title: Suicidal patients and special observation.
abstract: Special observation is a nursing practice utilized in in-patient psychiatric facilities for patients who are suicidal. Special observation is carried out by an allocated registered nurse remaining continuously at arms length from, or within sight of (as specified), the patient; or a registered nurse observing the patient within a 30 min interval. In this exploratory study, we investigated the role of the registered nurse when caring for patients on special observation. Semistructured interviews were conducted with 10 randomly selected registered nurses from 4 acute psychiatric wards. The 9 themes that emerged were: 1) Safety; 2) Therapeutic relationships; 3) Supporting patients and carers; 4) Consequences of special observation for nurses; 5) Continuity of care concerns; 6) Peer support; 7) Suicide indicators; 8) Responsibilities and rights: nurses and patients; and 9) Nurses, doctors and the hospital hierarchy. Recommendations for alleviation of the concerns about the practice of special observation are outlined and discussed.
authors.affiliation: Central Sydney Area Mental Health Service (CSAMHS), Rozelle, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Cleary
authors.forename: R
authors.initials: R
authors.lastname: Jordan
authors.forename: J
authors.initials: J
authors.lastname: Horsfall
authors.forename: P
authors.initials: P
authors.lastname: Mazoudier
authors.forename: J
authors.initials: J
authors.lastname: Delaney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D006801:Humans; D007587:Job Description; D008875:Middle Aged; D009517:New South Wales; D009730:Nursing Assessment / Q000379:methods*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D019370:Observation; D010362:Patients' Rooms; D011568:Psychiatric Nursing / Q000379:methods*; D012308:Risk Management / Q000379:methods; D017751:Safety Management / Q000379:methods*; D012944:Social Support; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention