Electroconvulsive therapy and the work of mental health nurses: a grounded theory study.
BACKGROUND
There is a long history of nursing practice in the area of electroconvulsive therapy (ECT). Opinions on the involvement of nurses in this treatment reflect the wider debate on its use in the professional and popular media. There is extensive literature on the issues raised by this particular treatment but little research into what nurses actually do when working with patients receiving ECT.


OBJECTIVE
The research question was: How do mental health nurses work with patients having electroconvulsive therapy?


METHODS
This was a Grounded Theory adopting a 'hybrid' approach to the methodology influenced by the differing perspectives of both co-originators, Glaser and Strauss.


METHODS
The research took place in wards and ECT departments in two hospitals in Scotland.


METHODS
Twenty-four mental health nurses, including 4 students working in National Health Service hospitals in Scotland were accessed through purposive, then theoretical sampling. This included non-participant observation of nurses in their work with patients throughout the treatment period and unstructured interviews.


METHODS
Analysis was based upon the constant comparative approach with open coding of data that was examined and compared for similarities and differences. This determined further data collection and theoretical development with regard to their properties and relationships to other codes until the point of saturation.


RESULTS
Nurses' actions in ECT characteristically involve two role groups: relational roles and treatment roles and two dilemmas: uncertain role and uncertain relationships. The core category 'being there' comprising 'engaged', 'present' and 'detached' accounts for nurses' actions in the ECT drama, approaches to difficulties encountered, and, paradoxically, how such actions contributes to this. Slipping is postulated as the basic social psychological process enabling nurses to manage their contact with the patient.
Gass
John
J
School of Nursing and Midwifery, Faculty of Health and Social Care, The Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7QG, UK. j.gass@rgu.ac.uk <j.gass@rgu.ac.uk>
D004565:Electroconvulsive Therapy; D006801:Humans; D011568:Psychiatric Nursing; D012606:Scotland; D000078329:Workforce