‘Shared‐rhythm cooperation’ in cooperative team meetings in acute psychiatric inpatient care

Abstract

The cooperative team meeting is one of the most important interventions in psychiatric care. The purpose of this study was to describe the participation of patients and significant others in cooperative team meetings in terms of unspoken stories. The narrative approach focused on storytelling. The data consisted of videotaped cooperative team meetings (n = 11) in two acute closed psychiatric wards. The QRS NVivo computer program and the Holistic Content Reading method were used. During the process of analysis, the spoken and unspoken stories were analysed at the same time. According to the results, while there was some evident shared-rhythm cooperation (the topics of discussion were shared and the participants had eye contact), there were many instances where the interaction was controlled and defined by health care professionals. This lack of shared rhythm in cooperation, as defined in terms of storytelling, was manifested as monologue and the following practices: the health care professionals controlled the storytelling by sticking to their opinions, by giving the floor or by pointing with a finger and visually scanning the participants, by interrupting the speaker or by allowing the other experts to sit passively. Implications for mental health nursing practice are discussed.

Patient restrictions: Are there ethical alternatives to seclusion and restraint?

“…All these findings also confirm earlier reports. 42,43 Although the nurses did not always feel able to find alternatives to seclusion or restraint, both they and the physicians raised numerous alternatives, as did health personnel in some earlier reports. [25][26][27] The participants described: (1) nursing interventions; (2) multiprofessional agreements involving patients; and (3) the use of authority and power as, chronologically, the first, second and third steps.…”

Mental health nurses' perceptions of good work in an acute setting

“…The nursing literature highlights the frustration of nurses being unable to do what they should be doing (Cleary & Edwards 1999; Cleary et al . 2011c; Ewashen & Lane 2007), being overwhelmed by the authority of medical practitioners (Taxis 2002; Vuokila‐Oikkonen et al . 2004), and the contradictions between actual practice in acute inpatient mental health units and mental health ideology (Cleary 2004; Deacon et al .…”

“…In mental health nursing, for example, consumer and carer-focused care is not transpiring to the degree hoped for by mental health policymakers and patients (Cleary et al 2005;Cutcliffe & Happell 2009;Grant & Briscoe 2002;Hall 2004;Hamilton & Manias 2008;Woodbridge & Fulford 2004), and there are many constructive suggestions provided in the published literature for improving professional practice in mental health facilities (Deacon et al 2006;Hughes & Fulford 2005). The nursing literature highlights the frustration of nurses being unable to do what they should be doing (Cleary & Edwards 1999;Cleary et al 2011c;Ewashen & Lane 2007), being overwhelmed by the authority of medical practitioners (Taxis 2002;Vuokila-Oikkonen et al 2004), and the contradictions between actual practice in acute inpatient mental health units and mental health ideology (Cleary 2004;Deacon et al 2006;Fourie et al 2005;Horsfall et al 2011). Controversial aspects of practice have also been highlighted, including involuntary treatment, seclusion, suicidality, boundary violations, and patient competence (Cleary et al 2010;Gabbard & Peltz 2001;Gutheil & Gabbard 1998;Hunt et al 2010;Taxis 2002).…”

Participation of inpatients in multidisciplinary team meetings: An explorative study of mental healthcare workers' perception

“…A few other studies suggested that involving inpatients in MTMs might promote an open and participatory communication in which there is more understanding, recognition and trust between the hospital staff and the patient which can lead to positive health outcomes (Donnelly et al, 2013;Oliver-Parker et al, 2005, 2009van Dongen et al, 2016;Wittenberg-Lyles et al, 2010). Furthermore, the studies of Vuokila- Oikkonen et al (2004) and Wittenberg-Lyles et al (2010) found that patient participation in MTMs improves therapy adherence in hospice care and the patients' ability to cope in daily life outside the hospital.…”