Critical Thinking and Reflection for Mental Health Nursing Students

Books

Marc Roberts

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    Transforming Nursing Practice

    Transforming Nursing Practice is a series tailor-made for pre-registration student nurses. Each book in the series is:

    • Affordable
    • Mapped to the NMC Standards and Essential Skills Clusters
    • Full of active learning features
    • Focused on applying theory to practice

    Each book addresses a core topic and they have been carefully developed to be simple to use, quick to read and written in clear language.

    Core Knowledge Titles

    Becoming a Registered Nurse: Making the Transition to Practice

    Communication and Interpersonal Skills in Nursing (3rd Ed)

    Contexts of Contemporary Nursing (2nd Ed)

    Getting into Nursing (2nd Ed)

    Health Promotion and Public Health for Nursing Students (2nd Ed)

    Introduction to Medicines Management in Nursing Law and Professional Issues in Nursing (3rd Ed)

    Leadership, Management and Team Working in Nursing (2nd Ed)

    Learning Skills for Nursing Students

    Medicines Management in Children's Nursing

    Nursing and Collaborative Practice (2nd Ed)

    Nursing and Mental Health Care

    Nursing in Partnership with Patients and Carers

    Passing Calculations Tests for Nursing Students (3rd Ed)

    Palliative and End of Life Care in Nursing

    Patient Assessment and Care Planning in Nursing (2nd Ed)

    Patient and Carer Participation in Nursing

    Patient Safety and Managing Risk in Nursing

    Psychology and Sociology in Nursing (2nd Ed)

    Successful Practice Learning for Nursing Students (2nd Ed)

    Understanding Ethics in Nursing Practice

    Using Health Policy in Nursing

    What is Nursing? Exploring Theory and Practice (3rd Ed)

    Personal and Professional Learning Skills Titles

    Clinical Judgement and Decision Making for Nursing Students (2nd Ed)

    Critical Thinking and Writing for Nursing Students (3rd Ed)

    Evidence-based Practice in Nursing (2nd Ed)

    Information Skills for Nursing Students

    Reflective Practice in Nursing (3rd Ed)

    Succeeding in Essays, Exams & OSCEs for Nursing Students

    Succeeding in Literature Reviews and Research Project Plans for Nursing Students (2nd Ed)

    Successful Professional Portfolios for Nursing Students (2nd Ed)

    Understanding Research for Nursing Students (2nd Ed)

    Mental Health Nursing Titles

    Assessment and Decision Making in Mental Health Nursing

    Engagement and Therapeutic Communication in Mental Health Nursing

    Medicines Management in Mental Health Nursing

    Mental Health Law in Nursing

    Physical Healthcare and Promotion in Mental Health Nursing

    Psychosocial Interventions in Mental Health Nursing

    Adult Nursing Titles

    Acute and Critical Care in Adult Nursing

    Caring for Older People in Nursing

    Medicines Management in Adult Nursing

    Nursing Adults with Long Term Conditions (2nd Ed)

    Safeguarding Adults in Nursing Practice

    Dementia Care in Nursing

    You can find more information on each of these titles and our other learning resources at www.sagepub.co.uk. Many of these titles are also available in various e-book formats, please visit our website for more information.

    Foreword

    When I started out as a mental health nursing student in the 1980s I had a naive expectation that everything that went on in the care of mental health patients was the best quality, the most effective and the best for the patient. It did not take me long to realise that, in this ever-increasingly complex world of mental health, this was not the case. It was only over time though, as I developed my ability to think critically and not accept at face value the information that comes from all sources around you as a nurse, that I became a more competent practitioner. It is not that long ago, historically speaking, that we were advocating deep insulin comas, ice-cold baths and other, now considered barbaric, practices in an effort to help people manage their mental health. If people had not questioned these practices perhaps they would still be in use today. Critical thinking is one of the most essential development tools you can foster; it is extremely important for the safety of patients in making sure that the care they receive is the least restrictive and truly effective for them.

    A particular area of concern in mental health care is the social control element of the service. This is long-standing and it is here, often, that we still see questionable practice ‘done to’ people despite clear indications from them that this is not what they need. The very existence of the Mental Health Act is often challenged and at odds with some of the Human Rights Act. In these complex times the art of thinking critically is ever more important and Critical Thinking and Reflection for Mental Health Nursing Students provides a comprehensive introduction to the subject.

