title: Nurse's perspectives on care provided for patients with gamma-hydroxybutyric acid and gamma-butyrolactone abuse.
abstract: OBJECTIVE
  To describe registered nurses' views and experiences providing care for gamma-hydroxybutyric acid and gamma-butyrolactone abuse inpatients in a psychiatric unit.
  
  
  BACKGROUND
  Gamma-hydroxybutyric acid and gamma-butyrolactone are illegal drugs with potentially fatal outcomes that are entering wider use in Scandinavia. Gamma-hydroxybutyric acid-dependent persons with withdrawal symptoms often require forceful withdrawal treatment provided in psychiatric units.
  
  
  METHODS
  A qualitative study with a purposive sample including interviews from registered nurses.
  
  
  METHODS
  Data were collected from interviews with 15 registered nurses working in specialised dependency units in psychiatric wards. The data collected were analysed through a descriptive, qualitative analysis.
  
  
  RESULTS
  The registered nurses' narratives revealed four main areas of convergence: feelings of anxiety and despair, preparation for unpredictable and precarious situations, striving for good relationship and striving to optimise and develop nursing care. The interviews revealed that registered nurses reflect on and discuss their feelings about their patients' situations with colleagues; prepare themselves for potential aggressiveness and unpredictable situations; improve their care through conscious attitude adjustment and relationship-forming behaviours; and strive to increase their personal knowledge, maintain a hopeful outlook and exhibit a positive approach. These themes were found in all nine categories and sixteen subcategories.
  
  
  CONCLUSIONS
  The findings based on the registered nurses' narratives indicated that the registered nurses experienced their work situation when caring for these patients to be very complex and demanding.
  
  
  CONCLUSIONS
  The study revealed that registered nurses worked extensively to craft their approach and attitude towards their patients. It is clear that registered nurses use themselves as tools or instruments for the creation of good relationships, thus providing the best care possible.
  
  
  CONCLUSIONS
  Registered nurses should be given more education, clearer guidelines and better guidance to assist them in facing such challenging and often problematic situations. One-on-one shadowing provides the possibility to create and develop relationship.
authors.affiliation: Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
authors.forename: Maja-Klara
authors.initials: MK
authors.lastname: Lundahl
authors.forename: Karl Johan
authors.initials: KJ
authors.lastname: Olovsson
authors.forename: Ylva
authors.initials: Y
authors.lastname: Rönngren
authors.forename: Karl-Gustaf
authors.initials: KG
authors.lastname: Norbergh
mesh_terms: D015107:4-Butyrolactone; D000328:Adult; D005260:Female; D006757:Hospital Units; D006801:Humans; D006885:Hydroxybutyrates; D007297:Inpatients; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D057184:Practice Patterns, Nurses'; D011568:Psychiatric Nursing; D012537:Scandinavian and Nordic Countries; D019966:Substance-Related Disorders / Q000451:nursing*
chemical_list: D006885:Hydroxybutyrates; C111420:4-hydroxybutyric acid; D015107:4-Butyrolactone
keywords: content analysis; nurse-patient relationship; psychiatric nursing; qualitative study; substance abuse