Experiences Of Psychiatric Nurses Research Articles

Immersion Experience in Undergraduate Psychiatric Mental Health Nursing

Immersion practica have been used in a variety of nursing settings to help prepare culturally competent nursing students. The psychiatric setting represents a diverse culture that traditionally has not appealed to nursing students when considering career options. This article describes the experiences of baccalaureate nursing students and hospital nursing staff following a brief immersion practicum at a psychiatric facility. Seven students were assigned to one practicum for six consecutive weekdays (45 hours), without the distraction of other classes. Both the students and staff rated the experience as positive. The students believed that their ability to form therapeutic relationships, develop clinical skills, and integrate theory into clinical practice was enhanced. While nursing faculty struggle to produce more graduates, with declining clinical sites and increased competition for these sites, the brief clinical immersion may be a reasonable alternative to a traditional rotation.

Attitudes of Japanese nursing personnel toward patients who have attempted suicide

Objective The aim of this study was to examine the attitudes among Japanese nurses together with their perceived need for training in relation to understanding the nature of suicidal behavior and preventive strategies. Methods The Understanding Suicidal Patients scale together with additional questions reflecting training and the psychiatric treatment of suicide attempters were administered. Results A total of 323 nurses attended this study. Overall, the nurses thought patients who attempted suicide were not treated well. The nurses who worked in the psychiatric unit or had the experience in psychiatric nursing had more favorable attitudes toward suicidal patients and viewed themselves as having more relevant skill training in dealing with suicidal patients than those who did not. The nurses who worked at emergency care/intensive care unit were less likely to understand suicidal patients, and were less inclined to be sympathetic and to verbally interact with suicidal patients concerning their problems. The nurses who have confidence in the psychiatric care of suicidal patients, confidence in their own skills, and have a need for more training had the more positive attitudes. Conclusions The results suggest that less favorable attitudes may to some extent be the result of lack of knowledge regarding suicidal patients. Future studies should focus on the evaluation of educational experiences on attitudes and skill acquisition of nurses.

Mentoring experiences of psychiatric nurses: From acquaintance to affirmation

Mentoring is regarded as involving a voluntary and mutually beneficial relationship in which one person is experienced and knowledgeable (mentor) who supports the maturation of a less-experienced person (mentee). While there have been studies on mentorship in a wide range of areas within nursing, so far studies on psychiatric nursing are scarce. The hallmark of psychiatric nursing is the use of interpersonal process as a means of bringing about positive health changes in the clients. If psychiatric nurses are involved in mentorship, they can, through experiential learning, be nurtured to use interpersonal process as therapeutic tools in their work more effectively. This study examines the mentorship experiences of psychiatric nurses. Personal accounts of 27 psychiatric nurses were analyzed using qualitative methodology. Results of the study shed light on the role of mentorship in facilitating the socialization of psychiatric nurses and revealed the main aspects involved in this process. Four themes experienced by mentees during the mentoring process are the key to its success. These are: becoming acquaintances, developing bond, feeling being included and obtaining affirmation. These themes were found to be progressive in terms of mentees' degree of connection with their mentors and their involvement in the nursing profession.

The inner door: toward an understanding of suicidal patients

To describe the suicide care dilemmas that psychiatric nurses experience and how they respond to suicidal patients. Background. Psychiatric nurses play a major role in helping patients after suicide attempts. Little is known, however, about the ways nurses resolve their suicide care dilemmas. Focused ethnography was used to describe the meanings and patterns of actions of psychiatric nurses in a medical centre in Taipei, Taiwan. Fieldwork included two years of participant observation and individual interviews with 18 psychiatric nurses. Data from transcripts of observation field notes and interviews were transcribed verbatim and analysed. An important factor, the inner door (an invisible door inside the nurse's mind), determined the nurse's ability to understand the inner worlds of suicidal patients and the nurse himself or herself. In the absence of such understanding, nurses felt discouraged, labelled the patients and even restrained them, thus closing their inner doors. On the other hand, the nurses' willingness to reflect on their own experiences and receive the patients' teaching helped them understand the defensive patients and nurses themselves, thus opening the inner doors and enabling them to treat patients as their family or friends. The opening and closing of the inner door is a dynamic process. Nurses need to understand the essential meaning of a suicide experience to develop the insight to open the door and keep it open. The concept of an inner door helps nurses better understand why they distance themselves from patients when they encounter clinical dilemmas and offers a way to resolve their inner conflicts through self-reflection and appreciation of the patient's experiences.

