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The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.

A focus group of 10 graduate psychiatric nurses with more than two years’ practice in inpatient psychiatric settings reflected on their last six months’ work placements and continuous employment. The transcripts and field notes were analyzed through thematic analysis of inductive data.

Two main themes emerged: management roles and clinical roles. The participants reflected on caring activities and obstacles encountered in fulfilling their professional roles.

Multiple practice issues emerged. The participants perceived that psychiatric nurse specialists are required to perform more caring functions than practicable in the inpatient setting due to an excess of noncaring duties, structural minimization of the caring role and inadequate training. They felt that many of the functions performed were not within their expectations of the caring role of a psychiatric nurse specialist and believed that changes in nurse education and attention to clarification of nurses’ roles might enhance the role they play in patient care.

Nurses with specialised knowledge, experience and education are needed to provide specific care in nursing subspecialties such as child and adolescent mental health (CAMH) nursing. However, some of these attributes are implicit and not clear to the wider nursing community. The purpose of this paper is to explore the applicability of a conceptual framework for CAMH inpatient nursing practice to other areas of CAMH nursing practice. This paper presents an exploratory study regarding the applicability of the framework to two small cohorts of CAMH nurses. This study was conducted in Tasmania, Australia and Northern Denmark. These settings were chosen due to the self-perceived knowledge gap surrounding the role and professional identity of these Australian and Danish CAMH nurses.

An exploratory qualitative study within the social constructivist paradigm was undertaken. The method of data collection was two focus groups of CAMH nurses in Tasmania, Australia and Northern Denmark. The data were analysed using an adaptation of a six-phase thematic analysis process.

The analysis of the data resulted in three themes: individual preparation and experience of CAMH nurses, knowledge transfer and nurses’ perceptions of their individual and team roles. The findings have contributed new knowledge of CAMH nursing.

The findings of this study may support the applicability of the conceptual framework with participants’ endorsing that it reflects their role.

Nursing teams supporting people with intellectual disabilities in inpatient settings are known to be vulnerable to burnout, compassion fatigue and vicarious trauma. Aspects such as resourcing, support, training and the fundamental challenges of supporting this patient group are known risk factors for these difficulties. The aim of this paper is to synthesise the literature on these issues and provide suggestions for operationalising solutions.

Literature on the experiences of nursing teams supporting people with intellectual disabilities in inpatient settings was considered, alongside the established offer of clinical psychologists working into these services.

There are common themes of staff’s emotional health and the impact this can have on patient care and the steps that managers and organisations can take to support their teams to remain emotionally healthy, compassionate and effective practitioners. Clinical psychology can play a role in offering this support only where services and teams are aware of the contribution they can make.

Clinical psychology has been undersold and under-represented in inpatient settings for people with intellectual disabilities, and this practice paper outlines the important contributions that they can make to the psychological well-being of all within the system, not just patients.

The purpose of this paper is to investigate professional quality of life of mental health nursing staff working within an adolescent psychiatric intensive care unit (PICU) setting. Professional quality of life is important, as there is a correlation between staff wellbeing and the quality of healthcare services delivered, particularly within mental health settings. Mental health nursing staff in adolescent PICU services deal with a wide range of physically and emotionally demanding challenges when providing care, yet the potential impact of this demanding work upon staff in this context has not been explored.

The study used a longitudinal non-experimental design with a purposive sample. Quantitative data were collected from a total of 17 registered mental health nurses and healthcare assistants (HCAs) working in an adolescent PICU in the North of England. Repeated measures were administered at three consecutive intervals, three months apart, using a validated self-report measure, the Professional Quality of Life Scale V (ProQOL V, Stamm, 2010). Data were analysed using descriptive and inferential statistical analysis using benchmark data from the ProQOL V instrument for comparison.

Analysis of results compared to ProQOL V benchmark data showed significantly higher than expected levels of compassion satisfaction, and lower than expected levels of burnout and secondary traumatic stress for adolescent PICU nursing staff within the study. There were no significant differences between qualified nurses and HCAs. Potential explanations and practice implications of these findings are discussed.

This is the first published study to investigate professional quality of life within the mental health nursing population working in adolescent PICU, providing empirical insights into a previously unexplored mental health context.

This paper adds to growing research of psychiatric intensive care units (PICU) by recounting descriptions of psychiatric intensive care settings and discusses the perceptions held by nurses of the organisational interfaces, arrangements and provisions of care in these settings.

Data gathered from focus groups held with nurses from two PICUs was used to establish terminology, defining attributes, related concepts, antecedents, values, processes and concepts related to current practices. A literature search was conducted to permit a review of the conceptual arrangements and contemporary understanding of intensive care for people experiencing acute psychiatric illness based on the perspectives held by the nurses from the focus groups.

Dissonance between service needs and the needs and management of individual patients overshadow strategies to implement comprehensive recovery-oriented approaches. Three factors are reported in this paper that influence standards and procedural practice in PICU; organisational structures; physical structures; and subtype nomenclature.

Acute inpatient care is an important part of a comprehensive approach to mental health services. Commonly intensive acute care is delivered in specialised wards or units co-located with acute mental health inpatient units mostly known as PICU. Evidence of the most effective treatment and approaches in intensive care settings that support comprehensive recovery for improved outcomes is nascent.

