This write-up focuses on the require for mental well being nurses to promote sexual wellness. As a mental wellness nurse I have observed that in the course of practice, nurses are encountering difficulties dealing with sexual well being problems in mental health. Clients have experienced sexual wellness requirements that nurses failed to meet and several nurses have experienced that they are out of depth.

Lomas (2009) carried out a survey with at least 283 mental wellness professionals of which half of them had been nurses.  Evidence from the research showed that even though 80% of the participants had been in support of the notion that sexual health promotion was a vital part of their role, only 30%, representing much less than half the participants regularly discussed sexual wellness with mental well being patients, (Lomas 2009).   A revelation also made by Lomas (2009), survey suggested that 92% of respondents had no clue that men and women with schizophrenia were at an increased risk of contracting HIV than the general population, 72% had been not even convinced that they were far more likely to engage in high-risk sexual behaviour.   From the participants, 14%  felt uncomfortable discussing sexual health issues with mental well being patients, gay and lesbian problems was a extremely uncomfortable topic for 13% of them.  This queries no matter whether mental health nurses are well equipped to promote sexual well being, (Lomas 2009),

By way of this, mental wellness nurses should  learn to appreciate the clause from the National Midwifery Council (2004) stating that wellness care professionals are expected to continuously update understanding and skills all through our working life and often take component in learning activities that develop our competence and performance.  In support to this, Higgins et al (2006)suggested that individuals with `severe’ mental wellness problems will most likely end up engaging in high-risk sexual activities producing the susceptibility to sexually transmitted infections.  In Higgins et al (2006)literature review from 1980 to 2005 focusing on sexual wellness education and sexual dysfunction emanating from prescribed medication, it was confirmed that sexual wellness education programmes were beneficial.   Education proved to generate a reduction in sexual risk activities compared to complete cessation. This undoubtedly highlights the issue that mental health professionals ought to make an effort to deliver holistic care that consists of sexual health promotion (Higgins et al 2006)

In a similar study conducted but this time it included Glove-wearing Hughes and Gray (2009) states that only 61% of the participants reported wearing gloves whilst administering an injection.  Hughes and Gray (2009) continue to say that the nurses are also risking infection by not wearing gloves.

Bahrick and Harris (2009) emphasises that antidepressants are a common trigger for sexual dysfunction.   This suggests that reassurance and advice from nurses becomes a necessity.  Having an understanding of sexual wellness would make it easier for nurses to give suitable advice because sometimes this becomes debilitating for the mental health clients and as a result requires intervention Bahrick and Harris (2009).  Hughes and Gray (2009) mentioned that the lack of awareness and information of sexual well being does not only leave the clients disadvantaged by not having reasonable access to sexual well being services or relevant info on sexual health.  Hughes and Gray (2009)   goes on to say that by this level of lack of understanding, the mental well being nurses continue to location themselves at risk.

In a study conducted by Cochran and Mays (2000), evidence was transparent that there was an escalated risk of suicide symptoms amongst homosexually skilled men.  Cochran and Mays (2000), further explains that some gay men also reported the risk of recurrent depression as slightly increased.  This once more makes it a necessity for mental health nurses to be conscious and nicely equipped w ith sexual well being information in order to be able to holistically help their clients in a non judgmental manner. (Cochran and Mays 2000)

Interestingly MIND (2008) highlighted another very good reason for mental health nurses to be aware of sexual health issues.  MIND (2008) explained that the distress skilled by some lesbians, gay men as nicely as bisexual’s mental distress is not due to their sexuality instead it is seen as the impact of heterosexism and homophobia,  MIND (2008).  As a result of this, several lesbians, gay men as well as bisexual’s find it a daunting task for fear of becoming seen as abnormal as well as not becoming understood.  MIND (2008) confirms that there is evidence that these concerns or worries are not baseless as homosexuality used to be seen as a psychiatric diagnosis in 1993.  Although nowadays there is an improvement in the awareness in the mental well being field, it would be much more advantageous for mental health nurses to be nicely equipped to deliver sexual health to clients with significant mental health problems (Mind 2008)

 

Implications for practice

This exercise has made it possible to identify gaps in service provision.  From my own expertise, I have witnessed scenarios were mental health clients bring contraceptive pills on the ward and the nurses role is to administer them.  This questions regardless of whether these clients suffering from severe mental illness are conscious of other sexual well being issues other than pregnancy.  In support to this, The Royal College of Nursing (2001) has highlighted that contraception alongside teenage pregnancies and sexual infections are some of the substantial problems that have a fantastic impact on health care practice. The Royal College of Nursing (2001) has highlighted that “sexual well being is about the holistic care of patients and clients”, it was also brought to attention that Clinical practice, Clinical education practice and Clinical policy development are important in ensuring holistic care in sexual health. This has proved that evidence based practice is vital in delivering effective holistic care.  This consists of sexual wellness for mental health patients facilitated by mental well being nurses.  In support to this, Dawes et al (2005) emphasises that evidence based-practice ensures that individual wellness professionals practice based on sound analysis and profitable outcome.  Each and every registered nurse needs to take into account the evidence-based for practice in a multitude of areas as this is a requirement of Nursing and Midwifery Council (NMC 2004).

