title: Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care.
abstract: Therapeutic nurse-patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values.
authors.affiliation: Department of Health Science, Luleå University of Technology, Luleå, Sweden. sebastian.gabrielsson@ltu.se.
authors.forename: Sebastian
authors.identifier: http://orcid.org/0000-0002-1624-1795
authors.initials: S
authors.lastname: Gabrielsson
authors.affiliation: Department of Health Science, Luleå University of Technology, Luleå, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sävenstedt
authors.affiliation: Department of Health Science, Luleå University of Technology, Luleå, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Olsson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D009728:Nursing Assistants / Q000523:psychology / Q000592:standards; D011568:Psychiatric Nursing / Q000592:standards; D011787:Quality of Health Care
keywords: interpretive description; nurse-patient relationship; nurses' practice environment; nursing practice; psychiatric inpatient care