Practising at the Crossroads: Experiences of Pacific Island Nurses Practising in the Mainstream Mental Health Services

Abstract

This thesis presents a research study, which explored the experiences of three Pacific Island psychiatric nurses practising in mainstream mental health services. The Pacific Island nurses were invited to reflect, discuss and share their nursing practice experiences both individually and in a group discussion. The study was grounded in, and framed by, the perception that the researched group are not only nurses from the Pacific Island with ethnic-specific cultural heritage, but also Pacific Island registered nurses who are health professionals with clinical knowledge and skills. The main purpose of the study was to bring to the forefront Pacific Island nurses' practice experiences to gain understanding of their working reality. It explores the impact of mainstream mental health services on Pacific Island nurses' practice, and reciprocal impact their practice has had on service delivery to Pacific Island people. The backdrop of this study is provided by the problematic Western conceptual framework of mainstream services and the role it plays in perpetuating culturally insensitive practices for Pacific Island users of mental health. This study, informed by ethnography, used the methods of structured and semi-structured interviews, group discussions and materials from the journals of two participants. Inter/intra role conflict, professional isolation, a holistic perspective of health, implications of when the two worlds meet, and from chaos towards transparency are the five themes isolated from the data analysis. The findings suggest that Pacific Island nurses' practice experiences are constructed within and shaped by a Western-orientated mainstream environment that determines their roles, function and the nature of their relationship to Pacific Island people for whom they provide mental health services. The study also suggests the importance of establishing clear role definitions in a creative and supportive environment, allowing for autonomy, professional growth and the development of individual potential to practise as competent Pacific Island nurses with both cultural and clinical skills and knowledge.