Abstract
BackgroundThe nurse’s primary task in psychiatric care should be to plan for the patient’s care in cooperation with the patient and spend the time needed to build a relationship. Psychiatric care nurses however claim that they lack the necessary time to communicate with patients. To investigate the validity of such claims, this time-motion study aimed at identifying how nurses working at inpatient psychiatric wards distribute their time between a variety of tasks during a working day.MethodsDuring the period of December 2015 and February 2016, a total of 129 h and 23 min of structured observations of 12 nurses were carried out at six inpatient wards at one psychiatric clinic in southern Sweden. Time, frequency of tasks and number of interruptions were recorded and analysed using descriptive statistics.ResultsAdministering drugs or medications accounted for the largest part of the measured time (17.5%) followed by indirect care (16%). Relatively little time was spent on direct care, the third largest category in the study (15.3%), while an unexpectedly high proportion of time (11.3%) was spent on ward related tasks. Nurses were also interrupted in 75% of all medication administering tasks.ConclusionsNurses working in inpatient psychiatric care spend little time in direct contact with the patients and medication administration is interrupted very often. As a result, it is difficult to establish therapeutic relationships with patients. This is an area of concern for both patient safety and nurses’ job satisfaction.
Highlights
The nurse’s primary task in psychiatric care should be to plan for the patient’s care in cooperation with the patient and spend the time needed to build a relationship
Patients express that continuity of nursing staff as well as interactions leading to trust and a sense of being taken seriously are important for creating a therapeutic relationship [5, 8]
Given the documented value of therapeutic relationships between patients and nurses and the necessity of sufficient time to establish such relationships, the aim of this study was to identify how nurses working at inpatient psychiatric wards in Sweden distribute their time across tasks during a working day
Summary
The nurse’s primary task in psychiatric care should be to plan for the patient’s care in cooperation with the patient and spend the time needed to build a relationship. Psychiatric care nurses claim that they lack the necessary time to communicate with patients. Time is an important factor when nurses and patients are building a trusting relationship [2]. This type of therapeutic relationship is important for the patient’s recovery [4]. The benefits of this kind of relationship between patients and nurses are that they combat self-stigmatization and demoralization [2], predict better short- and long-term patient outcomes [4] and make the patient feel valued [5].
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