Title : Supporting mental health nurses managing adolescents with mental illnesses: Lesson learned from a DREAM presence practice workshop series
Background: Presence as a concept is regarded to have originated from the Latin verb “praeesse” referring to “being present before everything”. Presence is the ability of nurses in enacting inter-relational experiences with their patients that yield positive patient outcomes. Studies have reported positive patient and nurse outcomes in presence practice such as patient satisfaction, relief from compassion fatigue, and nurse job satisfaction.
Objective: To assess and validate the DREAM (Dedication, Respect through relationship, Environment, Art of nursing and Motivation) presence practice guideline owing to the dire need for presence practice to improve quality nurse and patient outcomes in South Africa. The effective practice of presence in care could facilitate positive nurse outcomes and presence among nurses providing mental health care to adolescents with mental illness.
Method: As part of a large pre-test and post-test research, workshop series was organized with nurses caring for adolescents with various mental health illnesses in the two major psychiatric hospitals in the North West Province, South Africa. Access was gained into the study areas after the researchers obtained approval from the Health Research Ethics Committee (HREC), North West University, South Africa, and the North West Province Department of Health and the various study areas. Three workshops were conducted in three separate weeks with nurses as frontline health care providers to adolescents with mental illnesses to educate them on DREAM presence practice guidelines. The workshops were audio recorded, transcribed, and analyzed thematically.
Results: Nurses want to care, they want to be there for the patients and equally important but constrained due to various factors such as understaffing, lack of adequate support, poor working conditions, and lack of available resources. Owing to the challenges associated with managing adolescents with mental illnesses and the need for presence practice to improve nurses and patients’ outcomes, there is a dire need to support specifically the nurses working in these wards including adequate psychosocial support, staffing, and funding of the wards to enable nurses effectively practice presence crucial in positive outcomes.