The lived experiences of nurses working in general medical areas when caring for patients suffering from psychotic features : an interpretative phenomenological analysis

Abstract

Background: Psychosis is described as a disorder where thinking and perception is impaired. This disorder manifests itself via both positive symptoms such as: delusions and hallucinations, and negative symptoms such as: apathy and reduced communication. There are many instances when patients suffering from psychotic features end up admitted in medical wards, as they present themselves with other medical comorbidities. Nurses working within medical wards may not be as accustomed to care for these patients as nurses who work in mental health settings. Studies have reported how nurses working in general wards find caring for these patients challenging and stressful. Studies are needed to determine and describe the experiences of general nurses when caring for patients suffering from psychotic features (Thompson et al., 2019). Objectives: The aim of this study was to gain insight on the experiences of nurses working in general areas when caring for patients suffering from psychotic features. The study aimed at exploring the attitudes of the nurses when caring for these patients, and how their work is affected. The challenges which these nurses face, as well as, any supporting needs which may be of benefit were discussed. Design: A study based on the principles of Interpretative Phenomenological Analysis (IPA) will be presented. Setting: The interviews took place via ZOOM at a day and time of the participants’ own choice. During every interview the participants and the researcher were at their respective homes. Participants: Five nurses working in general medical areas and have cared for patients exhibiting psychotic features. Methodology: The participants were recruited via purposeful sampling via an intermediary (a staff nurse as well), who provided them with a consent form and information letter detailing the required information about the study. Following approval, these nurses partook in a one-to-one interview with the researcher, via Zoom. The interview took no more than an hour. The questions asked were self-designed with the intent to gain an in-depth understanding about the perceptions of the participants. The interviews were then transcribed verbatim. Results: One superordinate theme, practicing with ambivalence was noted. Three subordinate themes were highlighted namely: deterrents to practice, ethical influences and supportive measures. Conclusions: The participants described how nurses require further training in the management of patients exhibiting psychotic features, and in other psychiatric illnesses. The nurses made reference to the incidence of burnout amongst themselves and the presence of stigma and discrimination within the healthcare system. The participants highlighted on the need for environmental, managerial and psychological assistance to nurses.