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Nursing Ethics Aug 2020In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored.
BACKGROUND
In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored.
RESEARCH DESIGN
A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke's six analytic phases were used.
ETHICAL CONSIDERATIONS
Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary.
FINDINGS
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.
CONCLUSION
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.
Topics: Adult; Female; Health Resources; Humans; Male; Middle Aged; Norway; Nurse-Patient Relations; Psychiatric Nursing; Qualitative Research; Stress Disorders, Post-Traumatic
PubMed: 31631779
DOI: 10.1177/0969733019877526 -
International Journal of Mental Health... Dec 2017The aim of the present qualitative, systematic review was to identify and summarize qualitative research that focussed on mental health nurse prescribing, synthesize... (Review)
Review
The aim of the present qualitative, systematic review was to identify and summarize qualitative research that focussed on mental health nurse prescribing, synthesize findings, and outline key themes discerned. In November 2016, a systematic search was conducted for primary studies of the electronic databases PubMed, Excerpta Medica, (Embase), Cumulative Index to Nursing and Allied Health Literature, Scopus, and PsycINFO. Of the 101 papers identified through the search strategy, 12 qualitative studies met the review inclusion criteria. These studies included perspectives from nurses, doctors, and patients/clients regarding their attitudes about, and experiences of, nurse prescribing. Three themes emerged from the review: (i) patient-centred care; (ii) professional role; and (iii) professional support. Nurse prescribers embrace a patient-centred approach, providing timely and effective medication management. Adequate education and continuing professional development inclusive of clinical supervision enable competency development in nurse prescribing, supportive professional relationships, and patient safety. Further research is necessary to establish safety and demonstrate enhanced clinical outcomes from mental health nurse prescribing.
Topics: Attitude of Health Personnel; Attitude to Health; Drug Prescriptions; Humans; Nurse's Role; Psychiatric Nursing
PubMed: 28771922
DOI: 10.1111/inm.12372 -
Australian Nursing & Midwifery Journal Mar 2015
Topics: Aged; Aggression; Clinical Competence; Humans; Inpatients; Nurse-Patient Relations; Nursing Staff, Hospital; Psychiatric Nursing; Victoria
PubMed: 26485818
DOI: No ID Found -
Online Journal of Issues in Nursing Jan 2015The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this...
The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this document identifies the focus of the specialty by defining nursing practice extents and limits. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. This article begins with a brief overview of the revision process. The author describes key factors that influenced the revision, such as external documents and current priorities in healthcare, and synthesizes significant changes to the document, including commentary and comparisons to the generalist Scope and Standards of Practice. Implications for nursing education and a companion resource are discussed.
Topics: Advanced Practice Nursing; American Nurses' Association; Clinical Competence; Consumer Advocacy; Education, Nursing; Ethics, Nursing; Nurse's Role; Psychiatric Nursing; United States
PubMed: 26824259
DOI: No ID Found -
Journal of the American Psychiatric... 2019This article summarizes the experiences that a Midwest college of nursing had when telepsychiatry was introduced for psychiatric-mental health post-master's nurse... (Review)
Review
This article summarizes the experiences that a Midwest college of nursing had when telepsychiatry was introduced for psychiatric-mental health post-master's nurse practitioner students to use in a clinical internship. Implications for nurse practitioner educators will be identified, and recommendations for future research will be explored. Described are the following: (1) policies and procedures the institution considered, (2) challenges that were encountered by faculty and students, and (3) strategies and limitations of these strategies defining best practice, what didactic content should be taught, and how clinical placements needed to be structured. Implications for nurse practitioner educators, practice, and research are identified. It is clear that telepsychiatry has an important role in the clinical education of psychiatric-mental health nurse practitioners. It is working well as a clinical internship option. The college of nursing is continuing to examine and address issues and is looking forward to enhancing the telepsychiatry experiences for students in the future.
