The Rural and Remote Mental Health Service of South Australia recognises that Mental Health Nursing is a speciality area of nursing, and values the contribution that Mental Health Nurses provide to the Multi-disciplinary team.

Mental Health Nursing as a speciality area of nursing must define its parameters and establish guidelines for accountability, standards of practice and desired outcomes. To address the issue of accountability and quality care there must be a consistent method of measuring standards of practice. Monitoring performance through clinical indicators, (for Standards of Practice) is now an accepted method of establishing an acceptable range of practice¹.

Mental Health Nursing is a specialised field of Nursing which focuses on meeting the mental health needs of the consumer, in partnership with family, significant others and the community in any setting. It is a specialised interpersonal process embodying a concept of caring, which is designed to be therapeutic by;

• Supporting consumers to optimise their health status within the reality of their life situation.
• Encouraging consumers to take an active role in decisions about their health care.
• Involving family/significant others and communities in the care and support of consumers.

Registered mental health nurses recognise the need for flexibility, adaptability, responsiveness and sensitivity as they continually shape their practice to the dynamically changing needs of the consumer, family, significant others and the community².

A Mental Health Nurse is a nurse registered with the Nurses Board, and works with people as individual consumers, their families, significant others or the community in any context where issues concerning mental health are present. Mental Health Nurses are accountable for their own practice².

All of the Nursing staff employed by the Rural and Remote Mental Health Service are aware of and are responsible to ensure that they comply with all legislation that may have an effect on nursing practice, including obligations under the various Legislative Acts listed below;

Standards should be designed to reflect the Nurses Act and should be based upon the Act and Regulations. Standards should be consistent with the ANCI Codes of Ethics, Conduct and Competencies standards. Standards should be sufficiently broad and flexible to achieve their objective and at the same time permit freedom for innovation, growth and change. Standards should be cognisant of consumers and other stake-holders expectations. Standards should be formulated according to requirements which facilitate their applicability and use by the Nurses Board³.

ANCI National Competencies for the Registered and Enrolled Nurse

The Australian Nursing Council Incorporated have developed national nursing competencies that have been accepted by Australian nurse registering authorities as core competencies to be demonstrated by nurses⁴. All of the Nursing staff employed by the Rural and Remote Mental Health Service are aware of the Competencies for the Registered Nurse in Recommended Domains and are responsible to ensure that they meet or exceed these competencies.

Practice for Mental Health Nursing in Australia"

1. The Mental Health Nurse ensures his/her practice is culturally appropriate through the sensitive and supportive identification of cultural issues.

2.The Mental Health Nurse establishes partnership as the working basis for therapeutic relationships.

3. The Mental Health Nurse provides systematic nursing care that reflects contemporary nursing practice and the client’s health care/treatment plan.

4. The Mental Health Nurse promotes the health and wellness of individuals, families, and communities.

5. The Mental Health Nurse commits to ongoing education and professional growth and develops the practice of mental health nursing through the use of appropriate research findings.

6. The Mental Health Nurse practices ethically, incorporating the concepts of professional identity, independence, authority and partnership.

7. Mental Health Nurses demonstrate advanced practice when they are able to integrate at a level of excellence, the previous six standards using skills in clinical practice, leadership, management, research or education².

8. All of the Nursing staff employed by the Rural and Remote Mental Health Service are aware of the ANZCMHN Standards of Practice and are responsible to ensure that their practice meets or exceeds these standards.

Various codes of conduct are issued as a guide to the proper behaviour of professionals and employees in the way they go about performing their day to day duties. For Nurses employed in the South Australian public sector there are two important codes that must be observed, the Code of Conduct for Public Service Employees and the ANCI Code of Professional Conduct for Nurses in Australia.

Code of Conduct for Public Service Employees

The Code of Conduct for Public Service Employees⁵ was issued as a guide to the proper behaviour of public employees in the South Australian public sector. It was issued by the Government Management Board to amplify the principles of conduct which the Government Management and Employment Act, 1985 requires all public employees in South Australia to observe. These principles are;

• employees shall comply with the provisions of this and any other Act governing their conduct;
• employees shall be conscientious in the performance of official duties and scrupulous in the use of official information, equipment and facilities;
• employees shall, in their dealings with members of the public or fellow employees, exercise proper courtesy, consideration and sensitivity;
• employees shall not conduct themselves in their private capacities in a manner that would reflect seriously and adversely on their employers or fellow employees.

