General Registered Nurses Concerns with the Management of Acute Psychiatric Patients in a General Hospital

Abstract

Since 2002, all health establishments in South Africa including district hospitals are compelled by the Mental Health Care Act No. 17 of 2002 to admit acute psychiatric patients for 72 hours without consent for assessment and observation. The admission of psychiatric patients and those with medical conditions in the same units came with new challenges for the healthcare team. With the shortage of psychiatric trained nurses in most settings, non-psychiatric nurses are expected to work with psychiatric patients. The purpose of the study was to explore and describe the concerns of non-trained psychiatric nurses who work with acute psychiatric patients. Indepth interviews with 15 general nurses were carried out between January and March 2013 in a Government Hospital in South Africa. Data collection and analysis were carried out simultaneously and a modified Tesch method of data analysis was used. Two themes emerged from the analysis ( safety related concerns and psychiatric nursing related concerns) and demonstrated the contextual nature and the interrelationships in the participants’ descriptions of their concerns with regard to nursing psychiatric patients while not trained to do so. The study concluded that violence from psychiatric patients poses tremendous risks and challenges for general nurses, other patients and their families.