Conceptualising nurse-patient therapeutic engagement on acute mental health wards: An integrative review

Suicide prevention is an important imperative in psychiatric hospitals, where nurses have a crucial role in and make essential contributions to suicide prevention and promoting the recovery of patients experiencing suicidal ideation. The present qualitative grounded theory study aimed to uncover and understand the actions and aims of nurses in psychiatric hospitals during their interactions with patients experiencing suicidal ideation. Interviews were conducted with 26 nurses employed on 12 wards in four psychiatric hospitals. The data analysis was inspired by the Qualitative Analysis Guide of Leuven. The findings show that nurses’ actions and aims in their interactions with patients experiencing suicidal ideation are captured in the core element ‘promoting and preserving safety and a life‐oriented perspective’. This core element represents the three interconnected elements ‘managing the risk of suicide’, ‘guiding patients away from suicidal ideation’, and ‘searching for balance in the minefield’. The enhanced understanding of nurses’ actions and aims can inform concrete strategies for nursing practice and education. These strategies should aim to challenge overly controlling and directing nursing approaches and support nurses’ capacity and ability to connect and collaborate with patients experiencing suicidal ideation.

Section: Discussionsupporting

confidence: 53%

‘Promoting and preserving safety and a life‐oriented perspective’: A qualitative study of nurses’ interactions with patients experiencing suicidal ideation

Vandewalle

Beeckman

Hecke

et al. 2019

“…Promoting such tools could provide practical ways to support co‐produced/ person‐centred care (Epstein, Fiscella, Lesser & Stange, ; Freeman et al, ) to aid therapeutic engagement. Although not a specific question on the topic guide, the discussion of ‘team‐level formulations’ (Johnstone, ) in groups 1 and 2 suggested deciphering patterns in behaviour to be important for developing staff knowledge and understanding of individual service users (McAllister et al, ). As a result of this, staff reported feeling more sympathetic, compassionate, and understanding towards the individual as has been reported by others (Wainwright & Bergin, ).…”

Section: Discussionmentioning

confidence: 99%

Exploring therapeutic engagement with individuals with a diagnosis of personality disorder in acute psychiatric inpatient settings: A nursing team perspective

Acford

Davies

2019

Individuals with a diagnosis of personality disorder (PD) face negative attitudes and are often deemed harder to care for than individuals with other diagnoses. To improve care and engagement with services, it is essential to understand the ways general psychiatric nursing staff approach this client group. This research aims to examine the ways inpatient psychiatric nursing staff therapeutically engage with individuals with a diagnosis of PD. Focus groups were conducted with Registered Mental Health Nurses (n = 7) and Health Care Assistants (formally known as nursing assistants; n = 12) who care for individuals with a diagnosis of PD in a general psychiatric inpatient setting. A thematic analysis indicated six themes: the right frame of mind, knowing the service user, knowing when to engage, service user input, a unified approach, and structured admissions. The findings highlight what non‐PD specialist inpatient nursing staff do in order to engage therapeutically with this group of service users and areas that require improvement. Supporting good practice could improve staff confidence when caring for this client group, lower stigma around the diagnosis, and promote a more positive experience of care for individuals with a diagnosis of PD who are using general inpatient mental health services.

“…Consumers and their carers have expressed dissatisfaction with a lack of therapeutic engagement in mental health services (McAllister et al . ; Rydon ; Tee et al . ; Theodoridou et al .…”

Section: What Is the Problem And Why Are Mental Health Care Plans Neementioning

confidence: 99%

“…During active engagement, nurses work within an integrated triad of listening, understanding, and responding (McAllister et al . ), all vital elements to care plan creation with consumer involvement. Active listening and understanding followed by a response with an adaptable approach using a variety of engagement techniques (McAllister et al .…”

Section: Why Are Meaningful ‘Consumer Involved’ Care Plans Not Alwaysmentioning

confidence: 99%

“…Active listening and understanding followed by a response with an adaptable approach using a variety of engagement techniques (McAllister et al . ) are required to identify and respond to the concerns raised by the consumer during care plan development. These can include going out for a smoke, spending time with family members, or accommodation issues.…”

Section: Why Are Meaningful ‘Consumer Involved’ Care Plans Not Alwaysmentioning

confidence: 99%

See 1 more Smart Citation

A lack of therapeutic engagement and consumer input in acute inpatient care planning limits fully accountable mental health nursing practice

Rio

Fuller

Taylor

et al. 2019

It is mental health consumer's human right to lead a fulfilling life as they are empowered to actively manage their recovery. This can be facilitated through care planning, yet research suggests that the care plan is not routinely created, discussed, or updated in acute mental health settings. Research on care planning and the role of the mental health nurse highlights the importance of therapeutic communication in care plan development. This paper argues that the lack of meaningful care plan discussions between consumers and mental health nurses in an acute setting is a limitation to the practice of fully accountable mental health nursing care. We explore this limitation in quality care provision by examining literature on accountability and conclude that in mental health nursing, accountability is frequently enacted through an overarching focus on the organizational need to manage risks, rather than on therapeutic engagement.