Patient initiatives during the assessment and planning of psychiatric nursing in a hospital environment (original) (raw)
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Journal of Psychiatric and Mental Health Nursing, 2000
To reveal the meaning of being a nurse working with inpatient care on a team psychiatric ward in Sweden, 22 psychiatric nurses were interviewed and the transcribed texts were analysed by means of latent content analysis. Three themes emerged from the analysis: developing a working relationship with the patient in everyday caregiving; encountering and handling the unforseeable in daily living; and struggling with professional independence and dependency. Developing a working relationship with the patient in everyday caregiving meant that the nurse-patient relationship was the foundation of the caregiving and included being with, as well as doing for, and with, the patient. Four different approaches in daily caregiving were revealed: networking, teaching, containing and protecting. The nurses' approaches in the nurse-patient relationship alternated between being an 'expert' and a 'collaborator'. Encountering and handling unforeseeable situations meant that the nurses were exposed to and had to be prepared for unpredictable situations where they were on their own, handling sometimes strong emotional reactions and relying on their own ability to act. Struggling with professional independence and dependency meant that the nurses seemed to lack professional confidence, although they had many responsibilities, but also less authority to decide about overall care planning. Contextual aspects such as organizational hindrance, unsatisfactory work-environment and co-operation difficulties were illuminated. The result indicates the need for a stable and predictable organizational structure if nurses are to manage the demanding nurse-patient relationships that everyday caregiving requires. A question highlighted by this study is whether multidisciplinary team organization has been effectively developed in Sweden, as uncertainty about the roles and responsibilities of nurses was apparent.
https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.4\_April2021/IJHSR-Abstract.027.html, 2021
Background: Nurses were facing various challenges while providing care to patients with mental illness. The study aims to explore those challenges so that practice guidelines can be developed. Methodology: Approach-Qualitative, Research Design-Phenomenological study, Sample-Nursing personnel, Sample size-10, Sampling technique-Purposive sampling technique, Setting-Indoor of Tertiary Care Hospital, Inclusion Criteria-Both male and female, Nurses working in Indoor and with work experience of at least one year. Results: Results shows that 10% of the subjects are male, 90% were female, 70% were Hindu, 30% were Christian, 10% were GNM, 20% were BSc. Nurse, 60% were DPN, 10% were Post Basic BSc. nurses, 70% were married, 30% unmarried, 40% of the subjects had 1-3 years of work experience, 60% had more than 10 years of work experience and no one had exposed to any training programs associated with it. Thematic analysis shows that major challenges were more work load, less number of staff, lack of personal safety and security, restricted hospital facility, psychopathology of acutely ill patients, negative attitude of family members and limited continuing up gradation of knowledge. Conclusion: The study results show that, nurses faced various challenges while delivering care to patients with mental illness.
Metasynthesis of Research on the Role of Psychiatric Inpatient Nurses: What Is Important to Staff?
Journal of the American Psychiatric Nurses Association, 2014
BACKGROUND: Inpatient psychiatric nurses are a large workforce, but their work is poorly articulated and thus poorly understood outside of the professional inpatient community. OBJECTIVE: To learn how inpatient psychiatric nurses depict their work, define important aspects of their role, and view the impact of the unit environment on their clinical practice. DESIGN: Metasynthesis of research that has focused on the ideas and perceptions of inpatient psychiatric nurses around their role and practice on inpatient psychiatric units. RESULTS: Three themes emerged from the analysis; the first was an umbrella for three important aspects of nursing work: the nurses' efforts to forge engagement with patients; their activities which maintained the safety of the unit and interventions nurses viewed as educating/empowering patients. The second theme captures the conditions that enabled nurses to do this work such as a cohesive nursing team and their sense of self-direction in their role. The final theme centers on difficulties nurses encountered in enacting their role which included multiple responsibilities for patient care and management of the milieu; intense work often with low visibility and scant support within the organization. CONCLUSIONS: Nurses need to articulate their practice so they can assert for the staffing and resources needed to keep units safe and promote patients' well-being, strive toward quality, and promote the development of the specialty.
Journal of Psychiatric and Mental Health Nursing, 2010
Accessible summary• Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes.• The transfer to community mental health services requires a re-conceptualization of nurses' roles.• Education can be a basic mechanism for eradicating the institutionalized ways of work.• Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes.• The transfer to community mental health services requires a re-conceptualization of nurses' roles.• Education can be a basic mechanism for eradicating the institutionalized ways of work.Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes.The transfer to community mental health services requires a re-conceptualization of nurses' roles.Education can be a basic mechanism for eradicating the institutionalized ways of work.AbstractFor centuries psychiatric services were provided by mental health hospitals, which were operating upon bureaucratic principles: strict hierarchies, slow processes and segmentation of duties. Research has shown that psychiatric nursing, as exercised in these traditional settings, has dealt with several problems in relation to: the amount and quality of time spent with patients, the type of duties performed, the lack of autonomy etc. The closure of many psychiatric institutions and their substitution with community-based settings, signified that health professionals should perform a variety of new duties, exhibit new skills and develop new perceptions about their work and the patients. In order for such alterations to occur, education can play a vital role in the re-conceptualization of psychiatric nursing and in the practical preparation of students for their future work. The present paper focuses on the contradiction between nursing as practised in Greek mental health hospitals and the current trends and demands placed upon nurses, to exhibit a new ‘face’. The purposes of this paper are: first, to review the research on psychiatric nurses' behaviours in mental health hospitals. Second, to present the outcomes of bureaucracy on employees and finally, to propose an educational scheme that could reinforce the shift from institutionalized work to de-institutionalized.For centuries psychiatric services were provided by mental health hospitals, which were operating upon bureaucratic principles: strict hierarchies, slow processes and segmentation of duties. Research has shown that psychiatric nursing, as exercised in these traditional settings, has dealt with several problems in relation to: the amount and quality of time spent with patients, the type of duties performed, the lack of autonomy etc. The closure of many psychiatric institutions and their substitution with community-based settings, signified that health professionals should perform a variety of new duties, exhibit new skills and develop new perceptions about their work and the patients. In order for such alterations to occur, education can play a vital role in the re-conceptualization of psychiatric nursing and in the practical preparation of students for their future work. The present paper focuses on the contradiction between nursing as practised in Greek mental health hospitals and the current trends and demands placed upon nurses, to exhibit a new ‘face’. The purposes of this paper are: first, to review the research on psychiatric nurses' behaviours in mental health hospitals. Second, to present the outcomes of bureaucracy on employees and finally, to propose an educational scheme that could reinforce the shift from institutionalized work to de-institutionalized.
