Being different: a phenomenological exploration of a group of veteran psychiatric nurses

Exploring the Experiences of Pharmacy Students and Their Transition to Online Learning during COVID-19

Due to the heavy focus on development of communication skills, compounding laboratories and many practical workshops, undertaking a registerable pharmacist qualification in an online format is typically not an option for students. COVID-19 presented on-campus pharmacy students with the opportunity to experience online learning. The aim of this study was to explore the experiences of on-campus pharmacy students who were required to move their studies to online learning during the COVID-19 pandemic. An interpretive phenomenological methodology was adopted, and semi-structured interviews were conducted with pharmacy students who were originally enrolled in on-campus learning and had to transition to online learning. Data were analyzed using a hermeneutic phenomenological approach whereby themes were identified to aid in the development of the phenomena guided by 'lived experience'. Seven interviews were conducted with pharmacy students. Four emergent themes resulted from the interviews: (1) life as an on-campus pharmacy student, (2) preconceived ideas of online learning, (3) learning differences as an online pharmacy student and (4) the future of online pharmacy programs. Students were initially hesitant to transition to online learning due to preconceived ideas and expectations that may have tainted their overall experience. Pharmacy students preferred face-to-face learning due to their sociable personality and heavy dependence on peer and teacher support. All participants reported that they preferred face-to-face learning and acknowledged that fully online programs were not suited to their learning style or to the discipline of pharmacy. After their experience of online learning, participants believed that there was a place for online learning components in pharmacy courses. Lectures and some discussion workshops could be delivered online, but some aspects, such as compounding; dispensing; counselling; and demonstration of medication delivery devices, such as asthma inhalers and injectable diabetes products, should be delivered on campus.

Utilizing the mental health nursing workforce: A scoping review of mental health nursing clinical roles and identities

Despite rising international needs for mental health practitioners, the mental health nursing workforce is underutilized. This is in part due to limited understandings of their roles, identities, and capabilities. This paper aimed to collate and synthesize published research on the clinical roles of mental health nurses in order to systematically clarify their professional identity and potential. We searched for eligible studies, published between 2001 and 2021, in five electronic databases. Abstracts of retrieved studies were independently screened against exclusion and inclusion criteria (primarily that studies reported on the outcomes associated with mental health nursing roles). Decisions of whether to include studies were through researcher consensus guided by the criteria. The search yielded 324 records, of which 47 were included. Retained papers primarily focused on three themes related to mental health nursing clinical roles and capabilities. Technical roles included those associated with psychotherapy, consumer safety, and diagnosis. Non-technical roles and capabilities were also described. These included emotional intelligence, advanced communication, and reduction of power differentials. Thirdly, the retained papers reported the generative contexts that influenced clinical roles. These included prolonged proximity with consumers with tensions between therapeutic and custodial roles. The results of this scoping review suggest the mental health nurses (MHNs) have a wide scope of technical skills which they employ in clinical practice. These roles are informed by a distinctive cluster of non-technical capabilities to promote the well-being of service users. They are an adaptable and underutilized component of the mental health workforce in a context of escalating unmet needs for expert mental health care.

Too Busy to Talk: Examining Service User Involvement in Nursing Work

Traditional ideas of mental health nursing are challenged in contemporary healthcare settings by developments focussed on more partnership and collaboration with people using mental health services. Yet service users have reported limited involvement in planning their own care. The purpose of this research was to explore accounts from multiple perspectives about service user involvement in mental health nursing processes. Qualitative research interviews and focus groups with mental health nursing students (n = 18), qualified nurses (n = 17) and service users (n = 13) were conducted, audio-recorded and transcribed verbatim. Participants' transcribed talk was thematically analysed to examine understandings about service user involvement and mental health nursing. Nursing work was often described as task-focussed, with limited collaboration with service users in areas like care planning. Service user involvement was seldom mentioned by nurses themselves, indicating it did not form an important part of mental health nursing processes. Mental health nurses appear to be complicit in care processes that do not include involvement of service users and may discourage novice practitioners from attempts at engagement.

Challenges Encountered by Nurses Working in Acute Psychiatric Wards: A Qualitative Study in Iran

BACKGROUND

The provision of care to patients with psychiatric disorders and working in a challenging environment lead to many problems among psychiatric nurses. The aim of this study was to explore the challenges nurses faced while working in acute psychiatric wards.

DESIGN

A qualitative design using content analysis was used. Fifteen nurses working in psychiatric wards in hospitals affiliated to a university hospital in an urban area of Iran were chosen using a purposive sampling approach. Semi-structured interviews were used for data collection. An inductive content analysis method was used to analyse the collected data.

RESULTS

Four themes were developed based on the analysed data: "experiencing psycho-social challenges," "experiencing psychological challenges," "encountering catalysts causing challenges," and "employing various strategies for coping with challenges."

