Contradictions between Ideals and Reality: Swedish Registered Nurses’ Experiences of Dialogues with Inpatients in Psychiatric Care

Abstract

This study explored ten registered nurses' experiences of dialogues with inpatients in psychiatric care. Data were collected through four focus group discussions, and two individual interviews. The nurses described contradictions between their nursing ideals about dialogues and the reality faced in psychiatric inpatient care, resulting in an unsatisfactory work situation and feelings of insufficiency. We conclude that in order to improve quality of care and increase well-being for both patients and health care workers, nursing interventions, such as dialogues and meaningful activities, need to be offered to patients. A management that is visible and present on-site should encourage and facilitate health care workers' participation in clinical supervision.

Nurses experiences of delivering care in acute inpatient mental health settings: A narrative synthesis of the literature

“…In this context, nurses were often left with a sense that they had insufficient time to deliver person‐centred care to consumers; they were not well supported; and their roles were ambiguous (Graneheim et al . ). Many of the tasks essential to person‐centred care were often believed to be invisible (Fourie et al .…”

“…Some nurses identified unsupportive organizational cultures which were often attributed to hospital administration practices (Cleary et al 2012b). In this context, nurses were often left with a sense that they had insufficient time to deliver person-centred care to consumers; they were not well supported; and their roles were ambiguous (Graneheim et al 2014). Many of the tasks essential to person-centred care were often believed to be invisible (Fourie et al 2005), non-clinical and at times not explicitly described as part of the nursing role (Cleary 2004).…”

Patients' experiences of taking part in Time Together – A nursing intervention in psychiatric inpatient care

“…However, due to administrative tasks and organizational roles, there is little time left for these interactions (Graneheim et al . ; Shattell et al . ).…”

Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care

“…Nurses have been reported to experience cognitive dissonance, conflicts between benevolence and malevolence, and feelings of fear, anxiety, and vulnerability (Chambers et al 2015). Ideals about having dialogues with patients might contradict with the reality of patient care, resulting in an unsatisfactory work situation and feelings of insufficiency (Graneheim et al 2014). More qualitative studies are needed to 'further explore the conditions that enable the development of therapeutic interactional skills and the relationship of these skills to the nuanced context in which they are practiced' (Cleary et al 2012b, p. 78).…”