The feelings and thoughts of mental health nurses concerning the management of distressed and disturbed in-patients: A comparative qualitative European study

Abstract

High levels of distress and disturbance amongst those experiencing acute mental illness can be a major problem for mental health nurses. The feelings ex- perienced by these nurses when caring for and sup- porting disturbed and/or distressed patients along with their concurrent thoughts are not well described in the literature. To date, this complex issue has not been explored within a comparative European con- text. The objective of this qualitative study was to explore the feelings and thoughts of mental health nurses when supporting and caring for distressed and/or disturbed patients in 6 European countries. Methods: Focus groups were used to collect data from 130 mental health nurses working in acute inpa- tient psychiatric settings. Results: Data were analysed using content analysis. Findings highlighted 6 broad themes: 1) Mixed emotions: expressive and respon- sive, 2) Procedure for caring for and supporting dis- turbed and/or distressed patients, 3) Use of guidelines for caring and supporting disturbed and/or distressed patients, 4) Team and organisational support, 5) Ethi- cal concerns: Cognitive dissonance and 6) Education and training. Commonalities and differences were found across all themes. Approaches to care, nurses’ role and education, clinical guidelines and/or stan- dards vary from country to country, therefore the care, treatment and management of distressed and/or disturbed patients are various. As a result, mental health nurses have different experiences, various emo- tional quandaries concurrent with cognitive disso- nance and different coping strategies when caring for and supporting distressed and disturbed patients. Conclusions: More emphasis needs to be given to the emotional quandaries and concurrent cognitive disso- nance experienced by mental health nurses caring for distressed and/or disturbed inpatients in acute psy- chiatric settings. Increased access to education and training with particular attention to interpersonal communication and relationship building within clini- cal teams needs to be a priority given the experiences described by mental health nurses.