Empathic processes during nurse–consumer conflict situations in psychiatric inpatient units: A qualitative study

Abstract

Empathy is a central component of nurse-consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in recovery (n = 7) reflected on a specific conflict situation where they had experienced empathy, as well as how empathy contributed more generally to working with nurses/consumers. Thematic analysis was used to analyse the data, utilizing a framework that conceptualizes empathy experiences as involving antecedents, processes, and outcomes. The central theme identified was 'my role as a nurse -the role of my nurse'. Within this theme, nurses focussed on how their role in managing risk and safety determined empathy experienced towards consumers; consumers saw the importance of nurse empathy both in conflict situations and for their general hospitalization experience. Empathy involved nurses trying to understand the consumer's perspective and feeling for the consumer, and was perceived by consumers to involve nurses 'being there'. Empathic relationships built on trust and rapport could withstand a conflict situation, with empathy a core component in consumer satisfaction regarding conflict resolution and care. Empathy allows the maintenance of therapeutic relationships during conflict, and influences the satisfaction of nurses and consumers, even in problematic situations. Nurse education and mentoring should focus on nurse self-reflection and building empathy skills in managing conflict.

Is restraint a ‘necessary evil’ in mental health care? Mental health inpatients’ and staff members’ experience of physical restraint

“…This is consistent with previous findings that restraint 'spoils the job' (Bigwood & Crowe 2008), and that mental health nurses experience tension in balancing their therapeutic role and the provision of empathic care with the potentially incompatible duty of managing risk to ensure safety (e.g. Bigwood & Crowe 2008;Gerace et al 2016). As with previous research (e.g.…”

“…However, there is tension in mental health care between this desire to reduce restraint and the need to provide and maintain a safe environment, which is recognized as central to the therapeutic milieu of mental health inpatient wards (e.g. Gerace et al 2016;Hopkins et al 2009;Muir-Cochrane et al 2013). Other barriers to the reduction of restraint also exist; for example, staff attitudes, patient acuity, and ward factors (e.g.…”

Barriers to recovery‐focused care within therapeutic relationships in nursing: Attitudes and perceptions

“…Nurses, such as the one quoted at the start of this paper, report that these tasks place demands on their time, consequently impacting relationship building (Harris & Panozzo, ; Perraud et al, ). It has also been identified that nurses may create a bubble around themselves to protect themselves from the stress of balancing the emotional needs of patients and other demands of practice, such as documentation and paperwork, resulting in lack of attention to the patient (Gerace et al, ).…”

Caring for the suicidal person: A Delphi study of what characterizes a recovery‐oriented caring approach

“…), and nurses trying to understand the other person's perspective (Gerace et al . ). This indicates that mental health nurses should consider what can enable nurse self‐reflection and time spent together as a foundation for recovery during inpatient care.…”