NuncEdwarirm Today (1990) IO,6345 0 Longman Group UK Ltd 1990

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WORK The standing advisory group for community psychiatric nursing: grasping the nettle?

Edward White and Charles Brooker

This paper reports on the work of the Standing Advisory Group for Community Psychiatric Nursing Education (SAGCPNE). A precis of the historical development of CPN education is provided and a stronger relationship with the Mental Nurses Committee is proposed. It is argued that the educational preparation of community psychiatric nurses is the sine qua non of desirable, high quality, community mental health services and that methods for the identification and protection of adequate financial resources for such preparation must be found.

INTRODUCTION

The Standing Advisory Group for Community Psychiatric Nursing Education (SAGCPNE) was inaugurated on 26 March 1986 and has met since, at, quarterly intervals, in the offices of the English National Board (ENB), London. Ini- tially, the SAGCPNE membership was open only to the Course Leaders of the ENB 810/811 Community Psychiatric Nursing course. More recently, this has been extended to ‘course organisors and educators whose prime function is the education of community psychiatric nurses’. The SAGCPNE meetings have observer-representatives from the Department of Health, The United Kingdom Central

Edward White MSc (Sot Poll MSc (Sot Res) RMN DipCPN Senior Lecturer in Health Studies, Department of Community Studies, Brighton Polytechnic, Falmer, Brighton BNl 9PH, Charles Brookr BSc (Hans) MSc RMN DipNEd Senior Lecturer in Health Studies, Department of Health Studies, Sheffield City Polytechnic, Sheffield SlO 2BP (Reprint requests to EW) Manuscript accepted 5 July 1989

Council (UKCC) and the National Boards. The aims of the SAGCPNE, as outlined in the groups operational protocol, are listed in the table.

The three years since the SAGCPNE first met, now allows for a timely reflection upon the relative success of the group in achieving the original aims. In order to do so, it is important to briefly locate the position of CPN education within an historical and developmental context.

CONTEXT

Interest in the notion of psychiatric community care, led the General Nursing Council, in 197 1, to acknowledge the need to extend student nurses learning experience beyond the hospital, by including periods of community experience in training syllabuses. For mental nurses in basic training, such experience was included in the 1974 Registered Mental Nurses (RMN) Syllabus. Concurrently, the Joint Board of Clinical Nursing Studies (JBCNS), originally set up in 1970 to regulate post-basic clinical nurse edu- cation, was reconstituted in 1973 to include the

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Table 1 The aims of the SAGCPNE

1.

2.

3.

4.

5.

To promote and develop the education of community psychiatric nurses. To develop a United Kingdom strategy for CPN education. To develop liaison and cross fertilisation of ideas between course centres. To support and assist the establishment of courses for CPN’s at new centres. To liaise with, and act as a pressure group to, Government; UKCC; National Boards, professional organisations and staff representative bodies.

specialist aspects of community, as well as hospi- tal, nursing in England and Wales.

Following an experimental course, held at Chiswick Polytechnic, London, the JBCNS con- vened the first Community Psychiatric Nursing

Specialist Panel in August 1972. By March 1974, it had published the Outline Curriculum in Community Psychiatric Nursing for Registered

Nurses (JBCNS course 800). Each course was to be one academic year in length and was struc- tured such that the theoretical components engaged during Polytechnic or School of Nursing attendance, were intended to be in-

tegrated into practice during the propor- tionately longer fieldwork placement periods. The BOO-course was both for RMN’s and Regis- tered Nurses of the Mentally Subnormal

(RNMS). Early in 1978, the Specialist Panel had been reconvened to reconsider the JBCNS-800 Outline Curriculum in terms of the differing

needs of the RMN and the RMNS. By April 1979, it had published the Outline Curriculum in the Nursing Care of the Mentally Ill in the Community (JBCNS course 810). The counter- part for RNMS’s was JBCNS-805. Although both remained structurally similar to the original 800-course, attention had been given to strengthen the skill acquisition potential of the new course and, by September 1982, the 800- Outline curriculum was withdrawn in favour of the 8 lo-successor.