Open Journal of Nursing, 2013
High levels of distress and disturbance amongst those experiencing acute mental illness can be a major problem for mental health nurses. The feelings experienced by these nurses when caring for and supporting disturbed and/or distressed patients along with their concurrent thoughts are not well described in the literature. To date, this complex issue has not been explored within a comparative European context. The objective of this qualitative study was to explore the feelings and thoughts of mental health nurses when supporting and caring for distressed and/or disturbed patients in 6 European countries. Methods: Focus groups were used to collect data from 130 mental health nurses working in acute inpatient psychiatric settings. Results: Data were analysed using content analysis. Findings highlighted 6 broad themes: 1) Mixed emotions: expressive and responsive, 2) Procedure for caring for and supporting disturbed and/or distressed patients, 3) Use of guidelines for caring and supporting disturbed and/or distressed patients, 4) Team and organisational support, 5) Ethical concerns: Cognitive dissonance and 6) Education and training. Commonalities and differences were found across all themes. Approaches to care, nurses' role and education, clinical guidelines and/or standards vary from country to country, therefore the care, treatment and management of distressed and/or disturbed patients are various. As a result, mental health nurses have different experiences, various emotional quandaries concurrent with cognitive dissonance and different coping strategies when caring for and supporting distressed and disturbed patients. Conclusions: More emphasis needs to be given to the emotional quandaries and concurrent cognitive dissonance experienced by mental health nurses caring for distressed and/or disturbed inpatients in acute psychiatric settings. Increased access to education and training with particular attention to interpersonal communication and relationship building within clinical teams needs to be a priority given the experiences described by mental health nurses.
Perceptions on psychiatric nursing care at a general hospital inpatient unit
Acta Scientiarum. Health Sciences, 2016
The objective was to investigate the perception of nurses, nursing assistants and patients about nursing care at a general hospital psychiatric unit. Exploratory study with 16/20 nursing professionals and 27/84 patients from the psychiatric inpatient unit of a general hospital. Interviews were based on guiding questions about the nursing care in said unit. Thematic content analysis was adopted. The subjects acknowledge that nursing promotes the recovery of patients, that it is essential during hospitalization, and defend that working in psychiatry requires a taste and profile for it. The patients value warmth, attention, serenity, good mood, patience, concern, presence, promptness, respect and responsibility. The professionals value affection, dedication, effort, patience, security and serenity. Professionals and patients wonder if changes in nursing care during hospitalization stimulate independence/autonomy for discharge or reflect carelessness. In conclusion, nursing care is esse...
Journal of Psychiatric and Mental Health Nursing, 2004
This case study explores what informs and organizes the assessment of patients, as undertaken by a nurse, a social worker and a psychiatrist in public, metropolitan, acute mental health service settings. The research data are the transcripts of in-depth interviews with three experienced practitioners, one from each of the three disciplines. The analysis draws on Foucauldian concepts: discourse as constructed through practices of discipline and the gaze. We explored examples of taken-for-granted assessment practices and their interplay with discourse. The findings suggest that participating practitioners use language in assessment in ways that support the powerful discourses of the professional disciplines. The competing discourse of management, associated with industry and economics, is evident in hospital admission processes, dictating the times and places of assessment. Professional and management discourses both effectively marginalize the perspective of another player in assessment, the patient.
Thematic analysis of psychiatric patients' perceptions of nursing staff
International Journal of Mental Health Nursing, 2014
Therapeutic and informal interactions with nurses are integral to the quality of care that psychiatric patients receive. How well these interactions are performed, and their impact on the experience and outcomes of inpatient care, have not been subject to systematic evaluation. The aim of the present study was to examine patients' perceptions of the personal and professional qualities of nursing staff and how these contribute to the ward environment. Patients (n = 119) from 16 acute psychiatric wards were interviewed using a schedule developed by a service-user researcher. Transcriptions of interviews were coded and organized into six themes: staff duties, staff disposition, control, communication and engagement, therapeutic ward environment, and consistency. Patients recognized that nurses have a difficult and stressful job, but frequently expressed feelings of anger, frustration, and hopelessness about their experience of the wards. Patients frequently felt that nursing staff did not understand issues from their perspective or attempt to empathize with them. The findings indicate poorly-communicated and inconsistent care. Initiatives to improve patients' experiences of acute psychiatric wards are urgently needed.