Prospect Place - PCRP 19

Placement Overview

Placement Title Prospect Place - PCRP 19
Trust
Your Placement Contact Lauren Fish - Send Email
Placement Contact's Role Charge Nurse
Placement Address Birchill Hospital, Birch Rd, Rochdale, OL12 9QB
Placement City/Town: Rochdale
Placement Phone 01706 676135/6676136
Your University Contact: Caroline Morton - Send Email

About this placement

What is organised for students on commencement of placement?

Orientation to the unit and introduction to colleagues in clinical placement area. Introduction to staff involved in focused service delivery e.g CBT etc. Shadowing of staff allocated to routine ward tasks e.g Security checks, medication administration, infection control audits. Key induction routine Student welcome pack and key service information Information re facilities locally for example cafes etc Programme of events pertinent to the student nurses placement e.g Clinical Team Meetings, Tribunals, Formulation meetings. 

What are the arrangements for mentors/assessors?

  • Engagement & Assessment Unit has three mentors one of whom is a sign off mentor for students completing their final placements
  • Recovery & Intervention Unit has one mentor
  • Social Inclusion Unit has one mentor who is also a sign off mentor for students in their final placements
  • The Dual Diagnosis worker is also a mentor for a full time student placement as well as spoke placements

What shift patterns are students allocated for learning?

Early:

7:30am-3pm 

Late:

12:15pm - 7:45pm 

Night:

7:30pm- 7.45am 

Shift Notes:

Normal shift patterns for full time staff are long days 7:30am - 7:45pm. Breaks are for 1hr:40mins. Students should negotiate with their mentor if they wish to work these patterns. 

What patient care situations are available in this placement?

  • Dual diagnosis assessment and individual and group interventions. 
  • Risk assessment using Trust approved assessments and then formulation of interventions and management strategies 
  • One to one patient contact, group therapeutic activities e.g Recovery strategies, Relapse prevention, Drug and Alcohol education, Recovery Group

What nursing model is used for planning care?

The focus of the service is to work with individuals with serious mental health problems and complex needs. The service acknowledges the recurring nature of the mental illness, which often leads to mental distress and chronicity. Although mental illness is experienced by a significant proportion of the general population, it continues to attract prejudice and stigma creating exclusion and social isolation.

The process of rehabilitation is focused upon building existing strengths, and developing skills and coping strategies to maximise each individuals functioning and to minimise the disabling effects of their illness. Bio-Psychosocial Intervention.

There is an acknowledgement that the task is complex and involves intensive work within all aspects of the individuals life. To achieve this, the service has adopted biological and psychosocial interventions (PSI) as the model of care.

This model encompasses a variety of approaches used in partnership with service users and their families. The aim is to modify the course of the illness by assisting the person develop realistic coping skills and by addressing particular problems within the persons environment through communication, education and problem-solving.

The main elements of PSI are;

1. Psychological and practical management of symptoms

2. Providing family support/therapy

3. Instituting early interventions to manage prodromal signs

4. Case-management and multidisciplinary care planning.

The care pathway provides a framework to facilitate the delivery of psychosocial interventions. Ciompi (1984) describes 9 components of psychosocial management:

1. Simplification of therapeutic setting

2. Continuity of care

3. Clear communication

4. Harmonisation of available information

5. Realistic positive expectations

6. Joint therapeutic goals

7. Unified therapeutic gradient

8. Avoidance of over/under stimulation

9. Synergistic combination of socio and pharmacotherapy.

Stress-vulnerability Model

(Zubin & Spring, 1977; Nuechterlein & Dawson, 1984)PSI is underpinned by the stress-vulnerability model (Zubin & Spring, 1977: Nuechterlein & Dawson, 1984), which suggests that individuals with schizophrenia have a predisposition to the illness when exposed to a level of stress, which can then trigger the psychotic symptoms. It is acknowledged that, during the course of someones life, they will unfortunately encounter a number of different problems. The Zubin and Spring, 1977 model provides a basic framework for understanding the relationship between stress and psychosis. Nuechterlein and Dawson, 1984 further developed the model by introducing a number of psychological, biological and environmental factors that were identified as either stressors or protectors against psychotic symptoms. They claim that these stress factors or the absence of protectors, if not managed effectively may result in the move into the prodromal state, which indicates the first stage of relapse.

Everyone is different and what might be thought of, as a problem to one person may be totally different to what might be a problem to someone else. Sometimes lots of little things mount up, or people may face a massive crisis. It is these problems that cause people stress and everyone can deal with different amounts of stress at different times throughout their lifetime. We are all born with slightly different genes that make us individuals e.g. black hair, freckles, short, thin etc. Genes also give us predisposition to getting certain illnesses i.e. diabetes or heart disease. We also have different life experiences, which influences our attitudes and personality. Various environments and living conditions can affect the way we live e.g. unemployment (poverty), overcrowding (lack of privacy) family far away (loneliness) or having noisy neighbours (causes distress). All of these factors, and many more, can make people vulnerable to various illnesses or disease.

Stress and vulnerability are the main factors that form the cornerstone of all rehabilitation intervention.

Recovery, Social Inclusion and Equality & Diversity

Wherever possible, service users will be given opportunities to maintain/develop the lifestyle or conditions of everyday living which they would choose in their own community, (Emerson, 1992). People with mental health problems are frequently excluded from their communities because of ignorance, fear and prejudice of mental illness in general.

Social inclusion is about having opportunities to participate fully as equal citizens (Disability Rights Commission, 2001). The aim of mental health services is to enable service users to do the things they want to do, to have lives that are valued, to have opportunities and choices, to have their rights protected and to live as a respected member of society.

i) A Recovery Approach

The term recovery has only recently been adopted by mental health services. It is a concept that has grown from evidence produced by a number of self-help groups where service users have described their pathway to recovery from their mental illness. Recovery involves the development of new meaning and purpose in ones life as one grows beyond the catastrophic effects of mental illness (Anthony, 1993).

What core clinical skills can be learnt?

There is an opportunity whilst on the unit to learn and demonstrate core clinical skills in accordance with the NMC Essential Core Clusters. 

What additional clinical skills can be learnt?

PATHWAY Pathway continues for as long as there is an identified clinical need and suitability for rehabilitation. ASSESSMENT Assessments (informal and standardised) are carried out at each stage of the clinical pathway and contribute to on going assessment, review and discharge planning. 

What resources are available to help students learning?

Intranet access can be organised by the Practise Education Facilitator so that electronic literature searches can be used for research. Access to individuals who provide specialist assessment and interventions in the fields of Cognitive Behaviour Therapy, Psychosocial interventions, Dual Diagnosis, Risk Assessment Occupational Therapists, Psychology, Dual Diagnosis Access to the individual clinical areas specialising in Engagement & Assessment of new clients and their journey through the recovery process via Recovery & Intervention and finally Social Inclusion. Risk assessment, formulation and multidisciplinary case management. 

Spoke Placements

  • Step Down Services (male and female) in Oldham,Tameside and Stockport
  • Dual Diagnosis
  • Psychology Services
  • Occupational Therapy services
  • Care Pathway team (assessment of referrals)