May 10, 2016 - This Nursing Week we are celebrating
the outstanding contributions of CAMH’s nursing staff. Today we hear from four
leaders on the vision of nursing at CAMH. Let’s take a closer look at how we
lead, how we innovate, how we leverage technology, and how we continue to
evolve the specialty of mental health and addictions nursing.
left: Kamini Kalia, Dr. Rani Srivastava, Gabriella Golea, Dr. Kristin
How we lead
By Dr. Rani Srivastava, Chief of Nursing &
Leadership at CAMH is multifaceted. It can be seen in evolving nursing roles
and positions -- and also in how nurses across this organization use their
expertise and wisdom to influence their colleagues, to drive change, to achieve
a leader means intentionally taking on the responsibility of influencing others
in positive ways. Nursing Leadership at CAMH continues to grow because we see
more nurses embrace the opportunities to influence the work that we do and how
we do it!
about leadership in action – for example, through the ideas exchanged at a CAMH
Nursing Practice Council meeting, in the projects led by a Barford Scholar or Intern, or through
the work of our dedicated After Hours Managers and charge nurses/team leaders
at CAMH. At every turn, you will see nursing knowledge combined with leadership
to support high quality care at CAMH.
Developing role models
are also developing roles that tap into nursing expertise and serve as role
models and support growth opportunities for others. Here are just a few examples
of new and evolving roles for our nursing leaders:
Kristin Cleverley is Joint
CAMH-University of Toronto Chair in Mental Health and Addictions Nursing
Strudwick is an Advanced
Practice Nurse for Research and Innovation, to support professional practice
innovation and scholarship.
Abela-Dimech is CAMH’s Quality
Patient Safety & Risk Specialist focusing on the area of clinical risk and
quality initiatives to mitigate risk and promote a Safe & Well CAMH
Influencing the health system
of our CAMH nurse leaders also influence the health system by actively engaging
with local, provincial, and national groups such as the Canadian Federation of
Mental Health Nurses, Mental Health Nursing Interest Group, the Academy of
Chief Executive Nurses, and the Registered Nurses Association. We are also
welcoming more nursing students at the graduate and undergraduate level who
come to CAMH with a focus on learning more about mental health as well as
a knowledge base that combines medical and psychiatric care -- and a 24/7 presence
to support clients, families, and colleagues -- our nurses offer a unique
perspective on care. Nursing Leadership is critical to transforming care and
invite each nurse at CAMH to develop his/her leadership and embrace
opportunities to influence -- with knowledge, with intention, and with pride!
How we innovate and leverage
Kamini Kalia, Manager of Clinical Education and Informatics
We’ve made some significant strides in the area of
clinical informatics over the last two years at CAMH. This would not have been
possible without the clinical expertise and support from nurses across the
With the introduction of the I-CARE clinical
information system in 2014, we now benefit from a fully integrated system with
new electronic documentation practices, and mobile devices. Under continuing I-CARE
optimization that aligns with CAMH strategic goals, we’re working with nurses
to identify ways to improve the care workflow experience. This will enable more
one-on-one time with clients and improve the overall functioning of the system.
care closer to clients
CAMH nurses utilize technology to bring care closer
to clients, and to increase client choices and strengthen client voices. As a
source of data, nursing documentation alone is integral to understanding the
client experience and care provided. This data will continue to be utilized for
clinical and operational decision-making, both at the bed-side and across the
organization. It’s about continuous improvement to the quality, safety and effectiveness
of the care we provide.
Our nurses are influencers of care and technological
innovation. They will continue to be closely involved and drive change -- every
step of the way.
How we foster inquiry and scholarship
Kristin Cleverley, CAMH Chair in Mental Health Nursing Research and
We’ve seen an exponential growth in innovation,
inquiry and scholarship of professional practice at CAMH in the past few years.
This has been driven partly by the excellent work completed during the Best
Practice Spotlight Organization (BPSO) initiative, the Barford Advanced
Practice Scholarship and Internship Program, the Care Delivery Model Review
(CDMR) project and the ongoing collaborations with our academic partners.
CAMH as a leader in mental health nursing
All of these activities have provided opportunities
for clinical staff -- both front-line and advanced practice -- to participate
in projects that position CAMH as a leader in professional practice development
and scholarship within mental health and addictions nursing.
Over the past year, several of these initiatives have
led to presentations at local and national conferences, opportunities to
consult other organizations, and several manuscripts submitted for publication
in leading nursing and mental health journals. We are excited to keep this
momentum going with the leadership of our Professional Practice Office and the
opportunities provided to our nursing staff through the Barford Program and
other initiatives at CAMH.
continue to evolve the specialty of mental health and addictions nursing
By Gabriella Golea, Director of Interprofessional Practice, CMI
the model of care
It starts with a holistic approach.
Contemporary mental health nursing uses theories from
the biological, psychological, spiritual, and social sciences as a basis of practice.
This holistic approach is necessary to understand and care for our clients:
people who are experiencing mental illness and/or addiction problems. The scope
of mental health nursing practice may also include areas of specialization such
as child-adolescent mental health, geriatric mental health, forensics, and
History gives context to show how far we have come.
In the 1800s, nurse Florence Nightingale aimed to meet the needs of psychiatric
patients with a custodial approach including proper hygiene, better food, light
and ventilation. In Canada, the first mental health nurse training school was
established at the Kingston (Ontario) Rockwood Asylum in 1888.
In the 1950s, an American nurse named Hildegard E. Peplau
emerged on the scene. Now known as the “mother of modern psychiatric nursing,” Peplau
helped revolutionize the academic preparation of mental health nurses. Her
approach recognized the importance of establishing therapeutic relationships
with patients, and providing evidence-based care to them.
Hildegard E. Peplau
The discipline of nursing in general adopted the
theoretical basis of mental health practice, while adding new frameworks of
psychiatric nursing to the discipline: holistic, interprofessional and
During the 1980s, the Canadian Federation of Mental Health Nurses
(CFMHN) was formed as an interest group of the Canadian Nurses Association
(CNA). In 1995, this group published the
first Canadian Standards of Psychiatric and Mental Health Nursing
Practice. Relying on these standards,
the CNA then created the opportunity for nurses to become certified in mental
health nursing -- as part of their larger certification program involving
various nursing specialist areas.
directions going forward
Fast forward to 2016. Both the International
Council of Nurses (ICN) and the CNA have taken the position that all registered
nurses must have the knowledge and skills to respond to mental health needs. As
well, subsequent to the work of the Mental Health Commission of Canada (2012),
six strategic directions have been guiding the Canadian approach to mental
health care and mental health nursing practice. These include promoting mental
health across the lifespan and preventing illness, fostering recovery,
providing timely access to care, reducing inequalities, working with First Nations,
and mobilizing leadership for knowledge and collaboration.
Organizations like CAMH continue to align with and
help drive these strategies and the improvement of mental health nationally and
across the globe. For example, CAMH nurses have played key roles in the
development of integrated care pathways.
Every day, our nurses deliver mental health care
across the lifespan to clients, their families, and the community – and advance
knowledge in the mental health field.