S.TRUEMAN PhD THESIS 2016

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difficult, this section primarily focuses on the remote nurses’ misguided perceived lack of abilities. Remote general nurses do not have post graduate mental health nursing qualifications, but are exposed to mental health nursing education as part of their undergraduate nursing qualification. Whether this exposure is enough to satisfactorily equip remote general nurses is a moot point, but probably not based on the literature (Aoun & Johnson, 2002; Clinton & Hazelton, 2000; Happell, Wilson & McNamara, 2014; Wynaden, 2012; Wynaden, Orb, McGowan & Downie, 2000; Wynaden, O’Connell, McGowan & Popescu, 2000). Despite this, the remote nurses in this study (see Chapter 6) and in the literature concerning rural and remote nurses (Jelinek et al., 2011; King, Judd & Grigg, 2001; Reed & Fitzgerald, 2005) have a belief that they are not skilled to care for mental health patients. In reality this is not true. This belief arises from misunderstanding and undervaluing their competencies. Obviously MHNs have skills and knowledge beyond or unknown to a general nurse, such as Cognitive Behaviour Therapy, Motivational Interviewing, Drug and Alcohol counselling, Risk Assessment, Mental State Examination and converse with medical staff (GPs and psychiatrists) employing appropriate and accepted psychiatric terminology. While these advanced, very necessary and important skills are valuable, they are arguably of little benefit or assistance in caring for most, or a large portion of remote mental health patients, when considering what are the reasonable (mental health) skills expected of a remote general nurse. What is reasonable mental healthcare is grounded in a comparison with another remote nurse in the same circumstances. It is not a comparison with that of a mental health

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