Intensive care psychiatric nursing--psychoanalytic perspectives.

Area of Science:

• Psychiatric Nursing
• Intensive Care Nursing
• Clinical Psychology

Background:

• Nursing care in general and psychiatric intensive care units (ICUs) shares commonalities.
• Bedside skills and physical nurse-patient contact are key elements in both settings.
• Understanding patient aggression and restraint is crucial in psychiatric ICUs.

Purpose of the Study:

• To draw parallels between general and psychiatric intensive care nursing.
• To examine the relationship between bedside skills and physical contact.
• To explore the psychological underpinnings of patient aggression and restraint in psychiatric ICUs.

Main Methods:

• Unobtrusive observations in general and psychiatric intensive care settings.
• Analysis of the correlation between nursing bedside skills and physical patient contact.
• Examination of patient-on-carer aggression and restraint procedures.

Main Results:

• A correlation exists between bedside skills and the frequency of physical contact in both nursing environments.
• Patient aggression and subsequent restraint in psychiatric ICUs may represent unconscious re-enactment.
• Physical holding of psychotic patients can be functional in restoring their bodily ego.

Conclusions:

• Physical touch and skilled bedside care are vital in intensive care nursing.
• Restraint in psychiatric settings may serve a therapeutic purpose in ego re-establishment.
• Future intensive care approaches for psychotic patients should consider these psychodynamic aspects.