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Roles and Responsibilities - SHED - Mental Health Nurse Navigator

Primary Roles

Overall aim to promote a collaborative and holistic approach to caring for mental health consumers during their time at SHED by empowering consumers to navigate the healthcare system/ ED by utilising the four key pillars of nurse navigation to streamline mental health services provided in ED. Role should remain fluid and meet the needs of the ED on a day to day basis.

 

  1. Creates Partnerships

Between the consumer and SHED

  • Promoting a holistic and patient orientated experience for consumers presenting to SHED.
  • Supporting consumers in accessing relevant services available to them whilst at SHED (ACE, EMH, WCASA, Wilim Berrbang, AOD etc).
  • Offer ongoing support and education around ED processes.
  • Provide education and resources on services available outside of ED (Support Services Brochure).
  • Establish rapport with consumer and outline mutual expectations around behavior and respect throughout their time at SHED.

Between EMH and SHED

  • Work alongside EMH to ensure appropriate referral pathways maintained
  • Communicating throughout shift with EMH clinicians
  • Create strong working relationships alongside the EMH team

Between AOD and SHED

  • Work alongside AOD to ensure appropriate referrals and care is maintained for consumers presenting with AOD concerns.
  • Liaise with AOD team if concerns arise around consumers presentation or if there are any changes to consumers presentation and withdrawal symptoms
  • Create strong working relationships with AOD clinicians

Between ACE team and SHED

  • Work alongside ACE team in ensuring appropriate referral pathways are maintained.
  • If required, support ACE team in managing and communicating with consumers (in particular if consumer is agitated, has a risk history or is receiving bad news).
  • Create strong working relationships with ACE clinicians.

 

  1. Coordination of Consumer Centered Care
  • Co-ordinate and complete initial risk screening for streaming of mental health consumers (alongside medical team) once ATS triage completed.
  • Ensure appropriate care pathways are maintained as per MHAOD model of care.
  • The MH Nurse Navigator (when on shift) is to be the designated lead for Mental Health Clinicians during Code Greys, Planned Code Greys, BOC calls and other arising situations in order to ensure best possible outcomes for consumers and reduce risk of restrictive interventions.
  • Support bedside nurses in ensuring that all appropriate processes and policies (including MHA + DOC) are complied with if restrictive interventions are used.
  • Support the bedside nurse, or the mental health transition nurse to assess the appropriateness for a consumer to engage in sensory modulation + appropriateness of being provided a distraction pack.
  • Promote proactive management of consumers presenting to SHED by:
    • By reviewing and accessing consumer’s history through EPI + CMI to gain a better understanding of consumers complete mental health history and treatment.
    • Ensuring PRN medications charted where appropriate.
    • By assisting triage nurses in both AV areas and wait rooms in supporting consumers during wait periods.
    • By discussing other potential strategies that may be utilized with consumers to minimize BOC or risk taking behaviors whilst at SHED (sensory modulation, calming techniques, pastime packs etc).
  • Offer secondary consultations for MO + ED RN’s in non-acute presentations if unsure of appropriate clinical pathways for mental health consumers.

 

  1. Facilitating System Improvements:
  • Real time auditing of restrictive intervention paperwork and processes ensuring practices in line with MHA. E.g. MHA paperwork being correctly completed, medical reviews being documented etc, NOK being notified.
  • Promote early intervention for mental health consumers in ED.
  • Frequent presenter plans
  • Implementation of relevant Safewards interventions in ED (Mutual Expectations, Positive words, Reassurance, Bad New Mitigation, Talk Down, Calm down methods)

 

  1. Improving Consumer Outcomes
  • Empowering consumers in terms of education, their rights, responsibilities and complaint pathways.
  • Provide consumers with resources to enhance health literacy (medication brochures, MHA statement of rights etc) and understanding of services available (Support Brochure, IMHA details).
  • Promoting gender sensitive and cultural sensitive practices (Aboriginal Health Workers etc).
  • Provide real time education and support to nursing staff to promote care for mental health consumers.

Communication Priorities

  • Communicate with consumers in a respectful and non-judgmental manner.
  • Communicate and handover appropriate information to ANUM on shift, Team Leaders, medical team caring for consumer.
  • Ensure appropriate handover and communication with bedside nurse, triage nurse or wait room nurses around assessment outcomes, care to be/being provided.
  • Ensure thorough communication with EMH, ACE and AOD clinicians across the span of the shift.
  • Clearly document assessment findings on EDIS as soon as clinically possible post contact with consumer.
  • If required, liaise with community teams and NOKs.

Escalation Plan

  • Escalate concerns as appropriate to ANUM in terms of need for cubicle, risk profile and potential of escalation etc.
  • Escalate concerns and assessments as appropriate to team leader, consultants.
  • If appropriate, escalate concerns to EMH, AOD or ACE for further assessment or input.
  • When required and if appropriate, liaise with Police (property damage, AWOL, assault etc).

Measures Of Success

  • Consumers feeling supported, empowered and respected throughout their admission to SHED.
  • Risk screening completed within ATS time frames for all mental health patients that present to ED
  • Clear and appropriate care pathways are utilised as directed by the MHAOD model of care.
  • Overall reduction in the use of restrictive interventions and if used, a reduction in breaches of MHA throughout their use.
  • Improved confidence for SHED staff in managing and caring for mental health consumers