The experiences of professional nurses working in a psychiatric hospital

[摘要] English: The need for care of people with mental health problems in psychiatric hospitals has increased globally. Professional nurses are the major providers of psychiatric hospital care and have become an important resource in the delivery of mental health care. However, the attitudes and ability of many nurses in providing this care has been shown to be poor, which has a negative impact on the quality of psychiatric care. As in the rest of the nursing profession, psychiatric nursing is undergoing significant difficulty in recruiting and retaining specialised and experienced professional nurses, due to many obstacles created by current conditions in psychiatric hospitals.The researcher opted to conduct research in a psychiatric hospital where the demand for care and education is high, while support from mental health nurses is low. The aim was to explore the professional nurses work experiences and the issues that they believe affect their care for people with mental health problems. It is essential to improve clinical nursing practice in preparation for the future and to foster collaboration/ competition in providing quality psychiatric care within the health care system.In an attempt to address this problem and to propose guidelines that assist professional nurses in managing mental health service delivery more effectively, the researcher identified the need to empower professional nurses with ways to learn how to cope with their challenging experiences. Based on the results of this research study, guidelines to improve nurse's work experience and thereby improve the quality of care to psychiatric patients are proposed.A qualitative (phenomenological, descriptive, explorative and contextual) study design was employed to conduct the studying in a central South African public psychiatric hospital. Purposive sampling was applied to select professional nurse participants. Focus group interviews were used as the method for data collection. Data saturation was reached after four rounds of group interviews. All interviews were audio taped and transcribed verbatim. The researcher, facilitator, facilitator assistant and an independent co-coder reached consensus regarding the identified themes from the data analysis, during a meeting organised for this purpose. The interviews were analysed by using Tesch's method of data analysis for qualitative research. Field notes were also kept. A literature control followed the description of the results.The findings suggest that the majority of the participants experience predominantly negative attitudes regarding working in a psychiatric hospital. The most prominent themes included that participants felt incompetent in managing aggressive or restless patients due to being short staffed, as well as working in an unmaintained, unsafe physical locality, with an unsupportive managerial environment.As a result, professional nurses working in a psychiatric hospital are emotionally, psychologically and physically affected. They respond with subsequent emotions and behaviour that include fear, anger, frustration, despair, hopelessness and helplessness, absenteeism, and the development of an 'I don't care 'attitude.Several recommendations have emerged from this study, with emphasis on sending the message to nursing management about the risks professional nurses face whenever they are performing their mental health care daily duties. Management support with regard to issues like availability of resources, enough staff and equipment should be the main priority to enhance trusting relationships. This might help in retaining and recruiting more registered nurses to work in psychiatric hospitals.

[发布机构] University of the Free State