Challenges Encountered by Nurses Working in Acute Psychiatric Wards: A Qualitative Study in Iran

Zarea, Kourosh; Fereidooni-Moghadam, Malek; Baraz, Shahram; Tahery, Noorollah

doi:10.1080/01612840.2017.1377327

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…While nursing is widely understood as a stressful occupation (Chang et al 2005;Sarafis et al 2016), acute and chronic stress may be particularly salient for MHN, given the range, distinctiveness and severity of stressors reported in qualitative (Fahy & Moran, 2018;Foster et al 2018;Zarea et al 2018) and quantitative studies of MHN (Foster et al 2020;Tsaras et al 2018) that are emerging globally. Prominent stressors related to MHN work include physical and verbal aggression and violence from consumers and staff (Al-Omari et al 2019;Kelly et al 2016;Niu et al 2019), intense workloads (Henderson et al 2008), high emotional labour (Delgado et al 2020), and moral distress from being involved in practices (e.g.…”

Section: Introductionmentioning

confidence: 99%

Mental health matters: A cross‐sectional study of mental health nurses’ health‐related quality of life and work‐related stressors

Foster

Roche

Giandinoto

et al. 2020

Int J Mental Health Nurs

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Mental health nursing is widely recognized as a stressful occupation; however, little is known about the relationship between work‐related stress and health‐related quality of life of mental health nurses (MHN). This study aimed to identify MHN health‐related quality of life (HR‐QoL) and work‐related stressors; associations between stressors and HR‐QoL; and predictors of HR‐QoL. An online cross‐sectional survey collected demographic data, work‐related stressors and HR‐QoL (SF‐12v2) of n = 498 Australian MHN. Prominent consumer/carer‐related stressors were verbal (90%) and physical aggression (85%). Collegial stressors included staff conflict (71%) and bullying (55%), and colleague‐perpetrated verbal (34%) and physical aggression (7%). Key organizational stressors included high workloads (74%), lack of organizational support (60%) and lack of adequate resources to perform nursing role (58%). The mean physical health score was 52.62 (SD = 8.30), and mental health score was 43.59 (SD = 11.34), with mental health substantially lower than national norms (mean difference = 10.11). There were statistically significant negative correlations between the number of work‐related stressors and HR‐QoL. Younger (21–30 years) and less experienced (<1–4 years) MHN had substantially lower mental health. Higher mental health was predicted with < 15 stressors, >4 years’ experience and working in the community. The poorer mental health of MHN has concerning implications for the well‐being, retention and practice of the largest group in the mental health workforce. There is a critical need for organizations to enact effective policy and initiatives to reduce workplace aggression, improve staff psychological and physical safety, and strengthen well‐being and resilience. New graduates are a priority group for urgent intervention.

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Section: Introductionmentioning

confidence: 99%

Mental health matters: A cross‐sectional study of mental health nurses’ health‐related quality of life and work‐related stressors

Foster

Roche

Giandinoto

et al. 2020

Int J Mental Health Nurs

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“…From an interpersonal perspective, stressors include the emotional labour of managing challenging situations such as suicidality, and building effective relationships with mental health consumers and families (Delgado, Upton, Ranse, Furness, & Foster, ; Edward, Hercelinskyj, & Giandinoto, ). Other interpersonal stressors include being confronted with consumer‐related violence and aggression (Itzhaki et al., ; Zarea, Fereidooni‐Moghadam, Baraz, & Tahery, ), colleague‐related conflict (Ennis, Happell, Broadbent, & Reid‐Searl, ) and/or bullying (Cleary, Hunt, & Horsfall, ). In respect to their practice, mental health nurses (MHN hereafter) report that lack of role clarity (i.e., what is expected from them) (Hanna & Mona, ), insufficient numbers of staff with high‐quality practice skills and values (Jones & Gregory, ), and changing consumer risk profiles and associated containment and observational practices (Barnicot et al., ) can be challenging and stressful.…”

Section: Introductionmentioning

confidence: 99%

Strengthening mental health nurses' resilience through a workplace resilience programme: A qualitative inquiry

