An exploration of experience and perceptions; AIN working in
Mental Health Drug and Alcohol Darrin Cowan Clinical Nurse
Consultant Practice development Northern Sydney Local Health
District
Background 2011 Northern Sydney Local Health District (NSLHD)
implements an initiative strategy to employ AIN Mental Health/Drug
and Alcohol (MHDA) settings. Modified Delphi Study (Cowan.D,
Brunero.S et al. 2013) constructs AIN Scope of Practice for MHDA
NSLHD establishes professional development framework for AIN
working in MHDA. 2013 Recruitment and training of AIN into MHDA
2014 Current research into experience of AIN in MHDA in NSLHD
Cowan.D, Brunero.S, Lamont.S and Joyce.M (2013). "Direct care
activities for assistants in nursing in inpatient mental health
settings in Australia: A modified Delphi study." Collegian: Journal
of the Royal College of Nursing, Australia In Press.
Sample & Collection The study employed a purposive sampling
method 11 AIN from NSLHD (7 Female / 4 male) All geographic sectors
of the LHD represented Both undergraduate and Certificate III AIN
represented Both Acute & Sub-acute settings represented Data
collection Semi-structure 1:1 interviews Utilised 5 questions
constructed to illicit AIN experience 1) Scope of Practice 2) role
perception 3) education 4) inter-staff relationships & 5) role
satisfaction
Method & Data Analysis Thematic Analysis utilised as
outlined by Braun & Clarke (2006) used to generate themes and
explore meaning 6 step process of data analysis 1) becoming
familiar with the data 2) generating a system for coding data 3)
searching for initial themes 4) *review of the themes against the
(a) coded extracts and the (b) entire data set 5) deconstruction
and thematic reconstruction of grouped codes, defining themes 6)
Synthesis of the final report that conveys the experience of the
participant * 4 researchers cross-referenced notes and themes to
ensure and validity and consistency amounts themes
Role definition and clarity Dual perception of role I
personally think if we do everything for them we rob them of their
independence, it sort of makes them, I dont know what words can
use, let me see These clients are fully fledged human beings just
like myself -Participant 4 Misinterpretation/understanding of SOP
by all staff I have been doing endless ECGs here. And, after five
months of working here I realise Im not actually allowed to do
that. -Participant 10 Scope and role malleable to suit ward
construct/workload etc. .at new admissions, I can cover almost
everything that the RNs do because sometimes they just dont have
the time -Participant 1
Socialisation and Adaption AIN generally happy with
integration/acceptance to MHDA the people you are working with,
thats the best thing that makes the workplace enjoyable. Theres no
more important thing than that. But I am very happy with this ward,
theyre all nice -Participant 3 Active mentorship and being included
are the greatest factors for positive socialisation you feel better
about your role when the nurses come to you and be like oh, you can
do ityou feel like you can do more and take on more responsibility,
it feels good being, like, your role. -Participant 10 Role
Satisfaction increase with familiarity to routine and environment.
The job became more enjoyable as I started to learn what the real
routine was -Participant 6
Education and Training Mixed response attendance at correlated
with higher satisfaction Yes, it was helpful, yes. But it my case I
already learnt about that from the school, so I could revise all
the content, the mental health content -Participant 7 AIN
identified both practical and theoretical areas for further
education I only learnt about how to write the progress notes in
general hospital, not the mental hospital. So, I do like to learn
what is different what is different from mental hospitals progress
note and general hospitals progress note -Participant 1 AIN wanted
education to follow their practical experience
Recommendation Further and continuing education needed For both
AIN and existing staff Appointment of ward-based Preceptor Further
research and exploration into Needs of Undergraduate & Cert III
AIN to be addressed Utilities of Undergraduate & Cert III AIN
to be addressed Constructing an professional identity for MHDA AIN
Retention Drawing undergraduates into MHDA Overarching governance
of AIN AHPRA registration
Conclusion Numerous avenues for improvement Positive culture
exists to cultivate AIN Likely that improvement in an of the
identified themes will have a positive impact on AIN utility and
efficacy.