Closeness, chaos and crisis: the attractions of working in acute mental health care

Abstract

This paper makes a case for the attractiveness of acute mental health inpatient nursing (acute nursing) and argues that an altered perception of this work is essential if we are to provide the most acutely mentally ill and vulnerable people with a stable and expert nursing workforce. The discussion draws on an ethnographic study conducted in an inner-city psychiatric unit in England and the advantages of this method for understanding nursing work are described. Within our findings, we set out two overarching themes: the contextual realities of the contemporary acute ward and features of attraction that encourage nurses to work in the acute care setting. The former includes nurses' responsibility for the total ward environment and the latter the 'comfort of closeness' and 'surviving and thriving in chaos and crisis'. In conclusion, we argue that despite the unpopularity of the acute inpatient mental health environment, the highly sophisticated skills employed by acute nurses actually ensure the promotion of health for the majority of service users.

Metasynthesis of Research on the Role of Psychiatric Inpatient Nurses

“…Here another aspect of the engagement process surfaces: within the relationship nurses seek to bring someone from the ravages of severe illness to positive health (Deacon et al, 2006). It is this work that makes the role fulfilling and brings significant satisfaction to nurses (Deacon et al, 2006).…”

Psychiatric Mental Health Nursing: A Dialogue on the Nature of Our Practice

“…As she noted, in working with patients, PMH nurses can make the extraordinary look very ordinary. Researchers have noted a similar phenomena when observing inpatient nurses; the caring, containing relationship often remains hidden in the chaos of the unit and the "mundane nature of everyday activities" (Deacon, Warne, & McAndrew, 2006). Deacon et al also found that nurses often had difficulty in articulating the nature of their interpersonal work.…”

Peplau and the brain: Why Interpersonal Neuroscience provides a useful language for the relationship process

“…Given the availability of such literature how could the nursing relationship remain ambiguous and unformulated [21] ? We suggest what remains elusive and ambiguous is not what nurses do but lack of a language to depict how they are thinking, sensing and responding to patients as they attempt to forge engagement.…”