Psychiatric Nursing Role and Care (Masters Thesis)

Psychatric Nursing Role and Care

A qualitative exploratory-descriptive study of registered nurses’ perspectives and expectations of psychodynamic therapeutic care in acute psychiatric inpatient facilities

Paper introduction:

Mental health services in Victoria, Australia, like elsewhere in the western world, have undergone rapid change over the past 10 to 15 years and have long been the subject of deep concern (Gournay 2005). According to the Victorian Office of the Public Advocate (2004), one in five Victorians will be diagnosed with a mental illness in their lives and will require mental health care. This report asserts that the care received by those requiring mental health interventions does not always reflect best nursing practice which, for this researcher, is worrying.

The Office of the Public Advocate (2004) suggests a number of recommendations aimed at placing a stronger emphasis on the provision of a greater range of approaches to mental health nursing care and treatment, including psychosocial interventions such as counselling. However, these recommendations fail to consider whether mental health nurses have the capacity to provide psychodynamic care to patients with a mental illness in acute inpatient psychiatric facilities. To gauge this capacity, further information was deemed to be necessary. Areas identified by this researcher requiring investigation were as follows:

• What are the perspectives and expectations of mental health nurses providing psychodynamic therapeutic care in acute inpatient psychiatric facilities?, and
• What processes influence mental health nurses’ perspectives and expectations in developing psychodynamic therapeutic relationships with patients and the provision of psychodynamic therapeutic care within acute inpatient psychiatric facilities?

As a consequence of harbouring a strong desire to answer these concerns this study with the following aims emerged.

Aims of the Study

• Explore and describe mental health nurses’ perspectives and expectations of the provision of psychodynamic therapeutic care in acute inpatient psychiatric facilities, and
• Explore and describe mental health nurses’ concerns with regards to the provision of psychodynamic therapeutic care in acute inpatient psychiatric facilities.

The central question emanating from the above aims for this inquiry was:
What are registered nurses’ perspectives and expectations of psychodynamic therapeutic care in acute psychiatric inpatient facilities?

Paper contents:

• Acknowledgments
• Abstract
• Chapter 1: Introduction and Review of the Literature
  1. Introduction
  2. Personal Journey of this Researcher
  3. Changing Patterns to Mental Health Service Delivery
  4. Aims of the Study
  5. Central Question that Informed this Study
  6. Synopsis of This Thesis
• Chapter 2: Methodology
  1. Introduction
  2. Methodology Employed for this Study
     1. Naturalistic Inquiry
        1. Ontological Considerations
        2. Epistemological Considerations
        3. Selection of a Particular Methodology for this Inquiry
  3. The Choice of Exploratory Descriptive Design for this Study: Taking a Pragmatic Approach
  4. Conclusion
• Chapter 3: Method
  1. Introduction
  2. Participant Selection
  3. Participant Profile
  4. Accessing the Participants
  5. Number of Participants
  6. The Interview Process
  7. Information Analysis
  8. Research Rigour for this Study
     1. Credibility
     2. Fittingness
     3. Auditability
     4. Confirmability
  9. Ethical Considerations
     1. Informed Consent
     2. Confidentiality and Anonymity
     3. Risk Classification
     4. Data Security
  10. Strengths and Weaknesses of the Study
  11. Conclusion
• Chapter 4: Findings and Description
  1. Introduction
  2. Description through the Participants’ Conversations
     1. Question One
     2. Question Two
     3. Question Three
     4. Question Four
     5. Question Five
     6. Question Six
     7. Question Seven
     8. Question Eight
     9. Question Nine
     10. Question Ten
     11. Question Eleven
     12. Question Twelve
  3. Conclusion
• Chapter 5: Summation Analyses of Findings
  1. Introduction
  2. A Review of Available Literature in Relation to the Findings of this Study
  3. The Process of Synthesising the Findings of this Study
     1. Deciphering the trees from the wood: A personal choice of a life-long career
     2. Adapting a philosophical disposition to practice: A position of difference
     3. Relating in a psychodynamic manner: The key to effective intervention
     4. Perceived barriers to the provision of psychodynamic therapeutic care
     5. Future hopes for the profession of mental health nursing
  4. Conclusion
• Chapter 6: Discussion With Review of the Literature and Conclusions
  1. Introduction
  2. Limitations of the Study
  3. Significance of the Study
  4. Implications for Nursing Education, Practice and Research
  5. Recommendations
  6. Conclusion
• References
• Appendices
• Appendix A - Plain Language Statement
• Appendix B - Research Consent Form
• Appendix C - Demographic Data

Paper author:

Patricia Awty RPN, RGN, BN, Cert Ed (Tertiary)

A highly qualified and experienced psychiatric and general nurse, Patrica works in her own private practice as a Mental Health Nurse Educator. Her initial nurse training and clinical experiences in the U.K. combined with substantial clinical work in Australia mainly focuses on the care of adults diagnosed with psychiatric disorders . In the research for her Master of Health Sciences degree thesis, completed in 2007, Patricia explored the psychodynamic therapeutic care of mentally ill patients.

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