Current descriptions from nurses substantiate wide variations in the provisions, design and classifications of psychiatric intensive care. Idiosyncratic and localised conceptions of psychiatric intensive care are not adequately entailing effective treatment and methods in support of recovery principles for improved and comprehensive outcomes. The authors suggest that more concrete descriptions, guidelines, training and policies for provision of intensive psychiatric health care encompassing the perspective of nursing professionals, would reinforce conceptual construction and thus optimum treatments within a comprehensive, recovery-oriented approach to mental health services.

This study aimed to determine the effect of role conflict and role ambiguity on job satisfaction, self-efficacy and nurses’ adaptability and improvement in service quality by analysis of quality function deployment.

This study used a cross-sectional study design. The research sample of 115 nurses and 299 patients was obtained through the use of probability sampling techniques. Data were statistically analyzed using Spearman’s test to see the correlation between independent and dependent variables. Kruskal–Wallis and one-way ANOVA were used to see the differences and quality function deployment analysis was conducted to improve service quality.

The study concluded there is influence of role conflict and role ambiguity on job satisfaction, self-efficacy and nurses’ adaptability. There are differences in role ambiguity in the inpatient unit, critical room and the emergency room.

The quality of service in the hospital can be improved by evaluating the behavior of nurses on the quality of service perceived by the patient. In addition, the necessary improvement of discipline and commitment between physicians and nurses in improving the quality of services at the hospital.

With this measure, the management of nursing at the hospital can translate patient’s needs into specific plans to produce products and services that bring together the needs of the patient to service quality.

Nurses working in acute mental-health services are vulnerable to occupational stress. One stressor identified is the challenging behaviour of some service users (Jenkins and Elliott, 2004). The purpose of this paper is to discuss the discourses drawn on by nurses to understand challenging behaviour and talk about its management.

Nurses working on acute and psychiatric intensive care unit (PICU) wards were interviewed, and data were analysed using discourse analysis.

Biomedical and systemic discourses were found to be dominant. Alternative psychosocial and emotional discourses were drawn on by some participants but marginalised by the dominant biomedical construction of challenging behaviour.

Existing studies have not considered how discourses socially construct challenging behaviour and its management in inpatient mental-health services.

The purpose of this paper is to present an evocative story “Resisting the Ban” which illustrates the ethical and pragmatic issues that nurses face when contending with smoking ban policies in inpatient psychiatric settings.

The creative story “Resisting the Ban” was developed based on an organisational auto-ethnographic approach. The story was crafted through employing creative writing techniques and through framing and critiquing memories via several theoretical frames.

The story illustrates how smoking ban policies have created pragmatic and ethical issues on wards. The work practices of nurses have changed as have their relationships with patients. The liberties of involuntary patients have also been infringed.

This approach can illuminate links between acts of resistance and issues associated with public policies.

The effects of smoking bans need to be considered more carefully particularly in relation to their effects on workers and patients. The social meaning of the smoking bans needs closer investigation. Policy needs to be recrafted so that it better addresses the liberties of involuntary patients. Also ward nurses need to be able to carry out their roles in a manner which is consistent with their values.

Public policies, such as smoking bans, can produce negative consequences maligning relationships, practices and cultures. Critical auto-ethnography provides a means of understanding issues that have resulted from problematic policies.

Scholarly work conducted on the relationship between everyday resistance in workplaces and public policies is rare. This study offers new “insider” insights into the negative effects of a smoking ban policy in psychiatric inpatient settings.

Centralization, mergers and cost reductions have generally led to increasing levels of span of control (SOC), and thus potentially to lower leadership capacity. The purpose of this paper is to explore how a large SOC impacts hospital staff and their leaders.

The study is based on a qualitative explorative case study of three large inpatient wards.

The study finds that the nursing staff and their frontline leaders experience challenges in regard to visibility and role of the leader, e.g., in creating overview, coordination, setting-up clear goals, following up and being in touch. However, large wards also provide flexibility and development possibilities.

The authors discuss the implications of these findings for decision makers in deciding future SOC and for future SOC research.

Only few studies have qualitatively explored the consequences of large SOC in hospitals.

The purpose of this paper is to better understand the influence of service quality and corporate image of Brazil’s National Cancer Institute (INCA) on the satisfaction of its outpatients.

The study is quantitative, with data collected from a self-administered structured questionnaire answered by a sample of 434 outpatients of Hospital do Câncer I, the largest and oldest hospital operated by the INCA. The data were treated with covariance-based structural equation modeling.

The results indicated that the corporate image of the INCA was the main factor having a positive influence on the patients’ satisfaction, followed by the quality of the services rendered by physicians and the quality of the hospital’s facilities.

The study shows that unlike indicated by the theory, quality does not have a direct impact on satisfaction with the nursing services, but rather an indirect impact via corporate image. Even though part of the explanation can be the fact that only outpatients were surveyed, who have less interaction with the nursing team than do inpatients, this result shows the strength of the hospital’s corporate image regarding patients’ satisfaction. Besides this, the study identified that hospitals with a strong corporate image transmit to patients the perception that they are being treated by technically qualified professionals, thus increasing the chances of cure and reduced suffering. This is fundamental for patients’ satisfaction, as most are unable to understand the technical attributes of the service. The study adds to the scarce Brazilian literature on the causal relation between the image of hospitals and their patients’ satisfaction.