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Emergency nurses working effectively with clients who self-harm: evaluation of an innovative solution focused education program
Abstract

Emergency nurses working effectively with clients who self-harm: evaluation of an innovative solution focused education program

Margaret McAllister
2007 University Research Conference Book of Abstracts, p.13
University Research Conference: Advancing Sustainable Regions, 2007 (Sunshine Coast, Australia, 21-Nov-2007)
2007
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Abstract

Nursing self-harm solution focused nursing emergency nurses
The incidence of self-harm among young people in Australia is rising, accounting for 20 percent of all hospital attendances and seven percent of admissions. Most clients are triaged and treated by generalist nurses, most of whom have never been trained in the issue. Unfortunately, many clients: do not have psychosocial assessments completed; leave before they are seen; are discharged without follow-up; or, find the experience traumatic and thus are at higher risk of repeated self-harm or even suicide. Yet, Lewis et al estimated that interventions immediately following self-harm might reduce the rate of subsequent suicide by 25 percent. It is recommended that clinicians adopt a more proactive and responsive style because it: (a) improves health seeking behaviour; (b) reduces the events that precipitate urges to repeat selfinjury; and (c) prevents the onset of a sense of despair and helplessness that might lead to suicidality. This suggests that there is much that emergency nurses can do to instil hope, facilitate effective meaning making and provide supportive connections for these clients. It was in this context that an education intervention for emergency nurses was designed and evaluated. The intervention was based on Solution Focused Nursing, a philosophy that draws on principles of the positive psychology movement, with its emphasis on generating strengths, coping mechanisms and goals for the future. Processes were used to gently interrupt nurses' tendencies to be concerned only about the presenting problem. The results showed significant improvements in attitudes and clinical skills, particularly in relation to consideration of the client's future behaviours. It engendered a belief that nurses do have the ability to positively influence clients. By teaching nurses brief strategies to assist them to join with the client, validate strengths and facilitate social connections, the intervention helped nurses to see their role as aiming to transform the present crisis into a turning point.

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