CONCLUSIONS

Given the importance of physical and mental well-being of nurses and the moral and professional responsibility of an organization to protect staff health, it is of prime importance to examine the inpatient psychiatric nurses' experiences to better understand them and hopefully use such knowledge so as to improve their work life.

Capturing the Interpersonal Process of Psychiatric Nurses: A Model for Engagement

Staff members' engagement with patients is a critical element of inpatient psychiatric care, essential to safety, the hospitalization experience and the development of a culture of care. Currently broad concerns exist around the amount of time inpatient psychiatric nurses expend in patient engagement and the quality of these interactions. In this paper we present a model of engagement that clarifies necessary skills to support the engagement process. The model is based on Peplau's theory of interpersonal relations, patients' ideas on healing elements of psychiatric hospitalization and research on inpatient therapeutic relationships. We are currently using this model for a web-based teaching/learning course to cultivate interpersonal engagement, and to explicate how through operationalizing their inpatient role, nurses support patients in the development of their mental health and well-being.

'Your experiences were your tools'. How personal experience of mental health problems informs mental health nursing practice

WHAT IS KNOWN ON THE SUBJECT?: 'Expertise by experience' has become an increasingly valued element of service design and delivery by mental health service providers. The extent and influence of mental health professionals' personal experience of mental ill health on clinical practice has seldom been interrogated in depth. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We investigate how mental health nurses' own personal experience of mental ill health informs their mental health nursing practice with particular reference to direct work with service users. Participants said that personal experience could impact on work in three positive ways: to develop their relationship with service users, to enhance their understanding of service users and as a motivation for potential mental health nurses to join the profession. This study moves the discussion of the state of mental health nurses' mental health further towards the recovery and well-being focus of contemporary mental health care, where 'expertise by experience' is highly valued. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We must address the taboo of disclosure within clinical nursing practice and debate the extent to which personal and professional boundaries are negotiated during clinical encounters.

ABSTRACT

Introduction 'Expertise by experience' is a highly valued element of service delivery in recovery-oriented mental health care, but is unacknowledged within the mental health nursing literature. Aim To explore the extent and influence of mental health professionals' personal experience of mental ill health on clinical practice. Method Twenty-seven mental health nurses with their own personal experience of mental ill health were interviewed about how their personal experience informed their mental health nursing practice, as part of a sequential mixed methods study. Results The influence of personal experience in nursing work was threefold: first, through overt disclosure; second, through the 'use of the self as a tool'; and third, through the formation of professional nursing identity. Discussion Mental health nurses' experience of mental illness was contextualized by other life experiences and by particular therapeutic relationships and clinical settings. In previous empirical studies, nurses have cited personal experience of mental illness as a motivator and an aspect of their identity. In this study, there was also an association between personal experience and enhanced nursing expertise. Implications for practice If drawing on personal experience is commonplace, then we must address the taboo of disclosure and debate the extent to which personal and professional boundaries are negotiated during clinical encounters.

Breaking down the stigma of mental health nursing: A qualitative study reflecting opinions from western australian nurses

WHAT IS KNOWN ON THE SUBJECT?: The rate of mental illness in the general population is ever increasing Mental health nurses are ageing, and this is not a preferred career for new graduates; thus, recruitment and retention of mental health nurses is declining Stigma is attached to the view of mental illness and the role of a mental health nurse. If this stigma can be reduced, it may provide an opportunity for the profession to become more popular and assist recruitment in this area WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Previous research has focused on why mental health nurses leave the profession which has not provided successful results This study adopts a new way of working whereby we gathered opinions from current mental health nurses focusing on why they originally wanted to work in mental health WHAT ARE THE IMPLICATIONS FOR PRACTICE?: New findings presented in this paper will guide improvements in nurse training, policy development for mental health services and improve recruitment of the next generation of mental health nurses The findings provide a strong message that in order to entice others to work in mental health, we need to first address breaking down the stigma related to mental health nursing ABSTRACT: Introduction A lack of understanding surrounding the role of mental health nursing is associated with recruitment and retention challenges. Additional complexities include stigma related to the role, an ageing workforce and dearth of graduates keen to pursue this career. Scientific Rational Previous research has focused on why nurses leave the profession which has not provided necessary solutions. There is a need to instead explore why nurses originally chose a career in mental health. Aim of study This qualitative study focused on opinions and experiences of existing mental health nurses to determine what could be performed to entice nurses to choose mental health. Methods A cross-sectional design involving a brief interview was conducted with 192 Western Australian nurses from one public mental health service. Results Thematic analysis revealed an overarching theme "breaking down stigma" and additional themes of: "visibility of mental health nursing" and "growing mental health nursing." Subthemes under "visibility" included "self-promotion" plus "industry and university promotion," whereas subthemes related to "growing" focused upon "improving the student experience." Finally, "recognizing the mental health specialty" was identified for an attractive career pathway. Discussion This study adds to international evidence and showcases unique insights from mental health nurses into why they chose a career in mental health whilst previously replicated research focused on why nurses chose to leave. Implications for practice Findings suggest that before we can entice nurses to choose mental health, there is urgency to reduce stigma related to the role. "Breaking down stigma" will allow the role to become more visible and be represented in a more positive authentic manner. New findings in this paper will drive improvements of future nurse education, policy planning and recruitment design for the next generation of mental health nurses.

