Time Geography, a Method in Psychiatric Nursing Care

Inpatient Suicides in Swedish Psychiatric Settings - A Retrospective Exploratory Study from a Nursing Perspective

In Sweden, approximately 1,200 individuals die by suicide annually. Inpatient suicide is considered rare, but death by suicide still occurs when admitted to a psychiatric hospital. This study was part of a national retrospective project covering data from all patients' medical records for the 2 years before death by suicide in 2015. In this study, 41 patients who died by suicide while being admitted to psychiatric care were identified. The aim was to retrospectively identify documentation of suicide risk, safety measures, and comparisons between those with and without suicide attempts for patients who died by suicide during psychiatric inpatient care. There was documentation of suicidal variables in 80% of the patients; 59% had a previous known suicide attempt, 63% were diagnosed with mood disorders, and 41% were assessed for elevated suicide risk. The most common suicide method was hanging, suffocation (68%), and 22% had died by suicide within 24 h after admission. Almost three-quarters were on voluntary care. No patients had constant professional supervision on a one-to-one basis, and 17% had 15-minute checks. One-third were on agreed leave at the time of the suicide. These results emphasise the lifesaving role of high-level supervision in the early stages of inpatient care.

The Core Elements of Psychiatric and Mental Health Nursing: Time, Honest Engagement, Therapeutic Relations, Professional Nursing and Lifetime-Perspective

Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a possibility to clarify psychiatric and mental health nursing based on humanistic philosophy in a general psychiatric care context. The aim was therefore to identify and synthesize the theoretical frameworks from which psychiatric and mental health nursing models are developed. We systematically collected and evaluated articles based on Grounded Theory (GT) methodology regarding psychiatric or mental health nursing. The PRISMA statement for systematic reviews was used and the formal process of synthesis, as a three-step process of identifying first -, second - and third-order themes following the examples of Howell Major and Savin-Baden. The synthesis resulted in a model describing five core elements of psychiatric and mental health nursing: 'professional nursing', 'therapeutic relationships' and 'honest engagement', with time as the all-encompassing theme, including the patients' 'lifetime perspective'. Psychiatric and mental health nursing is a caring support towards recovery, where the patient's lifetime perspective must be in focus during the caring process with a relationship built on an honest engagement. Time is therefore essential for psychiatric and mental health nursing.

The time, places, and activities of nurses in a psychiatric inpatient context - A time and motion study with a time-geographic perspective

Nurses in psychiatric inpatient care spend less time than desired with patients and investigation of the nature of nursing in this setting is needed. This study explores how nursing activities in psychiatric inpatient wards is distributed over time, and with a time-geographic perspective show how this relates to places. Observations were used to register place, activity, and time. A constructed time-geographic chart mapped the nurses' path which showed that nurses spent little time in places where patients are. There might be constraints that affect nursing. Nurses need to evaluate where time is spent and interventions that facilitate relationships are needed.