Ways of understanding nursing in psychiatric inpatient care – A phenomenographic study

Abstract

Aim The aim was to describe the ways that nursing staff in psychiatric inpatient care understand nursing. Background Nursing in psychiatric care is marginalized with ambiguous role definitions and imperceptible activities. Nurse managers' capabilities to establish a direction and shared vision are crucial to motivate nursing staff to take part in practice development. However, before establishing a shared vision it is important to identify the different ways nursing can be understood. Methods Sixteen individual semi‐structured interviews with nursing staff members were analysed using a phenomenographic approach. Results Five ways of understanding nursing were identified. These understandings were interrelated based on the way that the patient, nursing interventions and the goal of nursing were understood. Conclusion The diversity of identified understandings illuminates the challenges of creating a shared vision of roles, values and goals for nursing. Implications for Nursing Management Awareness of staff members' different understandings of nursing can help nurse managers to establish a shared vision. To be useful, a shared vision has to be implemented together with clear role definitions, professional autonomy of nurses and support for professional development. Implementation of such measures serves as a foundation to make nursing visible and thereby enhance the quality of patient care.

Zombies Wanted! Descriptions of Nurses in Psychiatric-Mental Health Care in Swedish Recruitment Advertisements

“…Aiken et al, 2014;Djukic et al, 2019), we must assume that employers are either unaware of-or choose to disregardthese findings. We believe that this devaluation of nursing education is representative of the lack of role clarity (Bladon, 2018;Lakeman & Molloy, 2018;Salberg et al, 2019;Terry, 2020) that plagues psychiatric-mental health nursing.…”

“…This conflict was essentially resolved in the 1950s through governmental licencing of the nursing profession and allocation of leading positions in psychiatric-mental health care to educated nurses (Svedberg, 2002, p. 121). However, the conflict might still be visible in the unclear division of responsibility between registered nurses and nursing assistants in Swedish psychiatric-mental health care (Gabrielsson et al, 2014;Salberg et al, 2019).…”

“…Nursing in psychiatric-mental health care has been described as a fading specialty (Lakeman & Molloy, 2018), with a lack of clarity in responsibilities and structure (e.g. Bladon, 2018;Lakeman & Molloy, 2018;Salberg et al, 2019;Terry, 2020). Nurses experience a conflict between the ideals and the realities of psychiatric-mental health nursing (Gabrielsson et al, 2016;Graneheim et al, 2014).…”

Time Together as an arena for mental health nursing – staff experiences of introducing and participating in a nursing intervention in psychiatric inpatient care

“…(2019) described nursing staff’s understanding of the real‐world phenomenon ‘nursing’ in the context of PIC and showed different perceptions of nursing described as either ‘ nursing is to respond to symptoms and behaviours’ and ‘ nursing is to support vulnerable human beings’ (Salberg et al . 2019, p. 1829–1830). Maybe the different assumptions regarding care and nursing represent parts of MHNs responsibility in psychiatric inpatient care.…”

Nurses need to step up to improve child and adolescent mental health globally

“…In many cases, nurses are prepared for practice with a three-year generic nursing degree, which offers only a basic understanding of mental health issues (Happell & McAllister, 2015;Logan, 2018). Across the world, there is variation in adequate benchmarks for effective education requirements for child and adolescent mental health, and nurses often do not have the skills, capabilities and depth of knowledge to navigate the counselling or psychosocial skills required to communicate engagingly and effectively with these young people (Salberg, Bäckström, Röing, & Öster, 2019).…”