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At 3 am who the Hell do you Call? Case Management Issues in Sole Practice as a Rural Community Mental Health Nurse

Objective: This paper presents a section of data from a larger study into the sole practice of rural community mental health nurses, highlighting the uniqueness of the therapeutic model and the stresses associated with sole practice. Method: A grounded theory method was used that involved interviews with senior community mental health nurses from five rural and remote sites in New South Wales. Results: Rural mental health nurses engage community structures in a unique way, strategically as therapeutic tools supporting recovery or maintenance of an independent lifestyle. Findings also highlight the current strain that sole practice places on nurses, such as the insecurity of bearing responsibility beyond which nurses are formally authorised, in the absence of formal mentoring or professional development. Conclusions: Suggestions for resolving these tensions include virtual teams and Nurse Practitioner roles.