Attitudes, knowledge and experience of nurses working in psychiatric hospitals in Greece, regarding borderline personality disorder: a comparative study

The objectives of this study is to determine the knowledge, attitudes and experience of psychiatric nurses regarding clients with Borderline Personality Disorder (BPD) and to compare nurses working in Psychiatric Hospitals with those in Psychiatric Clinics of General Hospitals. The study was performed in two public Psychiatric Hospitals and the Psychiatric Clinics of two public General Hospitals in the area of Greater Athens. The 23-item questionnaire of Cleary et al. was used in this study. It was sent to all nurses (n = 127) in 15 psychiatric wards. The staff have good enough knowledge regarding the diagnosis and treatment of the BPD patients. In Psychiatric Hospitals (A) the staff comes in contact with BPD patients less frequently than in the Psychiatric Clinics in General Hospitals (B). In the diagnostic question of 'the unstable mood with rapid shifts' most of the nurses who responded correctly belong to group A than to group B. In group A, nurses believe that not informing the patients of their disorder is the reason for their inadequate treatment, while in group B it is not reported as a reason. In group A, the staff consider that it is within their role to assess BPD patients, far more than in group B. Our hypothesis that nurses in psychiatric hospitals had less knowledge and experience as well as negative attitudes towards BPD patients was not confirmed, although the contact frequency with BPD patients was found statistically low.

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: a cross-sectional study

BackgroundViolence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life.MethodsSelf report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored.ResultsThe prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms.ConclusionAlthough high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.

Psychiatric nurses' knowledge, experience and attitudes towards clients with borderline personality disorder

There is evidence in the literature to suggest that mental health care staffs' attitudes towards clients with borderline personality disorder (BPD) are less than favourable. This study reports on a survey of psychiatric nurses' knowledge, experience and attitudes towards care received by clients with a diagnosis of BPD. The questionnaire was sent to all clinical nurses (n = 157) working in a psychiatric service in Dublin, Ireland and received a response rate of 41.4% (n = 65). The results indicate that the majority of nurses have regular contact with clients with BPD and nurses on inpatient units reported more frequent contact than nurses in the community. Eighty per cent of nurses view clients with BPD as more difficult to care for than other clients and 81% believe that the care they receive is inadequate. Lack of services was cited as the most important factor contributing to the inadequate care and the development of a specialist service is reported as the most important resource to improve care.

Suicidal patients as experienced by psychiatric nurses in inpatient care

Psychiatric nurses have a major influence on the lives of patients with suicidal behaviour in inpatient care. Despite this, there is a lack of knowledge about how nurses experience patients with suicidal behaviour in a deeper sense. The aim of this study was to investigate how psychiatric nurses experience patients with suicidal behaviour within an inpatient psychiatric context. Semi-structured interviews were carried out with 11 psychiatric nurses, each of whom had more than 5 years of experience caring for patients with suicidal behaviour. Data were analysed using qualitative latent content analysis. Two main themes emerged from the data analysis. These are 'labelled' and 'suffering'. In the nurses' natural attitude, they saw patients as being labelled with different conditions and/or behaviours based on objective signs. These were categorized into different groups or identities such as psychiatric diagnosis, mask wearer, screened-off, or the social, relapsing or determined patient. On reflection, however, the nurses described the patients' suffering in terms related to feelings of hopelessness, meaninglessness, and being out of control. The nurses' experiences of the patients as suffering were based on their subjective reflective experience of the patients. The study gives support to the conclusion that two main logic systems are represented in the care of patients with suicidal behaviour: technical practical and nursing perspectives. In order to ensure that these two logic systems combine, it is necessary for the psychiatric care organization to intervene to support the nurses in reflecting on their everyday work.

Tomorrow's Psychiatric Nurses: Where Are We Today in Providing Students' Clinical Experiences?

BACKGROUND: The increased enrollment of students, scarcity of faculty, and reduction in psychiatric beds challenge traditional ways of providing clinical psychiatric nursing experience to undergraduates. OBJECTIVE: The purpose of the study was to describe the current clinical psychiatric nursing experiences of undergraduates throughout the country. STUDY DESIGN: An online survey was dispersed to undergraduate nurse educators to describe clinical experiences in psychiatric mental health nursing. The survey included demographic questions, questions about students' clinical experiences, and open-ended questions regarding choices of and obstacles to a successful clinical experience. RESULTS: The 160 respondents reported concerns such as availability and quality of clinical sites, poor nursing role models, number of clinical hours, and lack of valuing their expertise. The results raise questions about the minimum number of hours needed to achieve competencies in psychiatric nursing, what simulations or laboratory experiences are essential, and what types of clinical settings provide needed experience. J Am Psychiatr Nurses Assoc, 2007; 13(1), 53-60.

