|dc.description.abstract||This thesis explores and describes the role of the mental health nurse in criminal courts in New Zealand. Nursing practice in criminal courts has not previously been examined in the New Zealand context. The court liaison nurse (CLN) is the sole health practitioner in a setting involving a high level of public and media scrutiny. It was therefore surmised that nursing in a setting at the juncture of two conflicting cultures, justice and health, would generate considerable tensions for the nurse. Naturalistic qualitative descriptive research design and mixed methods were used to gather rich information about this discrete cohort of CLNs and their nursing practice. A survey-questionnaire was sent to all nurses practicing in the role. In-depth interviews were then conducted with six CLNs who also completed a two week audit of their day-to-day practice.
The findings reveal that despite their seniority and wealth of experience, their work and educational experiences had not prepared the nurses for practice that was immersed in a legal setting. CLNs encountered multiple challenges to maintaining their nursing values and focus. Significantly, they had to adjust their professional language to realise effective communication. CLNs experienced alienation because of the novel practice setting, a lack of understanding about the role and the absence of a structure for professional support. They felt as if they did not belong in either the legal or health setting. There was a pervasive sense of a group of nurses who felt undervalued by their colleagues, epitomising the isolated nature of the role. As a result, CLNs are a disparate group who would benefit from a supportive national CLN forum.
CLNs encountered many complications on a daily basis in the course of brokering court liaison and court diversion. Disparities were uncovered in relation to resourcing and some practices. Two aspects of their practice were particularly troubling for CLNs. They reported that obtaining consent in the court setting and the exchange of health and offending information was problematic. These aspects were complicated by the public nature of the court and the involvement of multiple agencies. Importantly, the research highlights the need for expert and dedicated professional support for the CLNs both at the coalface and in an ongoing capacity.
CLNs have attained advanced and additional knowledge and skills regarding the interplay between the mental health and justice systems. Their level of expertise is currently not recognised. A way forward to embed this nursing practice for the future is suggested through development of a framework for practice including standards and competencies for practice, an educational pathway and a professional support structure. Consideration could then be given to specialty practice areas or an expanded Registered Nurse (RN) scope.
These nurses perform a crucial role in working with people with mental health concerns in courts and advocating for health interventions for the person. CLNs have a vast amount of valuable knowledge regarding the intersection of mental health and justice systems. It is hoped that bringing together the CLNs’ experiences and knowledge into the public arena of mental health nursing will stimulate and motivate others to continue the drive for acknowledgement, continuity and ongoing evolution of this important and necessary nursing role.||en_NZ