Acute Psychiatric Nursing Research Articles

Exploring a social work lead mindfulness-based intervention to address burnout among inpatient psychiatric nurses: a pilot study

ABSTRACT Acute psychiatric nurses experience workplace stressors related to organizational factors including staffing shortages, along with interpersonal conflict with patients and colleagues. The pilot study examined the experience of burnout among acute care psychiatric nurses and the usefulness of a social work lead mindfulness-based intervention for reducing burnout elements. Findings indicated participants experienced emotional exhaustion associated with their work, but also a significant degree of personal accomplishment. Nurses identified the intervention as having the potential to promote better emotional regulation in the workplace and beyond. Social worker education on mindfulness techniques may represent an untapped resource for improving the emotional wellness and effective patient care.

Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands.

In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke's six analytic phases were used. Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally 'flat', cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients' suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves.

Don't Just Survive, Thrive: Understanding How Acute Psychiatric Nurses Develop Resilience

With one in five Canadians estimated to experience mental illness, retention of registered nurses in the acute psychiatric hospital setting becomes a pressing issue. The key for these nurses to survive and potentially even thrive in practice has been identified as resilience. From interviews with four registered nurses, maintaining a “vast” perspective, becoming an “expert” of self, clarifying “belief systems”, and being “present” through “staying awake” were identified as key in developing resilience. Although participants expressed that the development of resilience is an individual process, the concept of development was similar. Developing personal resilience may be a matter of self-development.

Psychiatric Patients Experiences with Mechanical Restraints: An Interview Study.

Objective. To examine psychiatric patients' experience of mechanical restraints and to describe the care the patients received. Background. All around the world, threats and violence perpetrated by patients in psychiatric emergency inpatient units are quite common and are a prevalent factor concerning the application of mechanical restraints, although psychiatric patients' experiences of mechanical restraints are still moderately unknown. Method. A qualitative design with an inductive approach were used, based on interviews with patients who once been in restraints. Results. This study resulted in an overbridging theme: Physical Presence, Instruction and Composed Behaviour Can Reduce Discontent and Trauma, including five categories. These findings implicated the following: information must be given in a calm and sensitive way, staff must be physically present during the whole procedure, and debriefing after the incident must be conducted. Conclusions. When mechanical restraints were unavoidable, the presence of committed staff during mechanical restraint was important, demonstrating the significance of training acute psychiatric nurses correctly so that their presence is meaningful. Nurses in acute psychiatric settings should be required to be genuinely committed, aware of their actions, and fully present in coercive situations where patients are vulnerable.

Breakaway and physical restraint techniques in acute psychiatric nursing: Results from a national survey of training and practice

The survey examined training and practice in the prevention and management of violence in nurses working in acute in-patient psychiatric services throughout the UK. Out of 2,152 questionnaires sent out, 771 completed responses were returned (36%). While the response rate was low, there were no obvious biases affecting it, and a high level of statistical power was attained. The study is the largest survey of training in the prevention and management of violence in this population conducted so far. Most respondents reported an acceptable ratio of theoretical input to practical skills training, although some important theoretical aspects received insufficient attention. The use of wrist flexion and pain compliance elements in the restraining holds taught were frequently reported. In clinical practice, breakaway techniques were reported as more frequently used than has been suggested in earlier research. Some redundancies in restraint training were also found, with some commonly-taught techniques being seldom or never used. Respondents were not particularly confident in their ability to use their skills safely or effectively. Training sessions were generally considered to have been safely and well run. The need for national standards in training that the findings suggest, and directions for further research are discussed.

An analysis of Roy's Adaptation Model of Nursing as used within acute psychiatric nursing.

This article examines the use of Roy's Adaptation Model of Nursing within acute psychiatric nursing. The analytical framework used to analyse the model was that of McKenna's (1997) framework. The author believed this framework would allow for analysis of an abstract nature to occur. After examining the model under different headings it was concluded that there exists a research gap in relation to the use of Roy's model within acute psychiatric nursing. It is recognized that Roy's model is well developed and therefore has the potential to positively effect nurse practice and patient outcomes within acute psychiatric nursing. However, it is also acknowledged that a greater level of research-based evidence is required in order to fully justify the use of the model within acute psychiatric nursing.