McKenna Brian G, O'Brien Anthony J, Dal Din Toni, Thom Kate
Centre for Mental Health Research, Policy and Service Development, The University of Auckland, Auckland, New Zealand.
Int J Ment Health Nurs. 2006 Jun;15(2):128-34. doi: 10.1111/j.1447-0349.2006.00412.x.
The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 District Health Boards and the Auckland Regional Forensic Psychiatry Services (n = 121). The response rate was 88.4% (n = 107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A descriptive statistical analysis was undertaken and open-ended questions were analysed using content analysis. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. There are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery.
本研究的目的是确定有多少注册护士担任“责任临床医生”，他们在立法的哪些阶段发挥作用，并描述护士承担这一法定角色的促进过程和障碍。向11名现任责任临床医生以及从21个地区卫生委员会和奥克兰地区法医精神病服务机构中各选出的5名高级护士发放了一份匿名描述性调查问卷（n = 121）。回复率为88.4%（n = 107）。该调查询问了受访者目前承担的法定角色。询问受访者责任临床医生这一角色对护士来说是否合理，以及他们是否有动力去获得这一角色。还询问了他们认为自己具备该角色的哪些能力、对认证过程的看法以及获得该角色所需的教育要求。进行了描述性统计分析，并使用内容分析法对开放式问题进行了分析。在全国约395名责任临床医生中，有11名（2.8%）是护士。大多数护士认为该角色是合理的。然而，许多人并不清楚该角色的能力要求和认证过程，并且由于当前的工作量、角色冲突和缺乏薪酬，对获得这一角色有些矛盾。突出了能力缺陷。鉴于立法意图，有理由鼓励护士担任责任临床医生。这将需要颁布适当的心理健康政策，以及心理健康服务提供方面的主要利益相关者共同努力。
