, coping mechanism and what predicted stress in these populations. 1,107 students took part. Nursing and midwifery students were found to be similar to students of other disciplines with respect to their experiences of stress.
Themes: Occupational stress; nurse education; midwifery education; student nurses; student midwives

The rationale for this study sprang from a desire to improve the transition experience from nurse to nurse educator. The knowledge gained would then underpin a developmental pathway for practising nurses to prepare for a new career in education. It turned out to be a journey of personal discovery!
Themes: Identity; transition; nurse education; role of doctorates in nurse education

The thesis makes a novel contribution to team formulation theory, by uniting team and case formulation research. It provides a model to guide future team formulation research. The utility of the model is demonstrated by the two studies conducted for the thesis. Both studies advance understanding of team conditions and their relevance to the knowledge sharing required in team formulation. Furthermore, the thesis provides opportunities for teams to develop or enhance team formulation practice by suggesting the theory based core components and flow of team formulation practice.
Themes: Team formulation; psychological case formulation; mental health and learning disability teams.

People with mental ill health face higher mortality rates and reduced life expectancy of up to twenty years. Mental health nurses have a role in supporting the physical health of people with mental illness. This mixed methods study explores mental health nurses attitudes towards managing physical health.
Themes: Physical health and mental illness; physical health care by mental health nurses; mental health nurses attitudes towards physical health management

This thesis used constructivist grounded theory to analyse a mix of survey, literature and interview data with qualified prescribers to show that mental health nurses were not as competent in managing medicines as they assumed they were prior to becoming prescribers.
Themes: Mental health nursing; prescribing; concordance; adherence; grounded theory

This study explores talk about mental health nursing, in a policy and practice climate that promotes service user involvement in nursing processes. The intention of this study was to gain multiple perspectives about mental health nursing and service user involvement through in-depth research interviews and focus groups with mental health nurses, nursing students and mental health service users. Analysis centred on the meaning making of participants’ talk and how mental health nursing identities are accounted for and constructed.
Themes: Mental health nursing; Service user involvement

Variation in nursing students understanding of recovery and the troublesome nature of their learning journeys is explored. Recognising student understanding and obstacles to learning provides important insights for teaching. Findings identify recovery as posing particular challenges for students requiring educators to consider a range of strategies to support transformational learning.
Themes: Student nurse education; recovery; phenomenography; threshold concept framework

The aim of the thesis was to gain greater insight into how military healthcare professionals experience the transition into a civilian work role informed by the author’s and other people’s experience of transitioning.
Themes: Veterans; heuristic inquiry; career transition

A qualitative methodology informed by Miles and Huberman was used to examine whether or not an education and training programme for nurses, nurse teachers and narcologists working in St. Petersburg had been effective in changing clinical practice and on city-wide education and practice provision. Thesis held by University of Portsmouth Library.
Themes: Nurse education; Health care professionals’ education; Narcology services; Russia; Applying Patton's work on utilisation focused evaluation; Applying Miles and Huberman

Unlike more general consideration of caring relationships, the important experience of the time patients and students share together in secure personality disorder units has not been specifically explored before. Patients and student mental health nurses participated in unstructured hermeneutic interviews. When students and patients shared time together they were being-with in their own time and space, engaging in the mundane everyday, sharing activities, common interests and having a laugh, ultimately making connections, which had lasting impact. This was in despite of experiences of past trauma and dehumanising landscapes, or the bearing of diagnostic labels. Students experienced a balance between therapeuticness and professionalism. The time students and patients shared together was a gift, enabling them to feel that they were ‘just people’ and valued, powerfully impacting on their sense of humanness.
Themes: Time; therapeutic relationships; patients; student mental health nurses; personality disorder; secure services; forensic nursing; phenomenology; hermeneutics; Heidegger.

New psychoactive substances (NPS) can cause severe physical and mental health harms, including death. Substance misuse and mental health service healthcare professionals (Hcps) face many challenges in the identification of NPS types, related symptomatology and responding to people who use NPS (PWUNPS). Findings indicated that Hcps experienced organisational issues, and this impacted the treatment for PWUNPS. These issues included a lack of training surrounding NPS, a lack of knowledge on the different NPS types, harm minimisation (HM) strategies and lack of assessment procedures and policy. The Hcps requested further trainings surrounding stigma associated with people who engage in chemsex (PWEICS), the homelessness, people with mental health problems and assessment of PWUNPS.
Themes: New psychoactive substances; substance misuse; health care professionals; symptomatology; assessment; harm reduction; training; knowledge; stigma

An examination of how acute psychiatric nurses form a therapeutic relationship. Six major themes are identified: making a connection; the utilisation of values; appraising the situation and manoeuvring; using and working with boundaries; managing the challenges and pressures of acute psychiatric work; and working as a team.
Themes: Acute mental health; acute psychiatric nursing; therapeutic relationships; nurse-patient relationship; mental health nursing; psychiatric nursing

Both caring behaviours and critical thinking are essential components of being a capable mental health nurse. By positioning student mental health nurses as psychosocial defended subjects, the research shows theoretically and empirically that caring behaviours and critical thinking dispositions are mutually inclusive and both are influenced by dynamic psychosocial factors.
Themes: Mental health student nurses; nurse education; capacities to care; critical thinking; psychosocial defended subjects

This thesis adopted a critical approach to explore compassion and examine how the concept has been discursively constructed in relation to power, institutions, and social practices. The study adopted a critical discourse method to examine various dimensions of discourse, at multiple social strata. Conducted in three phases, it encompassed data arising from a document analysis, interviews with mental health nurses (n=7), and interviews with patients (n=10). While compassion was considered essential for the recovery process, unseen forces in the social world inhibited compassion, e.g., medical discourses were shown to dominate the discipline and practice of psychiatry, which were theorised to have influenced individual and group systems of attitudes, beliefs, and values such that discourses of compassion and humanistic approaches were marginalised. Hence, the implicit value and function of compassion to positively impact health and wellbeing was easily overlooked.
Themes: Compassion; discourse; nursing; politics; mental health