Swedish mental health nurses’ responsibility in supervised community care of persons with long‐term mental illness

Abstract

The aim of the present study was to describe psychiatric nurses' experience of how the changing focus of mental health care in Sweden, from in-patient treatment to community-based care, has influenced their professional autonomy. Eleven psychiatric nurses were interviewed and a qualitative content analysis was used to identify major themes in the data. Three main themes were found: pattern of responsibility, pattern of clinical judgement, and pattern of control through support and supervision. All themes were related to the nurse's identity, moral responsibility and the feelings of loneliness and independence in his/her daily work. Together, the three themes were found to constitute a process. This study shows the complexity involved in nursing care provided in the patient's home. Achieving control over the patient's everyday life through support and supervision does not imply taking over the patient's autonomy, but rather reducing the stigma attached to mental illness and facilitating the process of rehabilitation.

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“…However, if the patients' mental state is deteriorating, the nurse must take control (Magnusson et al . ).…”

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“…; Magnusson et al . ). They also have a higher burnout rate than other mental health professionals or community health nurses (Imai et al .…”

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“…The organizational processes such as deinstitutionalization and integration of patients in community-based mental health services have made the challenge to create a clear definition of health at all levels in mental health care even more essential (Magnusson, Högberg, Lützen, & Severinsson, 2004). …”