Case study 1
Title: Teaching care planning in mental health
What was required?
During a meeting with local Trust managers, it was suggested that students needed to improve the way they wrote care plans in mental health settings and to work more in partnership with service users.
How did you address it?
One of the nurse managers was invited to work alongside the lecturer and a service user to provide a joint learning experience for students centred on the perspective of the service user. The manager agreed and invited a service user with wide experience of forensic, acute and community mental health services who had already been involved in staff training. The outline of the sessions was discussed and agreed.
How did it go?
The lecturer gave an introductory overview of the importance of care planning in mental health, using slides and a quiz linked to reading provided beforehand online. The manager then joined the session and spoke about the importance of working sensitively with service users. Then the service user joined us and was introduced. He was knowledgeable, confident and very personable and spoke about his experiences of being acutely psychotic and of the care he had received in forensic, acute and now community services. He also talked about his personal life and how he now had a young son and was fulfilling his dreams by making and recording music, playing a track to the class.
He explained how his illness and then medication had made it very difficult to accept the help of nurses and other staff but how small examples of compassionate caring had connected with him and made a difference. He spoke about a nurse ‘playing the slowest game of Scrabble ever’ with him, when he was unwell. And of a student nurse that had sat and read stories out of the paper while he, in his own words, ‘sat there unable to speak’. He spoke of how over time he gained greater understanding of his condition and how best to manage it. He still takes medication and now lives an independent life with his girlfriend and son.
After the service user had left, the manager and lecturer worked with the students to explore how they might go about developing and writing a care plan with a service user at different stages of their illness and how they might overcome the apparent challenges of working in partnership with someone with limited cognitive abilities.
What worked well? Any particular challenges?
The involvement of the service user made the session ‘real’ – the students quickly warmed to this person who was now in recovery but spoke of times when he was very unwell. He helped them see the person and his hopes in life and how being alongside someone at their most difficult times establishes a therapeutic relationship that can be built on.
The involvement of an experienced nurse manager to help facilitate the sessions and explore with students how they could translate this into meaningful and useful care plans added to the success.
In future, it might be good to think about how service users might work alongside students in writing care plans.