Feature Article
Nursing practice environment: A strategy for
mental health nurse retention?
Robina Redknap,
1,2
Di Twigg,
1
Daniel Rock
3,4,5
and Amanda Towell
1
1
School of Nursing and Midwifery, Edith Cowan University, Joondalup,
2
Graylands Hospital, North Metropolitan
Health Service, Mental Health,
3
North Metropolitan Health Service, Mental Health,
4
School of Psychiatry and
Clinical Neurosciences, and
5
School of Population Health, The University of Western Australia, Perth, Western
Australia, Australia
ABSTRACT: Historically, mental health services have faced challenges in their ability to attract and
retain a competent nursing workforce in the context of an overall nursing shortage. The current
economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with
significant nursing shortages predicted for the future. Mental health services need to develop strategies
to become more competitive if they are to attract and retain skilled nurses and avoid future shortages.
Research demonstrates that creating and maintaining a positive nursing practice environment is one
such strategy and an important area to consider when addressing nurse retention. This paper examines
the impact the nursing practice environment has on nurse retention within the general and mental
health settings. Findings indicate, that while there is a wealth of evidence to support the importance
of a positive practice environment on nurse retention in the broader health system, there is little
evidence specific to mental health. Further research of the mental health practice environment is
required.
KEY WORDS: mental health, nurse retention, nursing, nursing shortage, practice environment.
INTRODUCTION
Mental health nursing has historically been seen as a less
attractive career option for nurses. Major advances
occurred during the 1950s–1980s, and can be attributed
to the rapid expansion in understanding the important
influence that nursing practice had on mental health
patient outcomes. This understanding primarily evolved
through the influence of nurse theorists, such as
Travelbee, Peplau, and Orlando. These theorists empha-
sized the importance of interpersonal relationships in the
development of compassionate and caring therapeutic
nurse–patient relationships; integrating nursing theory
into practice; and the ability for nurses to use their per-
ception, thoughts, and feelings in the identification of
patient needs (McCarthy & Aquino-Russell 2009; Moses
1994; Potter & Tinker 2000). This had a dramatic effect
on mental health nursing practice, and resulted in greater
recognition for the therapeutic influence that mental
health nurses have in ensuring positive patient outcomes
and a reduction in the medical dominance and servility of
mental health nurses (Hayman-White et al. 2007; Holmes
2002; The Sainsbury Centre for Mental Health 2005).
However, the attraction and retention of nurses by
mental health services continued to be problematic
(Happell 2009). Patients and staff continue to hold differ-
ent perceptions of the ward environment, with different
factors influencing the satisfaction they feel (Friis 1986;
Roos 1997; Rossberg & Friis 2004). This has left today’s
mental health nurse leaders with significant challenges to
Correspondence: Robina Redknap, Graylands Hospital, Brockway
Road, Mt Claremont, Western Australia 6010, Australia. Email:
redknapr@gmail.com
Robina Redknap, RMHN.
Di Twigg, PhD MBA, B Hlth Sc (Nsg) Hons, RN, RM, FACN,
FACHSM.
Daniel Rock, PhD, MN.
Amanda Towell, D Cur, M Cur, B Cur (Ed et Adm), DCH, RCCN,
RN.
Accepted December 2014.
International Journal of Mental Health Nursing (2015) 24, 262–271 doi: 10.1111/inm.12126
© 2015 Australian College of Mental Health Nurses Inc.