title: Reasons for admission and their implications for the nature of acute inpatient psychiatric nursing.
abstract: The purpose of acute inpatient psychiatric care, and nurses' role within that, are in need of clarification and restatement in order to provide a framework for practice, education, research and development. Inpatient psychiatry has suffered from a paucity of research in recent years. In addition, being a complex system, involving multiple professions with differing ideologies, means that widely accepted succinct descriptions of its purpose are hard to achieve. Yet such a framework is essential to support positive attitudes to patients and for good staff-management relationships. Using an oblique strategy, this paper defines the function of acute inpatient psychiatry, and the role of psychiatric nurses, via a structured examination of the literature on reasons for admission to acute inpatient psychiatric wards. Seven such reasons were discovered and are described: dangerousness, assessment, medical treatment, severe mental disorder, self-care deficits, respite for carers, and respite for the patient. Acute inpatient psychiatric nurses are therefore: providing safety for the patient and others; collecting and communicating information about patients, giving and monitoring treatment; tolerating and managing disturbed behaviour; providing personal care; and managing an environment where patients can comfortably stay. The implications for psychiatric nursing are discussed.
authors.affiliation: Psychiatric Nursing, City University, London, UK. L.Bowers@city.ac.uk
authors.forename: L
authors.initials: L
authors.lastname: Bowers
mesh_terms: D000208:Acute Disease; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D003142:Communication; D003617:Dangerous Behavior; D006272:Health Facility Environment; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000451:nursing; D016294:Models, Nursing; D008991:Monitoring, Physiologic / Q000451:nursing; D024802:Nurse's Role; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009736:Nursing Process; D010343:Patient Admission / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D010344:Patient Advocacy / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011568:Psychiatric Nursing / Q000458:organization & administration*; D012144:Respite Care; D018570:Risk Assessment; D017751:Safety Management; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000451:nursing; D012720:Severity of Illness Index; D006113:United Kingdom