All of the Nursing staff employed by the Rural and Remote Mental Health Service are aware of the Code of Conduct for Public Service Employees and are responsible to ensure that they conduct themselves according to this code.

ANCI Code of Professional Conduct for Nurses in Australia

Upon entering the practice of nursing each nurse accepts the responsibility and trust vested in the nursing profession and the corresponding obligation to adhere to the profession’s standards of professional conduct. Nurses have a responsibility to the individual, society, and the profession to provide safe, competent nursing care which is responsive to individual, group and community needs. The Code of Professional Conduct for Nurses in Australia is a set of national minimum standards for accountable professional nursing conduct⁶.

Each Nurse will;

1. Provide safe and competent nursing care.
2. Uphold the agreed standards of the profession.
3. Practice in accordance with laws relevant to the nurse’s area of practice.
4. Respect the dignity, culture, values and beliefs of patients/clients and significant others in the provision of nursing care.
5. Promote and support the health, well-being and informed decision making of patients/clients in the provision of nursing care.
6. Promote and preserve the trust that is inherent in the privileged relationship between nurses and their patients/clients with respect to both their person and their property.
7. Treat as confidential personal information obtained in a professional capacity.
8. Refrain from engaging in exploitation, misinformation and misrepresentation, in regard to health care products and nursing services⁶.

All of the Nursing staff employed by the Rural and Remote Mental Health Service are aware of the ANCI Code of Professional Conduct for Nurses in Australia and are responsible to ensure that they conduct themselves according to this code.

Nursing practice is undertaken in a variety of settings. Any particular setting will be affected to some degree by factors which are not within a nurse'’ control or influence. These include resource constraints, institutional policies, management decisions, and the practice of other health care providers. Nurses also recognise the potential for conflict between one person’s needs and those of another, or of a group or community. Such factors may affect the degree to which nurses are able to fulfil their moral obligations and/or the number and type of ethical dilemmas they may face⁷. 

 ANCI Code of Ethics for Nurses in Australia

Nurses support and enable individuals, families and groups to maintain, restore or improve their health status, or to be cared for and comforted when deterioration of health has become irreversible. A traditional ideal of nursing is the concern for the care and nurture of human beings regardless of race, religion, status, age, gender, diagnosis or any other ground. The Code of Ethics has been developed for nursing in the Australian context and is relevant to all nurses working in Australia⁷.

ANCI Value Statements

1. Nurses respect persons’ individual needs, values and culture in the provision of nursing care.
2. Nurses respect the rights of persons to make informed choices in relation to their care.
3. Nurses promote and uphold the provision of quality nursing care for all people.
4. Nurses hold in confidence any information obtained in a professional capacity, and use professional judgement in sharing such information.
5. Nurses respect the accountability and responsibility inherent in their roles.
6. Nurses value the promotion of an ecological, social and economic environment which supports and sustains health and well-being.

All of the Nursing staff employed by the Rural and Remote Mental Health Service are aware of the ANCI Code of Ethics for Nurses in Australia and are responsible to ensure that they conduct themselves according to this code.

All Nurses employed by the Rural and Remote Mental Health Service will participate in an Annual Performance Appraisal, conducted at the beginning of each calendar year.

Each appraisal will be based on the professional standards and codes of conduct as outlined above, and also the Statement of Key Outcomes and Associated Activities as listed in each Job and Person Specification in item 4.

The objectives of the appraisal are to provide an opportunity for self evaluation, provide appropriate feedback, and to provide a record of performance. The performance appraisal is seen as a staff development tool and will not be used as a disciplinary measure and will not be used for selection or promotion purposes except at the request of the employee.

REFERENCES

1. Australian and New Zealand College of Mental Health Nurses "Clinical Indicators

for Standards of Practice" Clinical Indicators Survey Manual (Version 1 - 1998)

2. Australian and New Zealand College of Mental Health Nurses "Standards of

Practice for Mental Health Nursing in Australia" 1995

3. Nurses Board of South Australia Standards pamphlet 1997

4. ANCI National Competencies for the Registered and Enrolled Nurse 1994

5. Code of Conduct for public employees South Australian Government Management

Board 1992

6. ANCI Code of Professional Conduct for Nurses in Australia 1995