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

Gabrielsson, Sebastian; Sävenstedt, Stefan; Olsson, Malin

doi:10.1111/inm.12230

Cited by 75 publications

(96 citation statements)

References 41 publications

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“…In their study involving relationship‐oriented nurses in inpatient mental health care, Gabrielsson et al . () found that the participants were unable to uphold good nursing care due to a malfunctioning practice environment. This meant that the nurses accepted the authority of the physicians, while not taking responsibility and assigning tasks to others.…”

Section: Discussionmentioning

confidence: 99%

Job satisfaction among Swedish mental health nursing personnel: Revisiting the two‐factor theory

Holmberg¹,

Caro

Sobis

2017

Int J Mental Health Nurs

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Swedish mental health-care services are experiencing a critical shortage of nursing personnel. Researchers suggest that this shortage is due to low levels of job satisfaction. Job satisfaction is frequently studied with the assistance of Herzberg's two-factor theory, and this theory has foremost been explored with studies using quantitative methods. The purpose of the present study was to provide a better understanding of Herzberg's theory in relation to job satisfaction among Swedish mental health nursing personnel within inpatient psychiatric care while using qualitative methodology. This explorative study was based on semistructured interviews with 25 nursing personnel. Qualitative content analysis of interview transcripts identified three main categories: (i) respondents' perception of their work duties, which was perceived as important, meaningful, and demanding; (ii) respondents' relations with colleagues and supervisors, which provided valuable support in everyday work; and (iii) the way the respondents experienced their professional role as mental health nurses, which was described as unclear and vague. Job satisfaction primarily stemmed from working for patients and with other professionals, but their perceived limited progression of responsibilities discouraged a career in the profession. Herzberg's theory proved useful in exploring job satisfaction in this setting, but the findings partly contradict the basic tenets of the theory. Career advancements and incentives, such as salary and compensation, were perceived as lacking, which negatively influenced job satisfaction. Ward managers should establish clinical ladder programmes to recognize and motivate the continuing professional development of nurses. This needs to be coupled with monetary incentives, and linked with increased clinical authority.

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Section: Discussionmentioning

confidence: 99%

Job satisfaction among Swedish mental health nursing personnel: Revisiting the two‐factor theory

Holmberg¹,

Caro

Sobis

2017

Int J Mental Health Nurs

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“…Hamrin et al () point to the impact of creating environments that foster the ability to build therapeutic relationships. In this context, meeting the patient's need instead of following the house rules requires a continuous focus and critical reflection on one's own caring practice, as supported in the work of Espinosa et al (), Gabrielsson et al () and Looi Rpn et al (). In our opinion, professionals should discuss the structural conditions of their professional practice in the mental healthcare context and participate in reorganize their services in line with changes in external conditions to create a secure working environment.…”

Section: Discussionmentioning

confidence: 99%

“…Bang () highlights that organizational culture exists as an inconsistency between defended values such as person‐centred care and lived values such as “distancing themselves” based on experiences of defended values as “overwhelming and too much” (Bachmann et al, ). Gabrielsson, Savenstadt, and Olsson () found in their study that the nurses were unable to improve poor circumstances in nursing practice. They promoted their own survival by refuting or redefining their responsibility.…”

Section: Introductionmentioning

confidence: 98%

Professional vulnerability in mental healthcare contexts: A focus group study of milieu‐therapists’ experiences

2019

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Aims and objectives To gain insight into how the workplace influences milieu‐therapists’ vulnerability in the mental healthcare context. Background Mental health services have experienced substantial changes. Reduced institutional treatment capacity is replacing the development of locally based treatment. Changes in external conditions in mental health services have influenced the working conditions of nurses and milieu‐therapists. Design Qualitative design. The study complied with the COREQ checklist. Methods Focus group interviews. Results “Vulnerability due to unpredictable and threatening working context” was the common key theme that emerged in both contexts. Two key themes were different and opposite. In municipal mental health care, “Alone and unprotected” and in institutional care, “Together and protected.” Conclusion The participants from both specialized and community mental health care, experienced vulnerability at different levels interpreted as a contradictory relationship between the healthcare system and their own ideals of what professional practice ought to be. Relevance to clinical practice This study contributes to extended knowledge and understanding about the experienced influence of the working environment on professional vulnerability of nurses and milieu‐therapists` in mental health services. The impact of contextual conditions on health professionals’ working conditions has multi‐professional relevance for milieu‐therapists and managers of mental health services, and it is an important topic in health and social higher education.

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“…'Being with' a patient may entail stepping away from health-related tasks for a moment and listening, being open to learning about a patient's situation in a non-judgmental, calm manner [18]. However, it may be hard to be present due to workload, tiredness and competing demands affecting concentration [19]. Likewise, taking a mechanistic approach to care, focusing on technology and technical skills, may put HCPs at risk of disengaging from the patient before them [20], resulting in staff doing for rather than being with patients [21].…”

Section: Discussionmentioning

confidence: 99%

Appraising the situation: a framework for understanding compassionate care

Tierney

Seers

Reeve

et al. 2017

J of Compassionate Health Care

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Background: Compassion in healthcare represents an ideal way of interacting with patients. It entails an active response to suffering, distress or discomfort that can be associated with people seeking health related support or treatment. However, reports from within healthcare highlight that compassionate care (CC) is not always achieved. It may be especially problematic when trying to work with a patient who seems unwilling or unable to engage with advice provided by a healthcare professional (HCP). Methods: We conducted a grounded theory study to understand the meaning of CC for HCPs working with patients with type 2 diabetes. Data were collected between May-October 2015 using focus groups and individual interviews; 36 HCPs took part in total. For the current paper, we used constant comparison to analyse data from transcripts where participants talked about working with a 'non-adherent' patient. Results: Analysis highlighted how appraisal of their encounter with a non-adherent patient could affect whether CC was seen as possible by participants. Therefore, we used a transactional model of emotions as a framework for understanding HCPs' narratives. This involved a consideration of their primary appraisal of such encounters, which participants said often resulted in a sense of threat, failure and rejection. Their secondary appraisals, which centred on coping resources, included problem-focused approaches (e.g. supporting the patient to plan how to move forwards in managing their health) and emotion-focused approaches (e.g. recognising change was hard, appreciating it may not be the right time for the patient to change). These appraisals could be modified by: a) gaining experience as a HCP; b) altering what was seen as professional success; c) their connection with the patient; d) how much autonomy they had in their job. Conclusions: Our findings provide new insights and emphasise that CC in response to non-adherent patients is not determined solely by a HCP's innate nature, but can be affected by an individual's appraisal of this interaction and the resources he/she has available to cope. This has implications for the environment within which staff work.

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

Cited by 75 publications

References 41 publications

Job satisfaction among Swedish mental health nursing personnel: Revisiting the two‐factor theory

Job satisfaction among Swedish mental health nursing personnel: Revisiting the two‐factor theory

Professional vulnerability in mental healthcare contexts: A focus group study of milieu‐therapists’ experiences

Appraising the situation: a framework for understanding compassionate care

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