    This book not only introduces you to the concept of critical thinking, reflection and practice – it also encourages you to think more widely about the idea of ‘other’. Through the sensitively created exercises throughout the book you are encouraged to think more deeply about many contentious issues, including the role of the media in perpetuating prejudice, and how stigma is often inherent in our practice in the ‘us and them’ attitude we can find ourselves taking without thinking. The author encourages us to consider ways in which we can address this stigma when we notice it in both ourselves, via closer observation of self-awareness practices, and others, by challenging it in gentle but effective ways.

    If you are a student nurse, a newly qualified nurse or even a nurse of some years’ standing looking for tips to update your portfolio of skills, Critical Thinking and Reflection for Mental Health Nursing Students will stand you in good stead for practice. It can be read as a whole, but can also be dipped into section by section as you come across situations in your journey that warrant further exploration or practice of that particular subject. Engaging with this book will help you to become a more effective practitioner of the art of mental health nursing, enhancing your ability to provide effective care for people of diverse backgrounds and needs as well as enhancing your ability to write academically.

    In the opening sentence of this book, the author states that there has never been a more exciting time to become a mental health nurse. I believe he is right.

    Sandra WalkerSeries Editor

    About the Author

    Dr Marc Roberts is an independent researcher and writer with extensive and varied experience working in mental health practice and education. In addition to being a registered mental health nurse, he is also a professional philosopher whose research is concerned with the manner in which critical thinking, critical reflection and philosophy more generally can contribute to the theory and practice of contemporary mental health care.

    Acknowledgements

    I would like to thank Becky Taylor for her work in commissioning this book, Eleanor Rivers for her valuable contributions throughout its development and Sandra Walker for her supportive reading of the original drafts. In addition, I wish to thank Robin Ion and the staff and students at the Centre of Excellence in Mental Health Nursing and Counselling at Abertay University, Dundee for the stimulating critical questions and discussions about all aspects of contemporary mental health care that inspired the present work. Finally, I would like to thank Philippa, Ruth and John for their encouragement, support and patience throughout the writing process.

  • Glossary

    Accountability:

    the condition of being answerable and responsible for one's actions and decisions.

    Acculturation:

    the process of change that occurs when an individual or group from one culture encounters an individual or group from other cultures.

    Aesthetic:

    relating to art, beauty and creativity.

    Affective:

    relating to moods, feelings and attitudes.

    Anthropological:

    relating to the study of humankind, and especially the origins and development of past and present cultures and societies.

    Autocratic:

    relating to autocracy and the political principle that the decisions that affect a group of people should be made by one person.

    Autonomy:

    the right, condition or capacity to make decisions and act in a manner that is free from undue control, constraint and influence.

    Beneficence:

    the principle and practice of acting in a way that seeks to benefit others and ensure good.

    Cognitive:

    relating to intellectual activity, such as analysing, reasoning and remembering.

    Consumerism:

    the principle and practice of pursuing and obtaining material goods, products and services.

    Core conditions:

    in the context of person-centred therapy and interpersonal communication more generally, the conditions or qualities that are considered necessary to establish therapeutic relationships and bring about therapeutic change (i.e. empathy, genuineness and unconditional positive regard).

    Critical evaluation:

    the practice of systematically thinking about a piece of information in order to determine its worth and importance.

    Democratic:

    relating to democracy and the political principle that the decisions that affect a group of people should be made by those people.

    Discrimination:

    the practice of treating a person or people less favourably because they possess, or are perceived as possessing, a particular characteristic.

    Disease-centred model:

    in the context of medication, the explanation that psychiatric drugs work by targeting specific underlying disease processes.

    Drug-centred model:

    in contrast to the disease-centred model, the explanation that psychiatric drugs produce a range of altered mental and physical states that may have both a negative and positive effect on the person and the symptoms associated with mental distress.

    Egocentrism:

    the condition of thinking, feeling and acting from one's own perspective without giving due consideration to alternative perspectives.

    Embodying:

    the practice of giving concrete form and expression to an idea, quality or disposition.

    Empirical:

    relating to observation, experience and experiment.

    Ethics:

    standards of right and wrong conduct and also a branch of philosophy that is concerned with questioning, analysing and reasoning about what is right and wrong conduct.

