Medication management: an exploratory study into the role of community mental health nurses

The recent emphasis on community care for those with mental illness has cha nged working patterns and modified inter-professional role boundaries withi n multi-disciplinary teams. Clients with serious mental illness are usually prescribed medications, which have a wide range of side effects. However, it is uncertain who is responsible for monitoring clients for the side effe cts of their medications, ensuring clients' and carers' understandings of t heir prescribed medications and optimizing compliance with medication. This paper discusses the findings of the first phase of an ongoing study design ed to assess the role of community mental health nurses* (CMHNs) in managin g clients' medication and the provision of appropriate continuing professio nal education. Our respondents were 14 CMHNs, seven of whom were preparing to undertake a pharmacology module as part of a higher education diploma, a nd seven who were to act as comparators. Data from questionnaires, intervie ws and clinical observations were triangulated. All respondents felt that i ssues surrounding clients' medication were not accorded a sufficiently high profile and that it was, in part, their responsibility to expand their rol es to meet these unmet needs of clients. Administering and managing clients ' medications were considered to be the main area of 'occupational territor y' which distinguished CMHNs from social workers. However, the nurses felt that their practice was limited by lack of appropriate educational preparat ion.