Senior nurses build a new model of care

Five clinical nurse consultants and a nurse practitioner form the core of St George`s Psychiatric Emergency Care Centre.

Nurse Practitioner Sue Kennedy says it wasn’t hard to recruit a team of experienced senior mental health nurses to staff St George Hospital’s PECC.

‘They saw it as a challenge and an opportunity to help build an innovative model of care from the ground up,’ said Sue, one of only eight mental health NPs registered in NSW.

Sue and five colleagues – all mental health clinical nurse consultants – played a key role in creating the PECC at St George.

They wrote all policies, protocols and job descriptions based on NSW Health guidelines and the national mental health plan.

‘It was a lot of hard work but it was also very exciting to be able to set the parameters of our work right from the start,’ Sue said.

In bringing the PECCs into operation, Sue and fellow PECC coordinators from other hospitals attended a series of NSW Health working parties.

‘I took the information back to the CNCs and together we worked out how the new model would operate.’

Having an ED and PECC staffed by senior mental health nurses has done a lot to raise the profile of mental health nursing in the hospital, Sue believes.

‘We now have six senior positions that more junior nurses can aspire to and work towards. It shows that senior nurses no longer have to move into management in order to follow a career path – as a CNC or NP you remain actively involved in patient care.’

Sue says that before the St George PECC was established, after hours patients would be managed by an ED nurse and/or doctor while waiting for an on-call psychiatric registrar or community team to come in.

‘The ED nurses did an excellent job, but they are very busy with a range of patients and there are aspects of mental health care they don’t have the background for.

‘Under the PECC system, patients now have fast access to a highly experienced mental health nurse, with a CNC on every shift.’

St George PECC is attached to but physically separate from the ED. Sue and the CNCs do an initial assessment of the patient and can admit them to the six-bed PECC unit for up to 48 hours if necessary.

‘We can do a lot of crisis intervention in 48 hours. We ask ourselves, “What will this patient need to make them better?” And we frequently liaise with a range of other professional people – psychiatrists, social workers, psychologists, drug health services and GPs – to achieve that outcome.

‘We are also involved in counselling and educating patients and families, and can assist with resources if they are homeless or having problems managing their money.’

Sue says some patients with more complex problems who need long-term care are not suited to PECCs.

‘In these circumstances we arrange admission to an in-patient facility, preferably in an area where the patient lives or we can also arrange ongoing community services to meet a patient’s ongoing needs.’