Foster

Cuzzillo

Furness

2018

Psychiatric Ment Health Nurs

119

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WHAT IS KNOWN ON THE SUBJECT?: Mental health nurses are affected by interpersonal, practice-related and organizational factors that can increase workplace stress and reduce their physical and mental health and well-being. Resilience programmes are a strength-based preventative approach to supporting individuals to overcome workplace adversities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This qualitative inquiry is the first study to report mental health nurses' perspectives and experiences on a workplace resilience programme. Strengthening mental health nurses' resilience through a resilience programme involved a process of understanding resilience, and applying resilience strategies such as positive self-talk, managing negative self-talk, detaching from stressful situations, being aware of and managing emotions, and showing more empathy, to address workplace challenges. To address the range of resources needed to support mental health nurses' resilience, a social-ecological approach to workplace resilience can be used to promote resource provision at individual, work unit, organizational and professional levels. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Resilience programmes are one resource for addressing the impacts of workplace stressors on mental health nurses. Organizational barriers and risks to staff well-being need to also be addressed to build a resilient workforce. Incorporating resilience strategies into clinical supervision or reflective practice models may help sustain beneficial outcomes following a resilience programme and support resilient practice. ABSTRACT: Introduction Mental health settings are potentially high-stress workplaces that can lead to nurses' poorer health and well-being. Resilience programmes are a strengths-based preventative approach for promoting mental health and well-being in the face of adversity; however, there is no prior research on mental health nurses' perspectives on resilience programmes. Aim To explore the perspectives of mental health nurses participating in a mental health service-initiated resilience programme (Promoting Adult Resilience). Method An exploratory qualitative inquiry was undertaken. Multiple qualitative data: open-ended responses and semi-structured interviews and focus groups, were thematically analysed. Results Twenty-nine registered nurses from a metropolitan mental health service participated. Four main themes were as follows: being confronted by adversity; reinforcing understandings of resilience; strengthening resilience; and applying resilience skills at work. Discussion This is the first study to report mental health nurses' perspectives on a resilience programme. Resilience programmes can help improve nurses' self-efficacy and ability to realistically appraise stressful situations and to moderate their emotional responses to others. Implications for practice It is recommended resilience programmes are provided to promote nurses' well-being and resilient practices. To build a resilient workforce, the wider barriers and risks to staff well-be...

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“…The challenges reported by healthcare professionals in acute psychiatric care from different studies are alike. They focus on increased use rates and increased workloads combined with staff shortage and limited resources, increased work stress, and unsupportive organizational cultures, loss of professional identity and unethical behaviors [19,23,45]. Thus, the clinical implications of this study for mental health nursing are particularly highlighted.…”

Section: Discussionmentioning

confidence: 99%

Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

Schmidt

Stjernswärd

Garmy

et al. 2020

IJERPH

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Encounters and interactions between healthcare professionals and patients are central in healthcare services and delivery. Encountering persons who frequently use psychiatric emergency services (PES), a complex patient group in a complex context, may be particularly challenging for healthcare professionals. The aim of the study was to explore healthcare professionals’ experiences of such encounters. Data were collected via individual interviews (N = 19) and a focus group interview with healthcare professionals consisting of psychiatric nurses, assistant nurses, and physicians. The data were analyzed with qualitative content analysis. This study focused on the latent content of the interview data to gain a rich understanding of the professionals’ experiences of the encounters. Two themes were identified: “Nurturing the encounter with oneself and colleagues for continuous, professional improvement” and “Striving for a meaningful connection with the patient”. The professionals experienced their encounters with persons who frequently use PES as caring, professional, and humane processes. Prerequisites to those encounters were knowing and understanding oneself, having self-acceptance and self-compassion, and working within person-centered cultures and care environments.

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Challenges Encountered by Nurses Working in Acute Psychiatric Wards: A Qualitative Study in Iran

Cited by 7 publications

References 31 publications

Mental health matters: A cross‐sectional study of mental health nurses’ health‐related quality of life and work‐related stressors

Mental health matters: A cross‐sectional study of mental health nurses’ health‐related quality of life and work‐related stressors

Strengthening mental health nurses' resilience through a workplace resilience programme: A qualitative inquiry

Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

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