Having a great knowledge base on sexual wellness promotion will not only assist to educate mental well being clients on sexual wellness but when health promotion is carried out by mental well being nurses, it could become cost successful.  This will also be supporting the Government in fulfilling its pledge in the NHS Strategy to make progress in the amelioration of ill wellness.  The Royal College of Nursing (2001).

By means of undertaking a literature review, this has also provided guidance that will enable us as mental well being nurses to be keen on development and evaluation of sexual wellness education programmes that will be advantageous for our service users.  However, this also enlightens us to the reality that mental well being nurses need to prioritise sexual wellness training and practice development or make an effort to make it part of their personal development program in order to bridge the theory and practice gap. It need to also be noted that they are also some hindrances. It is certainly a rather daunting task right after thinking about the monetary problems faced by the government as a result of the recession.   The Royal College of Nursing (2001) has highlighted that a lack of interest to develop understanding in sexual health has been one of the hindrances.  On the other hand, yet another benefit brought about by continuing professional development is that resources are utilised more successfully. This is confirmed by the Chartered Institute of Professional Development (CIPD 2010), continuing expert development makes staff grow to be a lot more productive and work with efficiency by focusing on their own studying by way of reflection, (CIPD 2010).

The wellness care delivery program is plagued by lack of resources. Updating knowledge and abilities ensures that the finest use of these resources is put into practice. A continuing professional development makes it possible for the individual to work out what region of practice needs development in this case sexual health promotion by mental well being nurses, This will be created feasible through highlighting gaps in their knowledge and expertise.consequently giving the individual a chance to compare what information and skills they possess, and what is expected at their level of skilled practice, (CIPD 2010).

Sexual well being skills are needed or desirable to meet the demands of the promotion of sexual wellness.  It also serves as a way of enhancing one’s competences to ensure satisfactory performance throughout sexual health promotion.  Enhancing understanding and skills for mental wellness nurses allows the individual to engage in evidence based practice. Simpson and Dodds (2004).  This promotes conventionality minimising ambiguity and rendering info shared between well being experts and clients.  Improving teamwork this way reflects a climate that very best supports a therapeutic environment (Simpson and Dodds, 2004).  An additional crucial point to make is that this form of practice could be useful to bridge the theory – practice gap as analysis evidence have proved that mental well being nurses surely need to have to be much better equipped to promote sexual health.  Hughes and Gray (2009) argue that it is important for policies to enhance in order to extend on the achievements of the National Service Framework for Mental Health. The New Horizons programme is a programme that was launched by the Department of Well being in 2009 this is a 10-year strategy to continue to boost the mental health services provided by 2020. Nevertheless, this does not mention sexual health, (NHS Choices 2010)

The Royal College of Nurses (2001), states that wellness promotion policies that dispel inequalities in sexual well being should be put in location and utilised. In addition to this, Gray et al (2002) pointed out that the sexual wellness policies of numerous mental health NHS Trusts are totally out dated, Gray et al (2002) further says that most of these policies basically states that patients are not permitted to have sex whilst on the ward.  Gray et al (2002) gave as an example a policy from a mental wellness Trust that basically states that ‘Sexual activity involving patients on hospital premises is not an acceptable form of behaviour’.

Developments and improvements in practice need to be made.  In order to accomplish safe effective nursing practice, it is paramount to be able to enhance knowledge, abilities, values and attitudes towards professional practice. This could be performed through staff training and adopting a learning culture. Nonetheless, time and duties require to be well managed in order to make this a success.  In addition to this, Nurse Week (2005), points out that nurses tend to spend most of their time in administrative and managerial duties which stop them from spending time engaging in a lot more therapeutic work with patients.  A understanding culture is a practice of a ‘no blame’ approach to management which according to Collier (2005) usually translate theory and directives into practice in a meaningful way.

Conclusion

In conclusion, this post has demonstrated the relevance of mental well being nurses having a good information base of sexual health and the rewards of it and substantiated it with evidence   The literature utilized in the course of this exercise highlights the want for mental well being nurses to have sexual well being understanding and how much the mental wellness patients will benefit from sexual wellness education.  It has also proved that with sexual well being education, evidence shows that they can be a reduction in sexually transmitted infections.   It is critical to state lastly that this exercise has given me a clear understanding of the importance of mental well being nurses being able to promote sexual health.    It is clear that clients with mental well being issues are more likely to encounter issues with their sexual wellness.

The experience I had produced me realise that knowledge is power and when faced with situations had been mental wellness clients have sexual wellness needs they do not have enough knowledge on.  Health promotion is also identified among the seven pillars of clinical governance initiative (DOH, 1998), in which I will be expected to engage in my professional practice as a registered nurse.  In order to practice ethically and to empower clients to live an independent life, mental health nurses want to have understanding about how to respond to the requirements of men and women with mental illness in an ethical, honest, and non judgemental manner and this includes sexual health.

By Beatrice Kungwengwe

Sexual Health