Subjective Experience of Psychiatric Nurses who had Suffered from Violence by Inpatients

Subjective Experience of Psychiatric Nurses who had Suffered from Violence by Inpatients

Psychiatric nurses' experiences with inpatient aggression

Using a survey instrument, the experiences of psychiatric nurses with inpatienaggression were investigated in East London, U.K. On this Perceptions of Prevalence Of Aggression Scale (POPAS), annual experiences with 15 types of disruptive and aggressive behavior were rated anonymously. Staff members were also asked to disclose the number of days missed from work due to inpatient violence. On the basis of these POPAS forms, internal consistency of the instrument, mean reported aggression frequencies, and days missed from work due to violence were calculated. Internal consistency of the POPAS appeared to be reasonable. Verbal abuse and threats were experienced by most of the psychiatric nurses during a one-year period (i.e., by about 80-90 percent of nurses). Sexual harassment or intimidation was also experienced relatively often on an annual basis (68 percent), particularly by female and young staff members. A minority of staff members (i.e., 16 percent) had experienced severe physical violence. Although not prevalent, this type of behavior was most strongly connected with reporting sick. In particular, staff members working with involuntarily admitted patients experienced much (severe) violence during their work. Although the validity of estimates of aggression prevalence with the POPAS instrument needs to be investigated further, such a survey may be helpful in gaining insight rather quickly into the level of day-to-day contact with aggressive behavior. Also, since information on verbal, physical, and sexual violence, and on days missed from work, can be provided anonymously, this rather delicate, but essential management information, may be accessed relatively easily with the POPAS.

Nurses’ Attitudes Toward People with Mental Illnesses in a Psychiatric Hospital in Singapore

<p>A positive attitude toward people with mental illnesses is a necessary dimension of psychiatric nursing practice. Although studies have been conducted in Israel and Australia to examine the attitudes of nurses toward people with mental illnesses, no such study had been conducted in Singapore. This study explored the factors influencing nurses’ attitudes toward and their involvement in caring for people with mental illnesses, and sought to establish the relevance and effects of mental health training on enhancing the nurses’ positive attitudes.</p><p>The study used a descriptive, self-administered questionnaire, which contained 24 statements scored on a Likert scale. Factors related to attitudes toward people with mental illnesses included age, professional qualification, years of psychiatric nursing experience, type of ward, and designation (i.e., position within the institution). The questionnaires were given to all of the local nurses working in a psychiatric hospital in Singapore, and 96% returned the questionnaires.</p><p>Results showed that nurses with any of the following characteristics had a more positive attitude: age group of 31 to 50; professional qualification of advanced diploma in mental health nursing, nursing degree, or post-basic certificate; or more than 10 years of psychiatric nursing experience. In addition, nursing officers had a more positive attitude than staff nurses or assistant nurses, and nurses working in the short-stay wards had more positive attitudes than those working in the long-stay wards.</p><div class="ftAuthorNotes"><p>Ms. Tay is Nurse Clinician, Ms. Pariyasami is Nurse Educator, Ms. Ravindran is Nursing Officer, and Ms. Ali and Ms. Rowsudeen were members of the Nursing Department, Institute of Mental Health, Woodbridge Hospital, Singapore.</p><p>The authors wish to acknowledge the following professionals for their support and guidance: Ms. Mary Yeo Kim Luang, Ms. Yeo Soo Gim, Associate Professor Chong Siow Ann, Ms. Mythily Subramaniam, Mr. Michael Wee, Ms. Tan Lay Wu, and Ms. Thavamani Ammavasi. They also thank all of the nursing staff of Woodbridge Hospital for completing the survey forms.</p><p>Address correspondence to Sim-Eng Clara Tay, RN, RMN, BHSc, Grad. Dip. Psychotherapy, Nurse Clinician, Nursing Department (Ward 33A), Institute of Mental Health, Woodbridge Hospital, 10 Buangkok View, Singapore 539747; e-mail: sim_eng_tay@imh.com.sg.</p></div>

Mental & Neurological Health 2004: The US experience

Nolan P. Nurse prescribing: the experiences of psychiatric nurses in the United States. Nursing Standard 2004; 18(26): 33–38.

Nurse prescribing: the experiences of psychiatric nurses in the United States.

