Knowledge exchange through elective mental health nursing placements abroad

A successful knowledge exchange for mental health nursing practice, policy, research and education between our School of Healthcare Sciences and Mid North Coast Local Health District (New South Wales, Australia) provided an opportunity for further knowledge exchange through international student placements.

Seren Roberts (Senior Lecturer in Mental Health Nursing)

The mental health nurse education models differ significantly between the two countries. UK-wide nurse education is field specific with four fields of nursing available at undergraduate level: child, adult, learning disability and mental nursing. In Australia, nurse education is generic with no field specialism at undergraduate level. The two countries also offer different models of recognition and registration with governing bodies to practice as specialist mental health nurses.

For this reason, facilitating a placement for undergraduate student nurses has important implications for practice learning and development of our future workforce in both countries. The value of international elective placements for undergraduate nurses’ professional and personal development as well as cultural competence, is well established (Adamson, 2018, Bagnasco et al., 2020, Browne et al., 2015, Carter et al., 2019, Johnston et al., 2022, Ulvund et al., 2023). International nursing student placements could also lead to a diffusion of knowledge and skills between different countries (Keogh and Russel-Roberts, 2009) as a form of knowledge exchange.

Building on our international collaborative partnership, we offered our mental health nursing students the opportunity to undertake an international placement with the Mid North Coast Local Health District for their elective placement. It is the first international elective placement in Australia for our nursing students. The elective observational placement last for 3 weeks and is mid-way through the programme. It allows students to experience a different healthcare context in the UK or abroad. In March 2024, our first student, a mental health nursing undergraduate student, went to Mid North Coast Local Health District for her elective placement. Abi tells her story about her experiences and learning during this elective placement.

Abi Fisher (Mental Health Nursing Student)

Completing one of my mental health nursing placements in Australia was an incredible opportunity. I have been able to take so much from this learning experience by gaining unique insight into a range of mental health care services in a small region of New South Wales – Coffs Harbour – and understanding more about the training pathway for mental health nurses in Australia.

I was lucky enough to spend time with a range of mental health services during my placement. This included time on a mental health rehabilitation ward, the psychiatric intensive care unit, with the community mental health team (CMHT) and with the emergency department mental health team.

I was incredibly impressed by the rehab ward programme. Designed from a therapeutic angle, the programme promoted a sense of community, friendship and self-worth. Each day was designed and organised by the service users during the morning meeting, with a range of proposed activities on offer. Staff were encouraged to participate in daily activities with service users as part of this inclusive programme.

Speaking to the service users, it became clear that their sense of being truly valued was an essential part of their personal journey to recovery. Conversation and reflection comes much more naturally in a non-directive environment (Joseph, 2015). For example, my most interesting and valuable conversation with a service user happened during a morning of horticulture in the ward gardens.

I feel that the nature and success of this rehab programme is worthy of recognition. My last placement in the UK was on a rehab ward and one of my reflections from that placement was the lack of community and interactive engagement between staff and service users. I feel that some of the elements of the rehab programme I saw in Coffs Harbour could be hugely valuable in informing and enhancing current and future mental health rehabilitation programmes in Wales and across the UK.

One aspect of nursing in Australia which stood out to me was the difference between the training pathways to become a mental health nurse. In Australia, nurses across all three branches complete the same general nursing degree. During their training, nurses have just a quarter of the placement time that we do in the UK.

Following this general nursing programme, there are options to do extra training in a specific area for example, mental health. As a result of this less specialist pathway, there are fewer specialist nursing roles available in Australia. All the nurse therapists I met on placement had done their specialist training in the UK and were using this qualification in quite a unique role in the Australian healthcare system.

I feel that the specialist training we get from the beginning of the nursing degrees in the UK sets us up well and provides us with more flexibility to move into more specialist roles. It would be interesting to find out more about if/how these significant differences in training pathways impacts treatment outcomes and staff and patient satisfaction.

I have taken a huge amount from completing one of my nursing placements in Australia. The international collaborative partnership that this opportunity has given rise to is undoubtedly invaluable. I would love for this experience to be offered to future nursing students and for this collaborative relationship to continue to grow. It has exciting potential to inform and enhance nursing practice in both Wales and Australia.