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

High levels of distress and disturbance amongst those experiencing acute mental illness can be a major problem for mental health nurses. The feelings experienced by these nurses when caring for and supporting 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 context. 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 inpatient psychiatric settings. Results: Data were analysed using content analysis. Findings highlighted 6 broad themes: 1) Mixed emotions: expressive and responsive, 2) Procedure for caring for and supporting disturbed and/or distressed patients, 3) Use of guidelines for caring and supporting disturbed and/or distressed patients, 4) Team and organisational support, 5) Ethical 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 standards 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 emotional quandaries concurrent with cognitive dissonance 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 dissonance experienced by mental health nurses caring for distressed and/or disturbed inpatients in acute psychiatric settings. Increased access to education and training with particular attention to interpersonal communication and relationship building within clinical teams needs to be a priority given the experiences described by mental health nurses.

The Impact of an eLearning Course on Nurses’Attitudes towards Mental Illness

Patients with mental illness are stigmatized. Health care professionals may even perpetuate stigma towards mental illness. Thus it is important to ensure that health care professionals have positive attitudes towards patients with mental illness. The aim of this study was to estimate the impact of an eLearning course on psychiatric nurses’ attitudes towards mental illness. A cluster-randomized trial (ISRCTN32869544) design was used. Twelve wards were randomly assigned to the eLearning course (ePsychNurse.Net) group or the education as a usual group. The participants (N = 228) were allocated to the intervention (n = 115) or control group (n = 113) according their baseline ward affiliation. Attitudes were rated according to the Community Attitude towards the Mentally Ill scale. Both groups were found to have positive, not stigmatized attitudes towards mental illness. No statistically significant changes were found at three-month or nine-month follow-up. It may be that by developing the ePsychNurse.Net course to include more material related to nurses’ attitudes and as nurses become more familiar with eLearning, the course may be effective in shaping nurses’ attitudes towards mental illness. On the other hand, our study’s nine- month time span may have been too short to change nurses’ attitudes.