Mental Health Nurses’ Narratives of Alcohol

Abstract

Alcohol is constructed by society as being both helpful and harmful. Drinking is a social norm, and in New Zealand, binge drinking is widely accepted. Alcohol is also attributed as a major cause of disease and injury, and in mental health, the problem drinking of clients is associated with poor health outcomes. Mental health nurses are in a prime position to implement alcohol interventions. Efforts to encourage nurses to intervene, however, have been largely unsuccessful. Previous studies have explored a range of barriers to intervening, yet the contradiction between alcohol as a social norm and a health problem has been largely overlooked. Given nurses are both members of society and health professionals, this contradiction may be particularly relevant and compounded by the fact that mental health nurses are more likely than other nursing specialities to consume alcohol. The aim of this study was to identify the relationship between mental health nurses’ personal and professional stories of alcohol, to gain an understanding of how this may influence the implementation of alcohol interventions in mental health settings. Seven nurses participated in this narrative inquiry. Their individual stories are told and four themes were identified from across their stories: living and working within normalisation, nurses consuming alcohol, knowledge of coexisting interventions, and not implementing interventions in practice. The findings suggest that nurses’ personal and professional stories of alcohol are intertwined and framed within a society which accepts and normalises drinking. Conflicting discourses of alcohol as a social norm and alcohol as a health problem are reproduced in nurses not implementing alcohol interventions with clients in mental health settings. Recommendations are made for changes in legislation and health policy, mental health service managers and leaders, mental health nurses, nursing education and the focus of research. Changes are required in all of these areas to increase positive health outcomes for clients accessing mental health services.