ABSTRACT
PURPOSE: This paper explores concepts central to acting, and details how these concepts can be related to mental health nursing practice. DESIGN AND METHODS: The work of the acting theorists Constantin Stanislavski and Lee Strasberg is examined and recontextualized to illustrate how their work is relevant in modern mental health practice, and the development of empathy. FINDINGS: While these concepts are still utilized in drama, they have not been fully explored in their original context. Their use could combat stress and burnout, heighten awareness, and enhance the projection of emotions. PRACTICE IMPLICATIONS: These concepts can be linked with reflective practice in mental health, and a stronger emphasis on the values of this approach could allow the nurse to strengthen the level of empathy they demonstrate.
Subject(s)
Drama , Empathy , Psychiatric Nursing/standards , Psychiatry/standards , HumansABSTRACT
PURPOSE: This paper addresses the conceptual wrangle that occurred during the initial stages of a grounded theory doctoral study into the nature of moral distress within multidisciplinary teams (MDTs) working within the acute mental health services in the Republic of Ireland. DESIGN AND METHODS: While grounded theory methodology directs that face sheet data (biographical details) are not collected unless they emerge as significant events within the data, practitioners within this study were asked to describe the structure, formulation, and practice of their team prior to interview, in order to establish the field of study. FINDINGS: Early analysis of the responses revealed that of 32 multidisciplinary members interviewed, none agreed on structure, formulation, and practice of their MDT. PRACTICE IMPLICATIONS: This finding suggests that caution needs to be taken in assuming a common understanding of the concept of MDT in research, policy formation, and team development.
Subject(s)
Mental Health Services/organization & administration , Nurses/psychology , Patient Care Team/organization & administration , Physicians/psychology , Stress, Psychological , Humans , Ireland , Morals , Patient Care Team/ethics , Psychiatry/organization & administration , Psychological Theory , Social Work, Psychiatric/organization & administrationABSTRACT
PURPOSE: The purpose of this study was to investigate moral distress in Irish psychiatric nurses. DESIGN: A qualitative descriptive methodology was used. FINDINGS: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings. PRACTICE IMPLICATIONS: The findings indicate that while multidisciplinary teams appear to function well on the surface, situations that give rise to moral distress are not always acknowledged or dealt with effectively. Furthermore, unresolved moral conflict impacts upon the quality of clinical decision-making by not allowing open and transparent discussions that allow clinicians the opportunity to address their concerns adequately.
Subject(s)
Adaptation, Psychological , Conflict, Psychological , Cross-Cultural Comparison , Ethics, Nursing , Moral Obligations , Psychiatric Nursing/ethics , Clinical Nursing Research , Decision Making , Female , Humans , Internal-External Control , Ireland , Male , Nurse's Role/psychology , Physician-Nurse Relations , Psychiatric Nursing/legislation & jurisprudenceABSTRACT
Moral distress has received much attention in the international nursing literature in recent years. In this article, we describe the evolution of the concept of moral distress among nursing theorists from its initial delineation by the philosopher Jameton to its subsequent deployment as an umbrella concept describing the impact of moral constraints on health professionals and the patients for whom they care. The article raises worries about the way in which the concept of moral distress has been portrayed in some nursing research and expresses concern about the fact that research, so far, has been largely confined to determining the prevalence of experiences of moral distress among nurses. We conclude by proposing a reconsideration, possible reconstruction and multidisciplinary approach to understanding the experiences of all health professionals who have to make difficult moral judgements and decisions in complex situations.
Subject(s)
Attitude of Health Personnel , Burnout, Professional/psychology , Morals , Nursing Methodology Research/organization & administration , Nursing Staff , Adaptation, Psychological , Burnout, Professional/etiology , Burnout, Professional/prevention & control , Codes of Ethics , Conflict, Psychological , Decision Making/ethics , Ethical Theory , Focus Groups , Health Knowledge, Attitudes, Practice , Humans , Interdisciplinary Communication , Judgment/ethics , Narration , Nurse's Role/psychology , Nursing Staff/ethics , Nursing Staff/psychology , Nursing Theory , Patient Care Team/organization & administration , Philosophy, Nursing , Psychological Theory , Research Design , Workplace/organization & administration , Workplace/psychologyABSTRACT
The purpose of this research was to investigate whether there currently exists among Irish psychiatric nurses a collective set of attitudes, values, and beliefs that underpin their lived experience as individual Irish psychiatric nurses. The study supports findings of a multifaceted role and suggestions that time spent with clients, accessibility and approachability, and the quality of nurse-client relationships as perceived by clients are valued by psychiatric nurses. The study also supports some aspects of study, in particular, the coordinating/"dogsbody" aspect of the psychiatric nursing role, the hindrance experienced in developing therapeutic roles, and the ad hoc and reactive nature of the role. In addition, the study supports the emphasis that these nurses put on the caring aspect of their role through the development of discrete interpersonal relationships with their clients; however, there was limited evidence of a formalized philosophy to support this practice, suggesting that Irish psychiatric nursing is in a pre-paradigm state.
