S.TRUEMAN PhD THESIS 2016

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There is some evidence that the attitudes and abilities of many of these nurses in providing such care are poor (Brunero, Jeon & Foster, 2012; Jelinek, Weiland, Mackinlay, Hill & Gerdtz, 2011; Sharrock & Happell, 2002). Remote nurses working in general healthcare settings have ‘difficulty’ in meeting the needs of a patient with a mental illness. A number of studies have reported that generalist nurses perceive themselves as lacking knowledge, skills and confidence in the assessment and management of mental health patients (Bailey, 1998; Brinn, 2000; Brunero et al., 2012; Fleming & Szmukler, 1992; Jelinek, Weiland, Mackinlay, Gerdtz & Hill, 2013; Gillette, Bucknell & Meegan, 1996; Jelinek et al., 2011; Muirhead & Tilley, 1995; Roberts, 1998; Sharrock & Happell, 2002; Wand & Happell, 2001). They also experience feelings of fear, inadequacy and a lack of understanding in caring for suicidal patients (Bailey, 1998). In other studies, nurses have described reduced work satisfaction, questioning their role, and giving priority to physical needs and task completion rather than caring for a patient’s mental health symptoms (Bailey, 1994; Fleming & Szmukler, 1992; Gillette et al., 1996; Reed & Fitzgerald, 2005). They find it particularly difficult when patient behaviour is perceived as difficult, threatening or disruptive (Happell & Sharrock, 2002; Heslop et al., 2000; Reed & Fitzgerald, 2005). Compounding these difficulties is a lack of resources, expert assistance and workplace policies in relation to remote and rural mental health patient service delivery (Bailey, 1998; Brunero et al., 2012; Ellis & Philip, 2010; Gillette et al., 1996; Reed & Fitzgerald, 2005; Wand & Happell, 2001) combined with an attitude of negativity (Bailey, 1998; Brinn, 2000; Fleming & Szmukler, 1992; Gillette et al., 1996; Mavundla & Uys, 1997).