S.TRUEMAN PhD THESIS 2016

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There is a (non-personal) tension between the reality of mental health nurses’ abilities to assist remote nurses, and the desires of remote nurses. Remote nurses wish that mental health nurse visits were regular. Regularity ensures that the workload of delivering mental healthcare by the MHN’s team is not ‘missed’ or falls behind schedule. Any inability of the MHNs has to be taken up by the remote nurses. One of the reasons for this is when mental health nurses do not complete their tasks it has to be undertaken by the remote nurses. Hence, if a mental health nurse visit is cancelled and a number of depot medication injections were due to be given, these cannot wait until the next planned visit. This task therefore becomes ‘additional’ work borne by the local remote nurses. Visits from mental health nurse teams may or may not coincide with visits from a psychiatrist. The majority of MHN team visits are not accompanied by a psychiatrist simply because there are more MHNs than psychiatrists (see Chapter 1). It is not physically possible for the psychiatrist to be present when mental health nurse teams visit a number of communities simultaneously. Remote nurses reported that when mental healthcare advice or assistance is sought during ‘work hours’, MHNs were the first to be contacted as opposed to a psychiatrist. There are number of reasons why this occurs. MHNs are more readily contactable, have an established working (and usually personal) relationships, know the clients more intimately and act pursuant to protocols that deem contact direct with a psychiatrist, occur either after discussion with a mental health nurse (or GP, and/or RFDS medical officer), or only for the more serious mental health issues.