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McCluskey A, Watson C, Nugent L, O'Connor T, Moore Z, Molloy L, Patton D. 'Sometimes You Have No Choice but to Give Them Medication': Experiences of Nurses Caring for People With Auditory Hallucinations in an Acute Unit. Int J Ment Health Nurs 2024. [PMID: 38965712 DOI: 10.1111/inm.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
The aim of this study was to explore psychiatric nurse's experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi-structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overall, participants identified their role in the management of risk within an acute unit, the importance of their therapeutic role and a perceived over-reliance on medication administration as a primary nursing intervention. These findings thus demonstrate the personal and professional conflict that nurses face when working in an acute unit with patients who experience auditory hallucinations. Nurses are in a prime position to provide effective interventions and assistance for people with auditory hallucinations in an acute unit. The findings of this study indicate that mental health nurses may require additional support and education to provide care in a truly recovery-based manner, with training in specific interventions and engagement skills for people who hear voices. Due to an unpredictable environment and sometimes high-risk workplace, nurses may also benefit from organisational assistance in this area.
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Affiliation(s)
- Anita McCluskey
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Chanel Watson
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Linda Nugent
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
| | - Tom O'Connor
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- School of Nursing and Midwifery and Lead Researcher, Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Nursing, Lida Institute, Shanghai, China
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Zena Moore
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- School of Nursing and Midwifery and Lead Researcher, Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Nursing, Lida Institute, Shanghai, China
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourbe, Victoria, Australia
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- University of Wales, Cardiff, UK
| | - Luke Molloy
- Department of Medicine and Health, School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Declan Patton
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Bail K, Merrick E, Fox A, Gibson J, Hind A, Moss C, Strickland K, Redley B. Ten statements to support nurse leaders implement e-health tools for nursing work in hospitals: A modified Delphi study. J Clin Nurs 2021; 30:1442-1454. [PMID: 33555638 DOI: 10.1111/jocn.15695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 11/29/2022]
Abstract
AIM To use expert consensus to develop guidance for nurse leaders implementing e-health tools to support nursing work in hospitals. BACKGROUND Nurse leaders are increasingly required to make decisions about the selection, development, implementation and optimisation of e-health tools for nursing work in hospitals. Guidance in this rapidly evolving and complex space is limited. DESIGN A two-phase modified Delphi study. METHODS Phase one involved in-depth interviews with five nursing informatics experts. Analysis used the qualitative framework method, informed by the Theoretical Domains Framework (TDF), to develop statements for an anonymous online Delphi scoring survey. This was distributed using snowball sampling methods to Australian nurse informatics leaders and experts. Final analysis involved synthesis of qualitative and quantitative data. The study adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. RESULTS Ten guidance statements to support nurse leaders to implement e-health tools in hospitals were developed from the synthesis of qualitative interview data and 29 experts' responses to the 55-item Delphi response survey. CONCLUSION Implementation of e-health tools for nursing work is complex in health settings and requires careful examination of multiple factors and interactions between clinicians, tools, service users and the health organisation. This research proposes ten statements to support nurse leaders with decisions about implementing e-health tools to support nursing work in hospitals. RELEVANCE TO CLINICAL PRACTICE The ten statements developed by this research provide a resource to assist policy and practice decisions about e-tools to ensure they are suited to supporting nursing work. Nurse leaders can use the ten statements for guidance in the selection, development, implementation and optimisation of e-health tools to ensure suitability and adaptation for nursing work in hospitals.
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Affiliation(s)
- Kasia Bail
- Discipline of Nursing, University of Canberra, Canberra, ACT, Australia
| | - Eamon Merrick
- School of Clinical Science, Auckland University of Technology, Auckland, New Zealand
| | - Amanda Fox
- School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia
| | - Jo Gibson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, ACT, Australia
| | - Alicia Hind
- University of Canberra, Canberra, ACT, Australia
| | - Cameron Moss
- University of Canberra, Canberra, ACT, Australia
| | - Karen Strickland
- School of Nursing, Midwifery and Public Health, University of Canberra, Canberra, ACT, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
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Rio JHM, Fuller J, Taylor K, Muir-Cochrane E. The impact of workplace culture on the accountability of mental health nurses to involve consumers in care planning: A focused ethnography. Nurs Health Sci 2021; 23:255-262. [PMID: 33389799 DOI: 10.1111/nhs.12807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 02/03/2023]
Abstract
Recovery-oriented mental health practice guidelines recommend regular consumer involvement in care plans, yet in many acute settings, these are not routinely created thereby compromising accountability. This study explored the impact of workplace culture on the capacity of mental health nurses to involve consumers in care planning and consequently to work accountably. A focused ethnography was undertaken in one Australian inpatient unit involving mental health nurses and other health professionals. Data were derived from in-depth semistructured interviews with 12 nurses and 6 months of nonparticipant observation of multidisciplinary meetings and clinical handovers. Workplace culture had an impact on mental health nurses' accountability practices. A culture that prioritized reduction in length of stay resulted in less recovery-oriented care. Health professionals who paid more attention to crisis and risk management resulted in fewer opportunities for consumer-involved care planning.
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Affiliation(s)
- Josephien H M Rio
- College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia.,Riverland Mallee Coorong Local Health Network (Mental Health Services), Berri, South Australia, Australia
| | - Jeffrey Fuller
- College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Kerry Taylor
- College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Eimear Muir-Cochrane
- College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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Rio JHM, Fuller J, Taylor K, Muir-Cochrane E. A lack of therapeutic engagement and consumer input in acute inpatient care planning limits fully accountable mental health nursing practice. Int J Ment Health Nurs 2020; 29:290-298. [PMID: 31859453 DOI: 10.1111/inm.12684] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2019] [Indexed: 02/03/2023]
Abstract
It is mental health consumer's human right to lead a fulfilling life as they are empowered to actively manage their recovery. This can be facilitated through care planning, yet research suggests that the care plan is not routinely created, discussed, or updated in acute mental health settings. Research on care planning and the role of the mental health nurse highlights the importance of therapeutic communication in care plan development. This paper argues that the lack of meaningful care plan discussions between consumers and mental health nurses in an acute setting is a limitation to the practice of fully accountable mental health nursing care. We explore this limitation in quality care provision by examining literature on accountability and conclude that in mental health nursing, accountability is frequently enacted through an overarching focus on the organizational need to manage risks, rather than on therapeutic engagement.
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Affiliation(s)
- Josephien H M Rio
- College of Nursing & Health Sciences Flinders University, Adelaide, Australia.,Mental Health - Central Australian Health Service, Alice Springs, Australia
| | - Jeffrey Fuller
- College of Nursing & Health Sciences Flinders University, Adelaide, Australia
| | - Kerry Taylor
- College of Medicine & Public Health, Flinders University, Adelaide, Australia
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