Concern regarding the low numbers of graduate nurses expressing interest in entering the psychiatric field leads to the question: who would be a psychiatric nurse? In this interpretative, phenomenological study, the lived experiences of seven veteran psychiatric nurses were examined in order to gain understanding of the reasons why they had remained in the field of psychiatric nursing. Each of these participants had more than 10 years' clinical practice in psychiatric nursing and shared a wide range of thoughts, memories, and experiences. The major emergent theme, 'being different', revealed what it is like for the participants being psychiatric nurses. These participants felt and saw themselves as different in many ways from other nurses and from society in general. Related to and an aspect of that difference was the high level of satisfaction they achieved from their role and the striving to achieve harmony.
The pharmacological management of violence and aggression is a common and substantial clinical dilemma in the emergency psychiatric situation. A literature search was conducted through PubMed and using the Cochrane Library. This was followed by a manual search of selected literature. Randomised controlled trials were sought that specifically addressed the acute situation, rather than the ongoing management of chronic conditions. There was a paucity of well-controlled data and insufficient evidence to support the use of many agents in emergency situations. Many studies had considerable limitations making comparison difficult. Efficacy data for a range of treatment options exists, including the use of classical and atypical anti-psychotic agents, benzodiazepines and combination therapies. Clinical risk, tolerability and environmental factors need to form part of a careful and considered judgement in the choice of treatment. Safety, tolerability and the potential for a positive experience are major considerations, thus paving the way for long term compliance.
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