During September 1980, the English National Board for Nursing, Midwifery and Health

Visiting (ENB) assumed double-running responsibilities with the JBCNS and began to

adopt Committee structures which were similar to those of the Joint Board. In April 1985, the ENB published Outline Curriculum for course number 811, Nursing Care of Mentally Ill People in the Community, in response to calls to yet further strengthen the skills basis of the CPN educational preparation. More recently still, in 1988, the Specialist Panel has again been reconvened to consider the effect on the 24 current 81 l-courses, of schemes of basic RMN

training based on 1982 Syllabus which, if imagi- natively interpreted, could have a substantial community orientation. In January 1989, the new Outline Curriculum proposed by the Panel for course 812 was approved by The Mental Nurses Committee of the English National Board.

SAGCPNE ACTIVITY

Since its formation, the work of the SAGCPNE

has been to inform the deliberations of such groups as the reconvened Panel above and the ENB Working Group with responsibility for the development of a Community Practitioner/ Teacherjoint course for Community Psychiatric Nurses, Health Visitors and District Nurses. Such information ensures that the planning of both courses takes into account developments in continuing psychiatric nursing, particularly in relation to a commitment to multidisciplinary teamwork in community settings. Moreover,

because the SAGCPNE is composed of edu- cationalists whose prime function is the edu- cation of CPN’s, members are singularly well placed to pool direct experience of educational innovation in the field. One outcome of such contact has been the production of a directory, which provides information about high quality student course-work. Thus, a national network of unpublished, though influential, monographs have been catalogued for the first time.

SAGCPNE members now meet regularly in sub-groups, in geographic areas which are co- terminus with the areas for which Education Officers of the National Boards are responsible. This has enabled a confident intelligence func- tion to emerge, so that it has been possible to

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discuss and publish work on the strategic plan- ning issues related to CPN education (Rushforth 1989). Those involved with the establishment of new course centres have also benefitted from their participation in these local discussions.

Such an intelligence function has also made it possible to communicate professional concerns to the Government, the UKCC, the National Boards and other relevant professional bodies. One example of this activity has been communi- cation with the Department of Health to insist that the sine qua non of high quality community mental health services is the appropriate edu- cational preparation of the staff who work in them. It is essential that the necessary financial resources, to exploit the education opportunities currently available, be identified and protected.

ISSUES

From the outset of its 1973 reconstitution the JBCNS insisted that for an effective system of post basic clinical nurse education to be estab- lished, courses needed to be adequately financed. It recognised that an absence of a tradition of further training for psychiatric nurses, except for admission to another part of the Register, partly explained an early reluc- tance to allocate necessary funds, even when the need for well trained nurses was clear and accepted, as with community psychiatric nurses. Such features have continued to characterise the debates over the following fifteen years and have pervaded all other satellite CPN issues (White 1989). Principal among these have been the notions of mandatory training, fieldwork super- visor preparation, distance learning packages and abridged substantive courses.

To compound an increasingly complex inter- relationship between basic and post basic psy- chiatric nurse education, the ENB has recently drafted the guidance for the RMN Branch Programme as part of the Project 2000 edu- cational preparation. Such guidance will offer curriculum planners the opportunity to further orientate basic training to fit contemporary service demands to Registered Practitioner level. The SAGCPNE will continue to engage these debates and, in particular, to influence the shape of the Specialist Practitioner preparation for community psychiatric nurses which has been recommended. This preparation should be located within the context of agreed, adequately resourced, strategic plans for both service and education. Closer consultative links between the SAGCPNE and the ENB and the Department of Health would be mutually beneficial. The membership of the SAGCPNE is drawn from those with curriculum development responsibili- ties, in the substantive area of current service policy initiatives, and is therefore especially well placed to promote a stronger advisory role to the Mental Nursing Committee of the English National Board. Such a relationship has become important because the exchange of knowledge and expertise is imperative at a time of rapid change in nurse education and service provision.

References

Rushforth D 1989 Market forces and community psychiatric nursing courses. Community Psychiatric Nursing Journal, December, pp 22-26

White E 1989 Historical development of the educational preparation of community psychiatric nurses. In Press, In Brooker C (Ed) Community Psychiatric Nursing Research, Chapman and Hall.