Skills and Resources of Psychiatric Mental Health Nurses to Support a Long and Uncertain Recovery Journey: A Grounded Theory Approach

Abstract

Introduction: The importance of recovery-focused practice is widely recognised. However, limited attention has been paid to how nurses continue to engage reflectively and creatively in long-term care settings. Aim: This study explored how nurses provided recovery-oriented care for people with mental illness in long-term, complex, and uncertain care settings. Method: A grounded theory approach was used to analyse data from 14 interviews. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. Results: The core category identified was ‘redefinition of care’, describing a dynamic process in which nurses revised their understanding, adjusted their perspectives, and created new meanings in practice. Key strategies included burden management, exploring new contexts and openness towards uncertainty. Discussion: The findings suggest that high-quality care provision extends beyond technical skills, to emotional resilience, interpretive openness and relational flexibility. Limitations: This study used nurses' retrospective narratives of past cases where recovery progressed. Ongoing cases were not explored. Implications: Nurses could remain present and responsive even with no immediate solutions, a trait described as ‘negative capability’. Supporting this reflective stance may be key to providing quality care. Recommendations: Educational approaches potentially strengthening recovery-oriented care include participatory workshop opportunities that foster pluralistic thinking, dialogue and openness towards uncertainty.