‘Something always comes up’: nurse–patient interaction in an acute psychiatric setting

Abstract

In this study, 10 nurses and 10 patients were interviewed to explore factors influencing nurse-patient interactions in an acute psychiatric inpatient facility. The six themes that emerged from the nursing interviews were; environment, something always comes up, nurses' attributes, patient factors, instrumental support and focus of nursing. The four themes from the patient interviews were; nurses' attributes, role perceptions, clinical care, and time. These findings have implications for clinical practice, the nurses' role and nursing education.

An Exploratory Analysis of the Relationship Between Psychiatric Nurses' Perceptions of Workload and Unit Activity

“…Psychiatric nurses have reported performing unnecessary routines including completing paperwork for personnel and billing and making duplicative documentation (Higgins, Hurst, & Wistow, 1999). Further, the lack of resources such as secretarial support increased nurses' administrative workloads, resulting in a decreased amount of time available for nurse-client interactions (Cleary, 2004;Cleary & Edwards, 1999;Fourie, McDonald, Connor, & Barlett, 2005;Higgins et al, 1999). In summary, psychiatric nurses must engage in various activities while maintaining patient safety and a therapeutic milieu.…”

The Conceptualization of Physical Restraint as a Nursing-Sensitive Adverse Outcome in Acute Care Psychiatric Treatment Settings

“…The extant literature related to inpatient psychiatric nurses was conducted in Australia and New Zealand (Berg & Hallberg, 2000;Cleary, 2004;Cleary & Edwards, 1999;Delaney, Clearly, Jordan, & Horsfall, 2001;Farrell & Dares, 1999;Fourie, McDonald, Connor, & Barlett, 2005;Happell, Martin, & Pinikahana, 2003;O'Brien & Cole, 2004;Taylor & Barling, 2004), Canada (Robinson, Clements, & Land, 2003), England (Callaghan, 1991;Fagin, Brown, Bartlett, Leary, & Carson, 1995;Fagin et al, 1996;Hall, 2004;Higgins, Hurst, & Wistow, 1999;Mistral, Hall, & McKee, 2002;Sammut, 1997;Sullivan, 1993;Whittington, 2002;Whittington & Wykes, 1992), Norway (Severinsson & Hummelvoll, 2001), Sweden (Severinsson & Hallberg, 1998), Japan (Ito, Eisen, Sederer, Yamada, & Tachimori, 2001), and a combination of two or more of the above countries (Melchior, Bours, Schmitz, & Wittich, 1997;Thomsen, Arnetz, Nolan, Soares, & Dallender, 1999).…”

“…Other nurses reported that they did not feel safe in their work environment (Poster & Ryan, 1994;Sammut, 1997). Furthermore, the lack of other types of resources such as secretarial support increased nurses' administrative workload resulting in a decreased amount of time available for nurse-client interactions (Cleary, 2004;Cleary & Edwards, 1999;Fourie et al, 2005;Higgins et al, 1999). In sum, staffing is a critical factor that can potentially influence the outcome of a physical restraint episode.…”

Talking about mental health nursing: a qualitative analysis of nurses’ and service users’ accounts

“…For example, Emlyn talked about the size of his CMHN's caseload and Sian showed her awareness that her CMHN had many other patients to see. Service user accounts included several references to mental health nurses who were 'too busy', which is echoed in other studies about mental health nursing (Cleary & Edwards, 1999;Stenhouse, 2011), reinforcing the notion that nurses' one to one time spent with patients was limited.…”

“…For example, the chaos and crisis of acute admission environments is highlighted by researchers (Deacon, 2003;Deacon et al, 2006), as nurses are reported as having to continually prioritise and reprioritise their work due to persistent demands. There is perhaps an expectation from staff that 'Something always comes up', which is how Cleary and Edwards (1999) titled their paper about the continual interruptions to nurses' planned activities in acute settings. Although at the time of interview Laura was employed in a nursing home, she had been placed on at least five wards during her student experience, and had background knowledge of inpatient environments.…”