Associations between Age, Years in Post, Years in the Profession and Personal Experience of Mental Health Problems in UK Mental Health Nurses

Nurses' mental health is of paramount importance, both in terms of patient safety and the sustainability of the workforce. Age, years in the profession, in post and personal experience or exposure to mental health problems are relevant to the mental health nursing workforce crisis in the United Kingdom. This study aimed to determine the relationship between age, years in the profession and post and self-reported experience of mental health problems using an online cross-sectional survey of 225 UK mental health nurses. Number of years in post was inversely correlated with overall experience of mental health problems, particularly living with someone else with mental health problems. Those with experience of living with someone with mental health problems had significantly fewer years of professional experience than those without. This article discusses possible explanations for this phenomenon and makes the case for future research on the topic.

Don't Just Survive, Thrive: Understanding How Acute Psychiatric Nurses Develop Resilience

With one in five Canadians estimated to experience mental illness, retention of registered nurses in the acute psychiatric hospital setting becomes a pressing issue. The key for these nurses to survive and potentially even thrive in practice has been identified as resilience. From interviews with four registered nurses, maintaining a "vast" perspective, becoming an "expert" of self, clarifying "belief systems", and being "present" through "staying awake" were identified as key in developing resilience. Although participants expressed that the development of resilience is an individual process, the concept of development was similar. Developing personal resilience may be a matter of self-development.

We are different: the voices of psychiatric advanced practice nurses on the performance of their roles

BACKGROUND

Many studies have affirmed that psychiatric advanced practice nurses (APNs) perform multifaceted roles. However, only a limited amount of research has been conducted on their perceptions of the performance of their roles.

AIM

To explore the lived experiences of psychiatric APNs concerning the performance of their roles.

DESIGN

Data were collected from individual semi-structured interviews and analysed using the interpretative phenomenological analysis method.

METHODS

The study was conducted in a hospital cluster in Hong Kong. Thirteen psychiatric APNs were purposively recruited.

RESULTS

Three themes were discerned, namely, 'We are different', 'Who am I?', and 'I am who I am'.

CONCLUSIONS

The findings can help psychiatric APNs and nurse administrators to better understand the needs of the role-bearers (APNs) and to develop strategies to support the development of advanced psychiatric nursing practices in Hong Kong and worldwide.

Motivational Factors that Help in Coping with Barriers to Provision of Psychiatric Nursing Care: Perspective of Psychiatric Nurses in a Hospital Setting in Nigeria

This qualitative case study explored barriers to provision of psychiatric nursing care in a hospital in Plateau State, Nigeria, and revealed motivational factors that helped the nurses to cope with these barriers. Data collection methods included grand tour and in-depth interviews and participant observation. Motivational factors were related to the psychiatric nurse's individual intrinsic belief system, as well as to their intrinsic belief system as influenced by the environment. These motivational factors highlight how psychiatric nurses continue to cope with the barriers they face in provision of care. The findings indicate the need for hospital management to create and sustain an environment to complement the existing intrinsic motivation of psychiatric nurses to provide psychiatric nursing care, and to provide prompt and appropriate emotional and psychological support to psychiatric nurses worldwide.

Choosing and remaining in mental health nursing: perceptions of Western Australian nurses

Mental health nursing has an ageing workforce with a critical shortage of nurses in Western Australia. Additionally, mental health is not the preferred career for many graduate nurses. Current challenges with recruitment and retention suggest that strategies are needed to address this issue. This research project adopted a novel approach that focused on exploring the positive aspects of why mental health nurses remain, rather than why they leave. A cross-sectional design was employed comprising a brief interview survey, and nurses working within one public mental health service in Western Australia were invited to participate. A total of 192 nurses participated across 5 months, from adult, older adult, forensic, and education/research programmes. Thematic analysis was conducted from five key questions, and responses from questions one and two are discussed in this paper: 'Why did you choose mental health nursing?' and 'Why do you remain in mental health nursing?'. The main themes extracted in response to choosing mental health nursing were wanting to make a difference, mental health captured my interest, encouraged by others, and opportunities. Subsequent themes extracted from responses to remaining in mental health nursing were facing reality, passion for mental health nursing, patient-centred caring, and workplace conditions. Findings will be utilized to inform strategies for recruitment and retention of graduate nurses; further development of support systems, such as preceptorship training and improving student clinical experiences; as well as improving professional development opportunities for existing mental health nurses.

