The physician's perspective on clinical assessment skills by nurses in psychiatry: A case study

Abstract

The physician's perspective on clinical assessment skills by nurses in psychiatry: A case study Abstract: Background: People with a mental and physical illness receive less good somatic care compared to the general population. Patients in psychiatry receive better medical care when nurses have in-depth medical expertise. Therefore, in a psychiatric institution in Switzerland in 2017, the Clinical Assessment and Decision Making (CADM) by nurses was implemented. Aim: The aim of the study was to investigate how physicians and senior psychologists experience the implementation of CADM by nurses in order to derive recommendations on how to optimize the collaboration and promote a sustainable establishment. Methods: An embedded single case study was used, and the data analysis was based on grounded theory strategies by Charmaz. Semi-structured expert interviews (n = 11) and open unstructured observations were conducted in a psychiatric institution in Switzerland. Results: The results showed nine relevant aspects regarding collaboration and CADM by nurses: "Strengths", "Weaknesses", "Risks", "Opportunities", "Expectations", "Challenges", "Benefits", "Competencies of CADM nurses" and "Wishes for the future". Conclusions: The physicians and senior psychologists considered the CADM by nurses as an added value for the interprofessional team and for the patients. Lack of clarity regarding the scope of responsibilities, role definitions and possible applications made the implementation of CADM difficult.