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Psychiatric Nursing in Czech Republic

European Festival of Psychiatric Nursing, Malta 07.11.200 8 Mgr. TOMAS PETR BLANKA NOVOTNÁ. Psychiatric Nursing in Czech Republic. Who are we?. Tomas Petr (MSc, BSc, RN) BSc General Nursing MSc Management in Health Care

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Psychiatric Nursing in Czech Republic

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  1. European Festival of Psychiatric Nursing, Malta 07.11.2008 Mgr.TOMAS PETR BLANKA NOVOTNÁ Psychiatric Nursing in Czech Republic

  2. Who are we? Tomas Petr(MSc, BSc, RN) BSc General Nursing MSc Management in Health Care Currently Manager of Psychiatric Intensive Care Unit, Central Military Hospital, Prague Blanka Novotná (RMN)MN) Registered mental health nurse Currently manager of nursing care, Psychiatric Hospital Prague

  3. Overview Introduction Health care system in Czech Republic General information about mental health Structure and organisation of services Nurses training, registration, professional bodies Specific issues, challenges

  4. Czech Republic Population: approx. 10 mil. Nationality: 95% Czech 5% Slovak, Polish, German, Vietnamese, Ukrainian Official language: Czech Capital: Prague

  5. Prague

  6. Health care system in The Czech Republic- main features - Social health insurance system Compulsory contribution – 13,5 % from salary (4,5% employee, 9% employer) State – contribution for unemploeyd people, children, retired people, women on maternity leave 9 insurance companies Since 1.1.2008 – regulatory fees (a doctor´s appointment – 30 CZK, 1 day at hospital – 60 CZK, prescribtion of drugs – 30 CZK = 1,2 EU etc.) Expenditure on health services – 7,3 % of GDP

  7. Percent of GDP spent on health care (OECD, 2004)

  8. Main challenges in nursing in Czech Republic • Changes in education - 3 900 nurses completed study - 200 started working in hospitals - 1 180 carried on with study on higher level - rest of them dissapeared • Lack of nurses (deficit of 1000 nurses in the system) • Re-defining competences of nurses (higher education, but the same competences) • Low salaries

  9. Mentalhealth care Cinderella between medical disciplines Lack of interest from politicians and public Retaining stigma of psychiatry (media, movies etc.) Insufficient funding (mental health – only 3,5 % from health care budget)

  10. Expenditure on mental health care % of health care budget 3.5% from health care budget Zdroj: MHEEN, 2004

  11. STIGMA OF PSYCHIATRYrepresentative sample of 1248 respondents, 1999 SOCIAL PRESTIGE 1 – the best, 5 – the worst

  12. Choosing a job ???

  13. Prestige of nursing job99 – the highest prestige, 0 – the lowest prestige Jobswiththehighestprestige Jobswiththelowestprestige • Physicians – 88 • Scientists – 82 • University teachers – 77 • Nurses – 72 • Secretary - 41 • Member of Parliament - 34 • Priest - 40 • Cleaner - 30 CVVM 9/2008

  14. On theway to becoming a psychiatricnursestep 1 age of 18 finished secondary education A. 3 years study on nursing school  general nurse B. 3 years on university (bachelor degree)  general nurse

  15. On theway to becoming a psychiatricnursestep 2 generalnursediploma 12 monthsoffieldexperience 3 yearspostgradual study 640 hours - 50% theory, 50% practice  psychiatricnurse Lessthen 30% ofnursesworkingatpsychiatrichospitalshavegotspecializationatpsychiatricnursing.

  16. Where to work, if you are psychiatric nurse?

  17. 20 • 68,8% ofhospitalisationshappenswithinasylums • averagelengthofhospitalstay – 79,4 days • 2,5% ofclientslongerthen 1 year • numberofnurses - 2 899 Asylum-like hospitals

  18. 32 • averagelengthofhospitalstay – 20,9 days • numberofnurses - 700 Psychiatric wards

  19. numberofthemisgrowingup (in 2005 – 24,4% more then in 2000) • private, paid by insurancecompanies • numberofnurses – not known Ambulatory care providers

  20. poor network • mainlyconcentrated in bigcities • problemswithfunding • numberofnurses - 6 Community care

  21. Structureofservices - mainissues - Most of the care happens within hospitals Lack of community services Long hospitalization Frequent rehospitalization High cost of care/low effectiveness Poor conditions within inpatients settings

  22. - 12 hours shifts • 1 nurse – group of 20 clients • Increase of paperwork • A lot of stress • Average salary – 1000 EU/month Psychiatric nurseWhat your job will be like?

  23. Registration of nurses Condition for renewing: • 40 credits • clinical practise • CRB • good state of health • Compulsory since 2004 • Registration term lasts 6 years

  24. Professional bodies CNNA – Czech National Nurses Association Member of ICN, PCN, WENR Divided into 69 sections 21 000 members Membership is voluntary

  25. 700 members • full member of Horatio Main activity: • Organizing conferences, congresses, workshops • Working on clinical guidelines • Participating in clinical research • Publishing study materials • Horatio congress in Prague - 2010 CNNA Psychiatric section

  26. Conditions within psychiatric hospitals- contrasts -

  27. TOMAS_PETR@HOTMAIL.COM BLANKA.NOVOTNA@PLBOHNICE.CZ Contacts:

  28. QUESTIONS

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