Exploring the experience of Canadian registered psychiatric nurses: a phenomenological study

This paper describes a phenomenological study that was conducted in 2012 and investigated the experiences of registered psychiatric nurses working in the province of Manitoba. Ten registered psychiatric nurses participated in semistructured, audio-recorded interviews, during which they described their experiences, yielding written protocols that were thematically analysed. Results from this study revealed six predominant themes that included (1) perception of psychiatric nursing; (2) patient aggression; (3) patient family involvement; (4) nurse-doctor relationship; (5) responsibility and worry; and (6) shift in practice and educational standards. The results of this study can assist in better understanding registered psychiatric nursing practice, inform educational programmes, and spawn future research.

Metasynthesis of research on the role of psychiatric inpatient nurses: what is important to staff?

BACKGROUND

Inpatient psychiatric nurses are a large workforce, but their work is poorly articulated and thus poorly understood outside of the professional inpatient community.

OBJECTIVE

To learn how inpatient psychiatric nurses depict their work, define important aspects of their role, and view the impact of the unit environment on their clinical practice.

DESIGN

Metasynthesis of research that has focused on the ideas and perceptions of inpatient psychiatric nurses around their role and practice on inpatient psychiatric units.

RESULTS

Three themes emerged from the analysis; the first was an umbrella for three important aspects of nursing work: the nurses' efforts to forge engagement with patients; their activities which maintained the safety of the unit and interventions nurses viewed as educating/empowering patients. The second theme captures the conditions that enabled nurses to do this work such as a cohesive nursing team and their sense of self-direction in their role. The final theme centers on difficulties nurses encountered in enacting their role which included multiple responsibilities for patient care and management of the milieu; intense work often with low visibility and scant support within the organization.

CONCLUSIONS

Nurses need to articulate their practice so they can assert for the staffing and resources needed to keep units safe and promote patients' well-being, strive toward quality, and promote the development of the specialty.

Perceptions from the front line: professional identity in mental health nursing

In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses (MHN) in Victoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of MHN: (i) the ambiguity of the MHN role; (ii) the weak definition and lack of understanding of the scope of the MHN role by nursing students; and (iii) a lack of communication about MHN as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of MHN; and (iii) more accurately defining the role of the MHN.

Perceptual shifts of priority: a qualitative study bringing emotional intelligence to the foreground for nurses in talk-based therapy roles

This paper presents the findings of a qualitative study conceptually framed by social constructionism that explored the experiences of mental health nurses engaging in talk-based therapy roles. Constructions from the participants' narratives are shown to have a powerful resonance with the construct of emotional intelligence, a resonance also echoed from the literature, and policies from the UK identified within the paper. Forwarded is that rather than prioritizing the development of technical approaches of specific therapies, nurses should equally be prepared for talk-based therapy roles through developing their emotionally intelligence capabilities.

Psychiatric nursing as 'different' care: experience of Iranian mental health nurses in inpatient psychiatric wards

Patients with mental illness require unique and specific care. The purpose of this study was to explore the experiences of nurses, who provide such care for mentally ill people, within the context of Iranian culture. This hermeneutic phenomenological study was carried out in a university-affiliated hospital in an urban area of Iran. We interviewed 10 mental health nurses to capture in detail their experiences in psychiatric units, and the approach developed by Diekelmann et al. was employed to analyse the data. Four themes and five sub-themes were identified: 'being engaged with patients' (sub-themes: 'struggle for monitor/control', 'safety/security concerns', 'supporting physiological and emotional needs'), 'being competent', 'altruistic care' and 'facing difficulties and challenges' (sub-themes: 'socio-cultural' and 'organizational challenges'). The results provide valuable insights and greater understanding of the professional experiences of psychiatric nurses in Iran, and indicate the need for a stable and responsible organizational structure for those nurses who are expected to manage patient care in psychiatric wards.

Facing the challenges and building solutions in clinical psychiatric nursing in Iran: a qualitative study

Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program.

Recruitment and retention of Canadian undergraduate psychiatric nursing faculty: challenges and recommendations

The education of psychiatric nurses in Canada has gradually evolved since its inception early in the 20th century. The most obvious advancement has been a move away from institutionally based training to undergraduate university preparation. Associated with this advancement is the ongoing challenge of recruiting and retaining qualified nurse educators. This essay addresses external factors (e.g. title disparity, association affiliation, societal perception of psychiatric nursing and professional identity) and internal factors (e.g. career transition and tenure and promotion) that influence faculty recruitment and retention. Existing challenges and recommendations designed to enhance recruitment and retention efforts are outlined.