– Psychiatric inpatient staff experience a lack of organizational support in providing person-centred, relationship-oriented care, says Sebastian Gabrielsson who recently became doctor of philosophy in nursing following a dissertation on psychiatric inpatient care from the perspective of professional caregivers.
A wish to meet patients needs
The thesis builds on literature reviews and interviews with a total of 38 nurses, ward managers and physicians in Swedish inpatient psychiatry. Findings show that while professional caregivers strive to do good the organizational features of care and scarce resources works against them. Sebastian Gabrielsson argues that good caring care is self-reinforcing as being content and seeing good results facilitates nurses taking a personal responsibility for their nursing practice, thus meeting patients individual needs. The opposite is also true.
– Nurses who are forced to participate in poor care feel bad and might respond by leaving inpatient care or the nursing profession. Others might adapt to lower standards or choose to focus on technical aspects of work, such as medication administration or documentation, rather than building relationships and meeting patients as persons.
Difficulties in taking a personal responsibility for patients’ well-being might contribute to poor quality of care and make inpatient psychiatry less attractive as a workplace which might in part explain the shortage of nurses in inpatient psychiatry, says Sebastian Gabrielsson.
Close relationships important
A main conclusion drawn in the thesis is that nurses in psychiatric inpatient care need to focus on patients’ experiences and needs. For this they need sufficient resources and time to be present and develop relationships with patients. Nurses in psychiatric inpatient care also need to take personal responsibility for their professional practice and reflect critically.
– Attempts to transform psychiatric care in a person-centred direction must consider all of these aspects and their interrelatedness. Further research on psychiatric inpatient care is needed to understand more about how the content of care relates to the context of care, says Sebastian Gabrielsson.
Sebastian Gabrielsson is a registered nurse specialized in psychiatric care and experienced in acute psychiatric inpatient care. The title of the thesis is A moral endeavour in a demoralizing context: Psychiatric inpatient care from the perspective of professional caregivers.