    Evidence-based practice:

    the explicit use of the best current evidence when considering which interventions and treatments to provide to those who use health care services.

    Existential problems:

    relating to questions, issues and problems surrounding human existence, particularly the purpose, direction and meaning of one's life.

    Homogeneous:

    the quality of being similar or the same.

    Individualism:

    a belief in the worth of the individual and the right of each individual to decide and pursue what is in his or her best interests.

    Institutional racism:

    the perpetuation of negative attitudes and unequal treatment by an institution towards a person or people based on their race.

    Leading by example:

    the practice of consistently acting in a way that sets a desirable standard for others to emulate and follow.

    Liberalism:

    the political principle and practice of protecting and enhancing the rights, freedom and liberty of the individual.

    Managerialism:

    the principle and practice of using professional managers to plan and administer the activities of a group of individuals. It is associated with the importance of setting targets, and obtaining those targets with maximum efficiency.

    Mass media:

    relating to the forms of communication that are designed to reach large numbers of people, such as television, films and newspapers.

    Modelling:

    the practice of performing certain competencies in such a way that one's actions can serve as an example, standard or model from which others can learn. It can also refer to the practice of learning from others by observing the manner in which they perform certain competencies.

    Non-attachment:

    the condition or practice of relating to events, and one's thoughts and feelings about those events, in a calm, composed and balanced manner.

    Non-maleficence:

    the principle and practice of acting in a way that does not harm others.

    Norms:

    beliefs, attitudes and behaviors that are considered normal in a particular group, culture or society.

    Open questions:

    questions which cannot be answered with ‘yes’ or ‘no’ and therefore enable a person to ‘open up’ and respond to a question in detail.

    Paradigm:

    a collection of assumptions, concepts and theories that form a framework by which to understand an aspect of the world or the world more generally.

    Paraphrasing:

    the practice of restating something that has been written or spoken using different words.

    Paternalism:

    the principle and practice of limiting, obstructing or overriding the freedom, self-determination and autonomy of others.

    Peer-reviewed:

    relating to the evaluation of a person's work by others who work in that area and possess a similar level of expertise.

    Plagiarism:

    the practice of using someone else's words, thoughts and ideas and, intentionally or unintentionally, presenting them as your own.

    Polypharmacy:

    the practice of prescribing ‘multiple’ medications (commonly understood as four or more) to the same individual.

    Prejudice:

    a preconceived and often negative opinion about others that is formed without good reason.

    Qualitative research methodologies:

    research frameworks or approaches – such as phenomenology, grounded theory, ethnography and case studies – that are adopted to carry out research into people's experiences and the quality of those experiences.

    Quantitative research methodologies:

    research frameworks or approaches – such as randomised controlled trials, cohort studies, case-control studies and cross-sectional studies – that are adopted to obtain measurable or quantifiable data.

    Randomised controlled trial:

    a research experiment in which participants are randomly assigned to receive one of two or more treatment interventions to determine the usefulness of those interventions.

    Reflection-in-action:

    the process by which a person thinks about his or her activity while in the midst of it.

    Reflection-on-action:

    the process by which a person thinks about his or her activity after it has finished.

    Self-determination:

    the right, condition or capacity to decide what is in one's best interests and act in a manner that is free from undue control, constraint and influence.

    Sick role:

    relating to the set of beliefs, behaviours and expectations associated with being sick that are placed upon someone or that an individual may adopt.

    Signs:

    in the context of health care, the physical indications of the potential presence of disease or disorder.

    Social determinants:

    the social and economic conditions that affect, influence and determine the health of individuals.

    Stereotypical:

    relating to a fixed and oversimplified image or idea about an individual or a group.

    Stigma:

    a characteristic that is judged to be unwanted and shameful and the disapproval of a person because he or she possesses, or is perceived as possessing, this characteristic.

    Symptoms:

    the subjective experiences and feelings about the potential presence of disease or disorder that a person may report to health care professionals.

    Technocratic:

    relating to technocracy and the political principle that the decisions that affect a group of people should be made by individuals who possess technical knowledge and expertise.

    Values-based practice:

    the practice of recognising and working with one's personal values, professional values and the values of those who use health care services when considering which interventions and treatments to provide.

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