title: Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992.
abstract: 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.
authors.affiliation: Centre for Mental Health Research, Policy and Service Development, The University of Auckland, Auckland, New Zealand. b.mckenna@auckland.ac.nz
authors.forename: Brian G
authors.initials: BG
authors.lastname: McKenna
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: O'Brien
authors.forename: Toni
authors.initials: T
authors.lastname: Dal Din
authors.forename: Kate
authors.initials: K
authors.lastname: Thom
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002568:Certification; D002983:Clinical Competence; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D003657:Decision Making; D004509:Education, Nursing, Continuing; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009520:New Zealand; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment / Q000458:organization & administration; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D017009:Professional Autonomy; D011568:Psychiatric Nursing / Q000193:education / Q000458:organization & administration*; D012649:Self Concept; D011795:Surveys and Questionnaires; D016526:Workload