COVID-19 and mental health: retaining and recruiting nurses now and beyond the pandemic
New plan for England highlights the unique selling points of mental health nursing
The continuing COVID-19 pandemic is having a significant effect on peoples mental health, increasing the demand for services now and in the future.
In these unprecedented times, any opportunities to recruit, retain, develop and value our staff are extremely important, says NHS England and NHS Improvement head of mental health nursing Emma Wadey.
Mental health is being highlighted at the moment and the stigma around it is reducing. As a result, people are recognising how valuable mental health nursing is as a career.
A framework for recruitment and retention
The highly rewarding nature of the
New plan for England highlights the ‘unique selling points’ of mental health nursing
The continuing COVID-19 pandemic is having a significant effect on people’s mental health, increasing the demand for services now and in the future.
‘In these unprecedented times, any opportunities to recruit, retain, develop and value our staff are extremely important,’ says NHS England and NHS Improvement head of mental health nursing Emma Wadey.
‘Mental health is being highlighted at the moment and the stigma around it is reducing. As a result, people are recognising how valuable mental health nursing is as a career.’
A framework for recruitment and retention
The highly rewarding nature of the specialty is one of the main messages of a competence and career framework for mental health nurses, which was launched in November.
‘We’ve tried to identify the unique selling points of mental health nurses and we’re on our way towards doing that,’ says Ms Wadey.
‘This framework is celebrating and promoting their role, showing how this is different to other fields of nursing,’ she says. ‘We recognise it’s a challenging career but it’s also fantastically rewarding, offering a huge number of opportunities.’
One of the framework’s tangible goals is to improve recruitment and retention.
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‘A driving force is the need for more mental health nurses across the NHS, social care and the voluntary sector,’ says Ms Wadey.
‘Having an accessible and comprehensive framework that outlines the expectations of mental health nurses, and the opportunities available to them, is a good retention and recruitment tool. Our hope is that it attracts more people into training.’
Mental health sector of nursing has an extremely high vacancy rate
In June 2019, the Interim NHS People Plan highlighted vacancies across all areas of nursing, with around 40,000 reported vacancies in substantive nursing posts. Mental health had one of the most significant shortages, a finding echoed by the latest figures from NHS Digital which show there were 9,541 mental health nursing vacancies in England by the end of September.
According to the data, excluding the north east and Yorkshire region, mental health nursing has the highest vacancy rate of all sectors of nursing in England.
Highlighting the abilities needed to work as a mental health nurse
Commissioned by Health Education England (HEE), the new framework has been produced by Skills for Health and covers all stages of the profession. It starts with registered mental health nurses at level five, moving through to senior roles at level six, advanced practice at level seven, nurse consultants at level eight and nurse directors at level nine.
Each section includes an overview of the specific level, a description of the requirements of that level, and the core competences needed, which are based on four pillars:
- Clinical practice.
- Education and the facilitation of learning.
- Leadership and development.
- Research, evidence and development.
At level six, for example, the overview says that mental health nurses ‘should demonstrate initiative and creativity in finding solutions to problems. They need to have some responsibility for team performance and service development, and consistently undertake self-development’.
The description highlights abilities such as working autonomously, enhanced critical thinking, and consolidation of specialist knowledge and skills, with core competences including undertaking complex assessments, contributing to evidence-based learning, and demonstrating clinical leadership of the team.
‘Leaders exist at all levels and everyone can demonstrate leadership. It’s an important element of mental health nursing,’ says Ms Wadey.
