Hospitals and emergency departments (EDs) are caring for increasing numbers of patients who present with underlying mental health issues. Managing these patients can be challenging for clinical staff who often lack the specialist knowledge and skills required to provide appropriate care. This article, part two of two on the evaluation of a newly formed mental health liaison team (MHLT) working in a general hospital, focuses on the perceptions and experiences of the MHLT participants, and explores three sub-themes derived from the interview data. The article considers the effect of these themes on practice, and the relationship between MHLT members and staff in EDs and the wider hospital.

Hospitals and emergency departments (EDs) are caring for increasing numbers of patients who present with underlying mental health issues. Management of these patients can be challenging for clinical staff who often lack the specialist knowledge and skills required to provide appropriate care. In April 2015, a mental health liaison service was introduced in Rotherham Hospital as part of a two-year pilot scheme. The aim was to provide assessment and treatment of adults with mental health problems admitted to the hospital. An evaluation of the new service was undertaken to assess the effects of the service. This article, part one of two, reviews the literature, as well as outlining the background to, and method of, evaluation. Part two, which will be published in December, examines the themes revealed by analysis of the service participants’ responses.

The hub and spoke model of nursing student placement has been around in various guises for some time. What began as an informal and unplanned arrangement is now policy, as student learners on placements are increasingly located across a range of environments to gain different experiences. Most commentaries on hub and spoke focus on the experiences of permanent staff and students on adult nursing programmes. This article describes a small-scale case study that examined perspectives on a hub and spoke placement programme of students taking a joint learning disability and social work degree. It also considers the placement providers’ perspectives. Analysis shows that service providers focused on accommodating students as best they could within the parameters of their service and that, although the students found the experience disorienting initially, they appreciated the benefits of moving between localities

Autism is a relatively new diagnostic category that has prompted debate among people diagnosed with the condition, their families and carers, and those working in academic and clinical specialisms. This is due in part to the distinction between autism and Asperger syndrome, and the overlap between people who are said to be on the autistic spectrum (AS) and those who have learning disabilities. Because of this overlap, learning disability nurses can have an important role in advocating and improving access to care for people on the AS, and in encouraging training in autism for other healthcare practitioners.

With the deregulation of services, people with learning disabilities are now looked after across a wider range of organisations and by a wider range of care workers than ever before. In these situations, the fresh observations and reflections of nursing students on practice placements can be particularly beneficial in discerning gaps between theory and practice, and identifying potential courses of action to improve services for people with learning disabilities. For example, it appears that some professionals, highly skilled in their own disciplines, remain uncertain when delivering care to individuals with learning disability. This is partly due to a persistently confused use of terminology when referring to learning disability, because terms and their meanings tend to vary between disciplines. The unintended consequences of suboptimal care point to the need for careful learning disability awareness training across disciplines and throughout provider organisations. The authors advocate a single vision of care with a shared language if the support and treatment of people with learning disability is to improve.

Just as there is a stigma associated with people with learning disabilities, there is a ‘parallel stigma’ that affects the nurses who care for them. Although parallel stigma has decreased in recent years, discriminatory attitudes and behaviours remain, especially as the already inequitable care of clients is threatened further by measures to reduce public sector spending. This article puts parallel stigma in a historical context and calls on nurses and other front line workers to prevent further erosion of care provision.

Aim

To explore nursing students’ experiences of caring for patients from different and often unfamiliar cultural backgrounds.

Method

Focus group discussions were conducted with nursing students from mental health, learning disability and adult nursing in one university, to obtain qualitative information about areas of difficulty in providing culturally competent care.

Findings

Nursing students expressed difficulties and challenges meeting the cultural needs of patients, with particular focus on issues related to language, food and gender.

Conclusion

Nursing students need to prepare for work in a culturally diverse healthcare setting and should receive education and training in this area to ensure ongoing personal and professional development.

When the contributions of a group of people with autism and Asperger syndrome to a study of stress were not acknowledged, the participants were understandably upset, but the researchers’ efforts to remedy the situation made things worse. This article explains why contributors and co-authors should be kept informed about the purposes of their work, and should be given time to comment on draft publications.

Families of people with learning disabilities report frequently that their relatives receive poor care when they attend hospitals as inpatients. Sometimes their attendances have fatal consequences.

Despite official acknowledgement of this situation, there is growing evidence to suggest that it is not improving and may even be worsening. This article, which is based on interviews with two close relatives, presents a case study of a man with learning disabilities who received poor care in hospital.

The article concludes that current provision of care for people with learning disabilities is inadequate, and that hospital staff need more training and education in this area. As the number of people with learning disabilities in secondary care grows, the need to ensure equity of care for all population groups becomes more urgent.