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Acute Inpatient Setting (acute + inpatient_setting)
Selected AbstractsMental health nurses establishing psychosocial interventions within acute inpatient settingsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2009Antony Mullen ABSTRACT Acute inpatient units provide care for the most acutely unwell people experiencing a mental illness. As a result, the focus for care is on the containment of difficult behaviour and the management of those considered to be ,at high risk' of harm. Subsequently, recovery-based philosophies are being eroded, and psychosocial interventions are not being provided. Despite the pivotal role that mental health nurses play in the treatment process in the acute inpatient setting, a review of the literature indicates that mental health nursing practice is too custodial, and essentially operates within an observational framework without actively providing psychosocial interventions. This paper will discuss the problems with mental health nursing practice in acute inpatient units highlighted in the current literature. It will then put forward the argument for routine use of psychosocial interventions as a means of addressing some of these problems. [source] ,She's manipulative and he's right off': A critical analysis of psychiatric nurses' oral and written language in the acute inpatient settingINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2006Bridget Hamilton ABSTRACT:, Remarks such as ,she's manipulative' and ,he's right off' are familiar to psychiatric nurses. This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses' writing and speaking about patients. Based on a review of the literature, this paper examines ethnographic studies and discourse analyses of psychiatric nurses' oral and written language. A prominent debate in the literature surrounds nurses' use of standardized language, which is the use of set terms for symptoms and nursing activities. This review of spoken descriptions of patients highlights nurses' use of informal and local descriptions, incorporating elements of moral judgement, common sense language and empathy. Research into written accounts in patient files and records show nurses' use of objectifying language, the dominance of medicine and the emergence of the language of bureaucracy in health services. Challenges to the language of psychiatry and psychiatric nursing arise from fields as diverse as bioscience, humanism and social theory. Authors who focus on the relationship between language, power and the discipline of nursing disagree in regard to their analysis of particular language as a constructive exercise of power by nurses. Thus, particular language is in some instances endorsed and in other instances censured, by nurses in research and practice. In this paper, a Foucauldian analysis provides further critique of taken-for-granted practices of speech and writing. Rather than censoring language, we recommend that nurses, researchers and educators attend to nurses' everyday language and explore what it produces for nurses, patients and society. [source] Patients' experiences of psychosis in an inpatient settingJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2003K. KOIVISTO RN MNSC The aim of this report was to describe patients' experiences of psychosis in an inpatient setting. Mental illness, as a result of psychosis, has traditionally been defined from the viewpoint of clinical experts. Psychiatric nursing, as an interactive human activity, is more concerned with the development of the person than with the origins or causes of their present distress. Therefore, psychiatric nursing is based on eliciting personal experiences and assisting the person to reclaim her/his inner wisdom and power. The design of the study, in the report discussed below, was phenomenological. In 1998, nine patients were interviewed regarding their experiences of psychosis in an acute inpatient setting. The verbatim transcripts were analysed using Giorgi's phenomenological method. The participants experienced psychosis as an uncontrollable sense of self, which included feelings of change and a loss of control over one's self with emotional distress and physical pain. The participants described the vulnerability they had felt whilst having difficult and strange psychological feelings. The informants experienced both themselves and others sensitively, considered their family and friends important and meaningful, and found it difficult to manage their daily lives. Furthermore, the informants experienced the onset of illness as situational, the progress of illness as holistic and exhaustive, and the admission into treatment as difficult, but inevitable. [source] Mental health nurses establishing psychosocial interventions within acute inpatient settingsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2009Antony Mullen ABSTRACT Acute inpatient units provide care for the most acutely unwell people experiencing a mental illness. As a result, the focus for care is on the containment of difficult behaviour and the management of those considered to be ,at high risk' of harm. Subsequently, recovery-based philosophies are being eroded, and psychosocial interventions are not being provided. Despite the pivotal role that mental health nurses play in the treatment process in the acute inpatient setting, a review of the literature indicates that mental health nursing practice is too custodial, and essentially operates within an observational framework without actively providing psychosocial interventions. This paper will discuss the problems with mental health nursing practice in acute inpatient units highlighted in the current literature. It will then put forward the argument for routine use of psychosocial interventions as a means of addressing some of these problems. [source] Section 5(4) (The nurse's holding power): patterns of use in one mental health trust (1983,2006)JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010R. ASHMORE bsc(hons) rmn ma pgce dip coun Accessible summary ,,Section 5(4) (Nurses' holding power) allows a mental health nurse to detain a patient admitted informally to hospital for treatment of a mental health problem for up to 6 h or until they are assessed by a doctor. ,,The use of the holding power has risen significantly since its introduction in 1983 to an average of 1442 per annum (range 789,1953 per annum). ,,The study identifies a number of factors in relation to the use of Section 5(4) including: gender, clinical setting, temporal patterns and medical response time. ,,Although the majority of patients are assessed by a doctor within 4 h of the holding power being applied, 8.3% are detained for 6 h or longer. There is a need to explore this and other issues further. Abstract The majority of studies exploring the use of Section 5(4) (Nurses' holding power) of the Mental Health Act 1983 are now dated, report on small numbers and have been undertaken over relatively short periods of time. A retrospective study was undertaken which sought to identify the factors associated with the use of the section in one mental health trust over a 24-year period (1983,2006). Section 5(4) was applied on 803 occasions, an average of 33.4 times per annum. The majority of sections were applied to female patients (58.4%) by male nurses (54.9%) within adult acute inpatient settings (93.4%). Significant differences were noted in the use of the section over the 24-h period but not for month of the year or day of the week. A total of 349 (43.5%) sections were implemented during doctors' ,office hours' (Monday,Friday, 9:00 h to 17:00 h). The mean length of time spent on the section was 140 min; 80.6% of patients were assessed by a doctor within 4 h; and 8.3% remained on the section for 6 h or more. The holding power was converted to another section of the Act on 642 (80%) occasions. A similar, multi-sited prospective study could be undertaken to validate the findings of this study. [source] Suicide-related behavior after psychiatric hospital discharge: implications for risk assessment and management,BEHAVIORAL SCIENCES & THE LAW, Issue 6 2006Jennifer L. Skeem Ph.D. Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||