TIDAL MODEL

The Application Of The Tidal Model To Practice

The Application Of The Tidal Model To Practice

Mental health nursing in the UK has had a poor relationship with nursing models. The merit of the medical model, although, frequently contested, still governs much nursing practice. Increasingly, nurses turn to social or psychological models - in the form of Psychosocial Interventions (PSI) or cognitive behaviour therapy - to find guidance for their practice. As Michael (1994) has pointed out, the only way many nurses can find confidence in their own practice has been to model themselves on another discipline.

The Tidal Model (Barker, 2000) is a radically new approach to the practice of mental health nursing based on a series of research studies conducted over the past five years, which sought to define how nurses might help empower users and their families, and to clarify what kind of 'care' people need from nurses( Barker et al, 1999). The Tidal Model is presently being established as the basis of nursing practice, across the whole adult mental health programme in Newcastle, and is being introduced into selected clinical and teaching setting in Australia and New Zealand, Finland, Scotland, Ireland and Wales.

Although the Tidal Model complements the care offered by other health and social care disciplines, it recognises that 'quality' nursing care is focused on a special kind of relationship with users and their families. The person's needs change from day to day and problems are not fixed things. Life flows through people and the problems of living they experience are equally fluid and changeable. Effective care needs to be based on a realisation of the changing nature of people and their life circumstances. The Tidal Model makes few assumptions about the proper course of a person's life, preferring instead to focus on the kind of support that people might need to rescue them from crisis, and help them to chart again the course of their own lives. Genuine psychiatric care should be focused on appropriate forms of 'emotional rescue' and mental health care should be focused on the kind of human development that will enable the person to 'put to sea' again. In this sense the Tidal Model is committed to helping people to recover their lives, taking up the journey of a lifetime that has been disrupted by the experience of trauma or breakdown.

The Tidal Model involves three distinct, but related, dimensions of caring:

In the world dimension, the nurse focuses on the person's need to be understood. This includes a need to have the personal experience of distress, illness or trauma, validated by others. A radically different form of nursing assessment - the Holistic Nursing Assessment - has been developed which documents what is significant and meaningful to the person now, at this point in their life journey. This assessment, which charts the person's journey to the 'here and now', identifies what needs to happen next, to help them, and is written in the person's own words. This enabled autobiography is one attempt to reduce ...