This study sought to elicit the views of psychiatric nurses in the United States on various aspects of nurse prescribing, with the aim of informing UK nurses about future problems and possible solutions. A survey design with an opportunistic sample of psychiatric nurse clinical specialists was used. The questionnaire consisted of 14 items seeking to elicit information on demographic data, current involvement in medication management, perceptions of the advantages and disadvantages of nurse prescribing, awareness of research about nurse prescribing, accountability and autonomy, and the prescribers' relationship with the pharmaceutical industry. Of the 80 questionnaires distributed, 51 (43 completed by female nurses and eight by male nurses) were returned--a response rate of 64 per cent. The results highlight the many advantages of nurse prescribing, which centre on improving the quality of care for patients; concerns relating to the relationship between nurse prescribers and non-prescribers; and the relationship between nurse prescribers and medical supervisors. Nurse prescribing has advantages for nurses and patients, including enhanced career development opportunities and better quality of patient care. However, though nurses may feel ready for this development, some members of the public may take longer to accept it.

News

A positive attitude toward people with mental illnesses is a necessary dimension of psychiatric nursing practice. Although studies have been conducted in Israel and Australia to examine the attitudes of nurses toward people with mental illnesses, no such study had been conducted in Singapore. This study explored the factors influencing nurses' attitudes toward and their involvement in caring for people with mental illnesses, and sought to establish the relevance and effects of mental health training on enhancing the nurses' positive attitudes. The study used a descriptive, self-administered questionnaire, which contained 24 statements scored on a Likert scale. Factors related to attitudes toward people with mental illnesses included age, professional qualification, years of psychiatric nursing experience, type of ward, and designation (i.e., position within the institution). The questionnaires were given to all of the local nurses working in a psychiatric hospital in Singapore, and 96% returned the questionnaires. Results showed that nurses with any of the following characteristics had a more positive attitude: age group of 31 to 50; professional qualification of advanced diploma in mental health nursing, nursing degree, or post-basic certificate; or more than 10 years of psychiatric nursing experience. In addition, nursing officers had a more positive attitude than staff nurses or assistant nurses, and nurses working in the short-stay wards had more positive attitudes than those working in the long-stay wards.

Psychiatric Nursing Recruitment: Roles for Educators and Nursing Staff

Recruiting new nurses to a relatively unpopular specialty in the midst of a nursing shortage is challenging. However, the literature offers educators and clinical nursing staff important insight regarding the promotion of student interest in psychiatric nursing. Clearly, a collaborative effort is needed. Educators and clinicians should work together to provide students with a satisfying psychiatric nursing experience. Through a combination of effective, intellectually stimulating classroom instruction and positive, welcoming clinical experiences, educators and clinical nursing staff may increase the number of nursing graduates who pursue this rewarding specialty.

Psychiatric nurses expressed conflicting feelings in the decision to use physical restraints

(2000) J Adv Nurs 31, 362. Marangos-Frost S, Wells D. . Psychiatric nurses' thoughts and feelings about restraint use: a decision dilemma . . . Feb; . : . –9....

Nurse--client relationships: the experience of community psychiatric nurses.

The aim of the present study was to construct an interpretation of the experience of the nurse--client relationship in the context of community psychiatric nursing. Hermeneutic phenomenology formed the framework of the study. Shared conversations were conducted with five experienced community psychiatric nurses and five clients. Themes of 'Being there', 'Being concerned', 'Establishing trust' and 'Facilitating transition' were identified from the nurses' conversations. This thematic structure was used to illuminate the centrality of the nurse--client relationship, and to articulate the skills that are involved in establishing and maintaining the relationship with clients with mental illness.

The morality of treating patients with depot neuroleptics: the experience of community psychiatric nurses.

The aim of this qualitative study was to gain an understanding of the meaning that community psychiatric nurses impart to their everyday interactions with patients in depot neuroleptic treatment situations. Nine experienced community psychiatric nurses were interviewed using semistructured, open-ended questions. Data analysis was by the phenomenological descriptive method according to Giorgi. Four themes were identified, highlighting aspects of the moral meaning of treating patients with depot neuroleptics: (1) 'benevolent justification' occurs when nurses perceive that the patient's welfare is at stake; (2) 'inability to advocate the patients' best interest' occurs when nurses feel they are at a disadvantage; (3) 'accommodative interactions' occur when nurses are able to respond to a patient's expressed needs; and (4) 'acceptable advocacy' occurs when physicians are sensitive to nurses' suggestions on patients' treatment. The findings indicate that treatment care planning involving both patients and nurses is essential to enhance patients' autonomy, which is a precondition for satisfactory interactions. This phenomenological study describes the meaning that nurses give to administering depot neuroleptic injections to patients in the context of community psychiatric clinics. The phenomenon of concern was identified as the moral aspect in the interactions with individual patients in the treatment situation.

The Morality of Treating Patients with Depot Neuroleptics: the experience of community psychiatric nurses

The Morality of Treating Patients with Depot Neuroleptics: the experience of community psychiatric nurses