Perspectives of a nurse, a social worker and a psychiatrist regarding patient assessment in acute inpatient psychiatry settings: a case study approach

Abstract

This case study explores what informs and organizes the assessment of patients, as undertaken by a nurse, a social worker and a psychiatrist in public, metropolitan, acute mental health service settings. The research data are the transcripts of in-depth interviews with three experienced practitioners, one from each of the three disciplines. The analysis draws on Foucauldian concepts: discourse as constructed through practices of discipline and the gaze. We explored examples of taken-for-granted assessment practices and their interplay with discourse. The findings suggest that participating practitioners use language in assessment in ways that support the powerful discourses of the professional disciplines. The competing discourse of management, associated with industry and economics, is evident in hospital admission processes, dictating the times and places of assessment. Professional and management discourses both effectively marginalize the perspective of another player in assessment, the patient.

Mental health nurses' views on therapeutic optimism

“…In the past, there has been a perception among some contemporary academics and consumer groups that mental health nurses in acute inpatient units are not providing consumer‐centred care, fulfilling their professional requirements or using psychological therapies, that social control is the primary modus operandi (Cutcliffe & Happell 2009; Deacon et al . 2006; Hall 2004; Hamilton et al . 2004; Mullen 2009), and that nursing work is reactive (Cleary 2003; Delaney & Johnson 2007; Horsfall et al .…”

“…Given the unpredictable and demanding nature of work in acute mental health settings along with the acuity of patients and their short-term stay, much contemporary literature unsurprisingly focuses on difficulties, challenges, and quality improvement (Callaly et al 2010;Cleary et al 2011d;Horsfall et al 2010a). In the past, there has been a perception among some contemporary academics and consumer groups that mental health nurses in acute inpatient units are not providing consumer-centred care, fulfilling their professional requirements or using psychological therapies, that social control is the primary modus operandi (Cutcliffe & Happell 2009;Deacon et al 2006;Hall 2004;Hamilton et al 2004;Mullen 2009), and that nursing work is reactive (Cleary 2003;Delaney & Johnson 2007;Horsfall et al 2011).…”

What is a comprehensive mental health nursing assessment? A review of the literature

“…In Australia, Hamilton et al . (2004) used in‐depth interviews to better understand what informs and organizes the assessment practice of nurses, social workers, and psychiatrists in acute inpatient settings.…”

In the know: cognitive and social factors in mental health nursing assessment

“…The intersection of nursing assessment with medical decision‐making is particularly contentious, often depicted as reflecting medical dominance and nursing disempowerment (e.g. Savage 1991, Hamilton et al. 2004).…”