Topics: Education, Nursing, Graduate; Humans; Midwestern United States; Nurse Practitioners; Psychiatric Nursing; Telemedicine
PubMed: 30387682
DOI: 10.1177/1078390318807967 -
Issues in Mental Health Nursing Apr 2020National health resources are considered inadequate to meet the needs of Mental Health services in Poland due in part to insufficient funding. The status of the nursing...
National health resources are considered inadequate to meet the needs of Mental Health services in Poland due in part to insufficient funding. The status of the nursing profession is autonomous and independent, and one that bears much public trust. Nevertheless, psychiatric nursing is in deep crisis. To determine the strengths and limitations of the psychiatric nursing system in Poland. Participants of a major Psychiatric Nursing Conference in Poland were surveyed in terms of professional job satisfaction and current problems encountered in psychiatric nursing. Results were appropriately categorized and subjected to quantitative analysis. There were 74 subjects, amounting to a 70% response rate who completed the study questionnaire. Problem areas were focused on how the mental health system is organized and on staff working conditions that included terms of employment and salaries. The main reasons for job satisfaction were those issues associated with the treatment process. Two participants replied that they were not satisfied. The numerous problems encountered in Polish psychiatry nursing require further debate and the updating of legal regulations to increase funding. Recently introduced regulations on the minimal standards acceptable for nurse/bed ratios have however been postponed until 2021. The issues concerning job satisfaction have also been referred to in previous studies. The crisis facing psychiatric nursing in Poland requires systemic changes in both legal regulations and financing. Notwithstanding, such professionals and their societies could facilitate the necessary changes through enhancing public debate and stimulating nursing-focused research.
Topics: Adult; Attitude of Health Personnel; Female; Humans; Job Satisfaction; Male; Middle Aged; Nurse's Role; Poland; Psychiatric Nursing; Surveys and Questionnaires; Young Adult
PubMed: 31855508
DOI: 10.1080/01612840.2019.1663456 -
Journal of the American Psychiatric... 2019
Topics: Mental Disorders; Psychiatric Nursing; Screen Time; Social Behavior; Technology; Telemedicine
PubMed: 31480914
DOI: 10.1177/1078390319869932 -
Journal of the American Psychiatric... 2014
Topics: Cooperative Behavior; Humans; Psychiatric Nursing; Societies, Nursing; United States
PubMed: 25502640
DOI: 10.1177/1078390314559778 -
Journal of the American Psychiatric... 2018
Review
Topics: Ill-Housed Persons; Humans; Mental Disorders; Psychiatric Nursing
PubMed: 29779464
DOI: 10.1177/1078390318771959 -
Journal of Nursing Management Apr 2020This research was conducted to examine psychiatric nursing managers' attitudes towards containment methods.
AIMS
This research was conducted to examine psychiatric nursing managers' attitudes towards containment methods.
BACKGROUND
Nursing management is regarded as a key issue in the reduction of coercion and containment. However, there has been little research on managers' attitudes towards containment methods.
METHODS
This descriptive, cross-sectional study utilized a survey design. Finnish inpatient psychiatric nursing managers (n = 90) completed the Attitudes to Containment Measures Questionnaire (ACMQ). The results were described with statistics, and the associations between attitudes and background variables were analysed using parametric tests.
RESULTS
Psychiatric nursing managers had the most negative attitude towards net bed and mechanical restraint, and the most positive attitudes towards as necessary medication and intermittent observation. A few associations were discovered between attitudes and background variables such as gender and number of employees.
CONCLUSIONS
In general, Finnish psychiatric nursing managers' attitudes towards containment methods seem to be quite negative, but more research is needed.
IMPLICATIONS FOR NURSING MANAGEMENT
This study provides fresh and unique data on the attitudes of psychiatric nursing managers towards containment methods. Managers' attitudes are important because of their ability to encourage investment in coercion reduction by nursing staff.
Topics: Adult; Analysis of Variance; Attitude of Health Personnel; Cross-Sectional Studies; Female; Finland; Humans; Male; Patient Isolation; Patients' Rooms; Psychiatric Nursing; Quality of Health Care; Surveys and Questionnaires
PubMed: 32106346
DOI: 10.1111/jonm.12986