Aims of the mental health nursing competence and career framework
- Identify the core competences of knowledge, skills and behaviours for mental health nursing at levels five to nine of the wider NHS career framework for health
- Inspire mental health nurses to adopt the good practices described and develop their own and others’ careers
- Highlight the particular contribution of mental health nurses, shaping the way forward for the profession across England by setting out a clear vision and aspirations, underpinned by key strategies and policies
- Articulate a sense of identity, including how the role is expanding, to ensure people with mental health difficulties are treated with dignity and respect while receiving the care and support they need
- Highlight the uniqueness of mental health nursing, including the breadth and depth of career opportunities in the different sectors, settings and specialties
- Inspire newcomers to see mental health nursing as a long-term and fulfilling career
A resource for those pursuing or developing a career in mental health nursing
The framework’s target audience includes those who are thinking about pursuing a career in mental health nursing, as well as registered mental health nurses who are pondering their next steps.
‘I hope anyone considering a career in mental health nursing would be able to look at this and get a clear idea of the skills, attitudes, knowledge and competence they need to become a mental health nurse,’ says Ms Wadey.
‘We also hope it’s a tool for everyone who is thinking about progressing their career. I’d like to see people receiving good quality opportunities for development.’
Another aim is to increase the diversity of the workforce.
‘We are hoping it will open up opportunities to those who may not have considered mental health nursing as a career before,’ says Ms Wadey. ‘We embrace a plethora of experiences, skills and knowledge, so people can use the framework to map where they might fit.’
Watch: Mental health nursing competence and career framework
‘Passion and energy’ went into developing the framework
Three stakeholder events were held as part of the framework’s development, with mental health nurses from all levels asked to articulate what had attracted them to enter and remain in the profession.
‘A lot of passion and energy has gone into developing the framework and I hope that comes across,’ says Ms Wadey. ‘The overarching message of the sessions I was lucky enough to join was that people wanted to celebrate the role.’
Comments from those who attended the events included:
- ‘Mental health nursing must be one of the few professions which values your uniqueness as an individual – if you are curious, dynamic, and interested by the complexities of the human mind, love talking to and helping people, and are a listener and a thinker, it allows you a scope of development and growth of self.’
- ‘I love that mental health nursing allows me autonomous decision-making and to work as an independent practitioner, and that it is less hierarchical and not task-led like other nursing.’
So far, the framework has been welcomed. ‘It’s landed well,’ says Ms Wadey. ‘We’ve had some positive responses.’
‘One of the things I love about my role is the autonomy’
Since graduating from Middlesex University in September, newly qualified mental health nurse Jill Lewis has worked in the South Camden crisis team, part of Camden and Islington NHS Foundation Trust in London. She says:
‘I love my job, which involves working with people who would probably be admitted to a psychiatric ward if we weren't working with them. Some people need to be in the hospital but it's not always the best environment for recovery. We aim to help people to stay at home and get good support for their mental health.
‘I decided to specialise in mental health nursing because you get a lot more time to talk to people. General healthcare is more task-oriented, but in mental healthcare we can sit and have good conversations and give people hope when they are feeling at their worst. It's more about relationships and being able to build a rapport.
‘One of the things I love about my role is the autonomy. Most of the time I carry out assessments on my own in the community and make independent decisions’
Jill Lewis, mental health nurse, Camden and Islington NHS Foundation Trust
‘The people we work with in acute mental health services often have complex conditions that can cause them great distress. When feeling particularly hopeless, they may act in risky and unpredictable ways. This can include feeling that suicide is the only option, which unfortunately does happen and is upsetting for everyone involved in their care.
‘But we have good managers, so are well supported when this kind of thing happens. We review the person's notes to see if anything could have been done differently, which usually isn't the case, and have one-to-one clinical supervision with someone more senior to us. Our well-being is looked after.
‘One of the things I love about my role is the autonomy. Most of the time I carry out assessments on my own in the community and make independent decisions. I go to see someone who has been referred to the team, then decide if they need to be in hospital or whether the crisis team can work with them safely in the community. Or maybe they don't need the crisis team and would benefit from a referral to another service.
‘I like taking the lead and doing risk assessments – I was a bit anxious about doing these on my own at first but there was no need to worry as we are well supported. I enjoy this side of my job and being able to work as an independent practitioner.’
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