title: 'We have to be satisfied with the scraps': South African nurses' experiences of care on adult psychiatric intellectual disability inpatient wards.
abstract: BACKGROUND
  Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.
  
  
  METHODS
  An exploratory descriptive-interpretivist method investigated nurses' experiences of psychiatric intellectual disability work. Sixteen free association narrative interviews were collected in 2013. Thematic analysis allowed findings to emerge from the data.
  
  
  RESULTS
  Findings reflect a number of themes: 'relational interaction', 'care burden', 'system fatigue', 'infantilising dynamic of care' and 'resources for coping'.
  
  
  CONCLUSIONS
  System fatigue contributes more to negative experiences of providing care than direct patient work, and nurses experience more relational reciprocity from patients than from institutional management. Organizations should meet nurses' needs for burnout prevention, afford them impact in implementing institutional controls, and engage in a non-exploitative and non-exclusionary way.
authors.affiliation: Psychology, University of Stellenbosch, Stellenbosch, South Africa.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Capri
authors.forename: Chanellé
authors.initials: C
authors.lastname: Buckle
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000209:etiology; D017028:Caregivers / Q000523:psychology; D017281:Cost of Illness; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008607:Intellectual Disability / Q000451:nursing*; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D011568:Psychiatric Nursing; D012944:Social Support; D013019:South Africa; D016526:Workload
keywords: FANI method; care drain; intellectual disability; intersubjectivity theory; nursing migration; psychiatric hospital