Nursing Practice Environment in Psychiatric Units: A Scoping Review

Abstract

The practice environment is a key element that influences the quality of psychiatric–mental health nursing care; however, little is known about it. For the current study, to explore the evidence on environmental factors influencing nursing practice in psychiatric inpatient units, a scoping review of primary research published between 2009 and 2019 was performed. PubMed, Web of Science, Scopus, and CINAHL databases were searched. Eleven articles were included. Main findings were: (a) the biomedical approach limits the development of the nursing model; (b) lack of opportunities, representation, and recognition of nurses in the organization; (c) greater support from managers for a greater perception of nurses' competence and therapeutic commitment; and (d) the need for a feeling of belonging to the team and the perception of emotional exhaustion, workload, and administrative tasks. Although psychiatric nurses have a slightly positive view of their practice environment, certain factors limit quality of care. The current review points to the need for nurses to have greater organizational support and the importance of promoting effective teamwork. Implications for mental health services include the need for support and recognition by managers, as well as the existence of a nursing model within the units. [ Journal of Psychosocial Nursing and Mental Health Services, 59 (11), 33–40.]

Constrained nursing: Nurses’ and assistant nurses’ experiences working in a child and adolescent psychiatric ward

“…Nurses who experience moral distress might add to the devaluing of good nursing practice, as they might respond by distancing themselves from patients and redefining their responsibilities (Gabrielsson et al 2016;Jansen et al 2020;Molin et al 2016). To escape the limitations of the medical perspective (Moreno-Poyato et al 2021;Santangelo et al 2018), it seems crucial that nurses are allowed to assume leadership and develop an autonomous nursing practice. Mental health nursing needs to break free and contribute to quality CAP inpatient care.…”

“…To escape the limitations of the medical perspective (Moreno‐Poyato et al . 2021; Santangelo et al . 2018), it seems crucial that nurses are allowed to assume leadership and develop an autonomous nursing practice.…”

“…Mental health nurses struggle to provide personcentred, recovery-oriented care in inpatient services, but such efforts are counteracted by conflicting demands and a lack of supportive practice environments (Gabrielsson et al 2016;Molin et al 2016;Moreno-Poyato et al 2021). From the perspective of young people, child and adolescent psychiatric (CAP) inpatient care can support recovery when staff engage young people and allow them to feel listened to, believed in and safe (Wallstr€ om et al 2021).…”

“…2016; Moreno‐Poyato et al . 2021). From the perspective of young people, child and adolescent psychiatric (CAP) inpatient care can support recovery when staff engage young people and allow them to feel listened to, believed in and safe (Wallström et al .…”

The experience of nurses moving into forensic mental health employment: A qualitative study

“…While the environmental demands and challenges for nurses working in mental health have been previously investigated (Moreno-Poyato et al 2021;Scanlan & Still 2019), issues such as increased security needs, personality disorders and offending behaviour are heightened in forensic mental health (Howard & Westmore 2018). A recent review by Newman et al (2021) indicates that forensic mental health nurses are frequently exposed to workplace trauma, including physical violence and verbal abuse.…”