Collaboration as a process and an outcome: Consumer experiences of collaborating with nurses in care planning in an acute inpatient mental health unit

Abstract

This qualitative study explores inpatient mental health consumer perceptions of how collaborative care planning with mental health nurses impacts personal recovery. Semi-structured interviews were conducted with consumers close to discharge from one unit in Sydney, Australia. The unit had been undertaking a collaborative care planning project which encouraged nurses to use care plan documentation to promote person-centred and goal-focussed interactions and the development of meaningful strategies to aid consumer recovery. The interviews explored consumer understandings of the collaborative care planning process, perceptions of the utility of the care plan document and the process of collaborating with the nurses, and their perception of the impact of collaboration on their recovery. Findings are presented under four organizing themes: the process of collaborating, the purpose of collaborating, the nurse as collaborator and the role of collaboration in wider care and recovery. Consumers highlighted the importance of the process of developing their care plan with a nurse as being as helpful for recovery as the goals and strategies themselves. The findings provide insights into consumers' experiences of care planning in an acute inpatient unit, the components of care that support recovery and highlight specific areas for mental health nursing practice improvement in collaboration.

Recovery‐oriented practice: Participant observations of the interactions between patients and health professionals in mental health inpatient settings

“…Informed by RSA, by a recovery-oriented practice we mean a practice integrating the patients' life goals, preferences, choices, and interests in terms of treatment plans, transferral, and discharge (O'Connell et al 2005). Similarly, in a study of patients' experiences of collaborating with health professionals in a systematic development of care plans based on personal goals, Reid et al (2018) found that, while patients appreciated the process of it, they did not find that their personal care plans were otherwise given any role or practical use. This is problematic given that recovery orientation not only entails collaboration between patients and health professionals but also requires that patients themselves and their personal experiences and preferences are recognized as the pivot points of any planning and provision of treatment and care (O'Connell et al 2005;Williams et al 2015).…”

“…This is problematic given that recovery orientation not only entails collaboration between patients and health professionals but also requires that patients themselves and their personal experiences and preferences are recognized as the pivot points of any planning and provision of treatment and care (O'Connell et al 2005;Williams et al 2015). Similarly, in a study of patients' experiences of collaborating with health professionals in a systematic development of care plans based on personal goals, Reid et al (2018) found that, while patients appreciated the process of it, they did not find that their personal care plans were otherwise given any role or practical use. This warrants an apprehension that even when recovery-oriented practices are formally acted out, they tend to remain superficial additions to practice rather than informing the clinical practice.…”

Barriers to recovery‐focused care within therapeutic relationships in nursing: Attitudes and perceptions

“…For example, Reid, et al . () found a prevalent theme in their qualitative study of consumer experiences of care to be fear of becoming a bother as a response to nurses' apparent busyness. Consumer interpretation that the nurse is not available or amenable to interaction creates a barrier to relationship.…”

“…Conscious or unconscious communication of feelings of being busy overwhelmed or under time pressure may be interpreted quite differently by consumers. For example, Reid, et al (2018) found a prevalent theme in their qualitative study of consumer experiences of care to be fear of becoming a bother as a response to nurses' apparent busyness. Consumer interpretation that the nurse is not available or amenable to interaction creates a barrier to relationship.…”

Patient perspectives of helpful risk management practices within mental health services. A mixed studies systematic review of primary research

“…Emphasis is not on risk prediction; rather, management is informed by personal growth, whereby risk taking is seen as part of daily living, underpinned by understanding that risk involves having opportunities to make life more satisfying (RCP, ). For this to occur, Reid, Escott, and Isobel () propose that this requires clinicians to share power, so that patients have active roles with navigating their own safety. This is echoed in policy, in that promoting safety is not only an endpoint of risk management, but patients feel safe to engage in its practices (DH, ).…”