Psychiatric Nursing Revisited The Care

Psychiatric Nursing Revisited is a detailed and empirical study of acute mental health nursing and patient activity that joins a family of similar successful studies, such as Altschul (1972); Towell (1975); Cormack (1976, 1983); Faulkner et al (1994) and Hurst (1993, 1995). The far-ranging recommendations made by the authors, based on their findings, make this book an essential resource for all those who nurse, manage or teach in the field of psychiatric nursing.

Ray Higgins and Keith Hurst are the authors of Psychiatric Nursing Revisited: The Care Provided for Acute Psychiatric Patients, published by Wiley.

Acknowledgements

ix

Psychiatric Nursing Revisited-An Overview

1

(12)

Setting the Scene

13

(16)

Historical Overview

Recent Context

Slow Progress Towards Community Care

Rising Demand for Services

Overview of Nursing Practice

Summary

Research Methods

29

(14)

Selection of Fieldwork Sites

Statistical Profile of Fieldwork Sites

Pre-pilot and Pilot Studies

Main Study

Non-participant Observation of Ward Staff and Patients

Analys ing Fieldwork Data

Postal Survey

Feedback Seminars for Fieldwork Sites

Summary

The Hospital Care Context

43

(24)

Ward Environments

Summary of the Features of Fieldwork Sites

Summary of the Ward Characteristics

Patient Populations

Features of Patient Populations

Discussion

Summary

Management and Leadership

67

(27)

Staff Cover

Organisational Arrangements

Service Development

Staff Support

Stress and Staff Sickness

Clinical Supervision

Barriers to Effective Management and Leadership

Responsibility, Accountability and Authority

Paperwork and Administrative Duties

Summary

Caring for Patients

94

(53)

Admission to Hospital

Risk Assessment and Management

Benefits of Hospitalisation

Admission Procedures

The Care Process

Therapeutic Relationship Between Named Nurse and Patient

Patients' Emotional Cues to which Nurses Respond

Nursing Care

Therapeutic Groupwork

Multidisciplinary Working

Communication and Counselling

Updating Care Plans

Other Ward Activities

The Role of Nursing Assistants

Basic and Continuing Education

The Nursing Contribution to Patient Care

Patients' Perceptions of Nursing Care

Discharge and Aftercare Arrangements

The Care Programme Approach

Summary

Summary of Findings, Conclusions and Recommendations

147

(12)

Patient Populations

Basic and Continuing Education

Activities Performed by Ward Staff

Grade E and D Nurse Activity

Defensive Practice

Multidisciplinary Working

Grade A Nursing Assistants

Patients' Perceptions of Nursing Care

Implications for Policy and Practice

Appendix 1 National and Regional Statistics

159

(14)

Appendix 2 Trust Profile

173

(4)

Appendix 3 Ward Environment List

177

(3)

Appendix 4 Ward Manager Questionnaire

180

(4)

Appendix 5 Fieldwork Plan

184

(2)

Appendix 6 Manager and Nurse Interview Questions

186

(29)

Appendix 7 Glossary for Nurse and Patient Schedules

215

(9)

Appendix 8 Report on the Qualitative Pre-pilot Project

224

(8)

Appendix 9 Report on the Qualitative Pilot Project

232

(12)

Appendix 10 Patient Profile

244

(1)

Appendix 11 Nurse Activity and Personal Details Questionnaire

245

(8)

Appendix 12 Postal Survey of Trust Profiles

253

(7)

Appendix 13 Postal Survey of Ward Profiles and Operational Routines for Acute Psychiatric Admission Wards

260

(14)

Appendix 14 Summary Reports from Feedback Seminars

274

(9)

Appendix 15 Additional Data for Text Figures

283

(21)

Bibliography

304

(11)

Index

315

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Psychiatric Nursing Revisited The Care Provided for Acute Psychiatric Patients

Summary

Author Biography

Table of Contents

Supplemental Materials