Children’s Nurses' Stories: Narratives of Navigating Working in Children and Young People’s Mental Health Services (CYPMHS)

Whilst children’s nurses are employed in Children and Young People’s Mental Health Services (CYPMHS) throughout the United Kingdom, there is an evident gap in the literature when considering children’s nurses working within this field and how their experience shapes their professional identity. Utilising a systematic approach to reviewing the literature, this identified research has typically focused on mental health nurses, or nurses in general, working in CYPMHS. Conversely, research investigating children’s nurses and mental health typically concentrates on the care of young people in mental health distress on children’s medical wards. A common recommendation from these studies is that more appropriate training is required, as nurses report feeling ill-prepared to care for these patients. And yet there are children’s nurses who choose to work in CYPMHS. To improve the holistic care of young people presenting to medical wards, as well those in CYPMHS, it is important to understand why some children’s nurses perceive their role to encompass mental health care, whilst others do not. The research aimed to investigate children’s nurses’ personal stories of how they interpreted and shaped their professional identity when navigating working in CYPMHS. Applying a Narrative Inquiry methodology, a Thematic Narrative Analysis approach was adopted to analyse stories from eighteen unstructured narrative interviews conducted with children’s nurses who had experience of working in CYPMHS. A metastory was created to visually depict the participants’ stories, identifying similarities and differences across the data, and included how the two prominent themes and subsequent recommendations were intertwined throughout. The first theme focused on how children’s nurses perceive their professional identity as an individual in CYPMHS and the second concentrated on how children’s nurses conceptualise their professional identity within the context of the CYPMHS team. Subthemes were identified within the themes, exploring the individual transferrable skills children’s nurses have to break free of the perceived expectations they should remain working on a children’s ward, and the various external factors that shaped the construction of their professional identity as a ‘hybrid’ nurse, including the wider team, supervision and role models. From the themes, three practice recommendations emerged: improve the mental health training of children’s nurses; develop upskilling programmes within children’s medical wards; standardise pathways into CYPMHS for children’s nurses. Finally, a plan was created for disseminating the findings and recommendations within the nursing domain, including practical examples of how the recommendations may be applied in practice.