Integrative care planning in acute psychiatry

Psychiatric nurses in Britain are increasingly utilizing the problem-solving techniques embodied in the nursing process in order to formulate programmes of care. The paper disputes the validity of an approach which suggests that one discipline (nursing) possesses the broad-based assembly of skills necessary to promulgate coping strategies in the client and his family or sustainer-group. The efficacy of such an approach is particularly questionable when we consider that much of our work as nurses is practised in a hospital environment, where the client is abstracted from his familiar surroundings and support networks. Suggestions are made for improving the appropriateness and quality of psychiatric nursing interventions within a multi-disciplinary care framework, and the argument is put forward that dogmatic adherence to the nursing process, with the emphasis upon finding answers to problems, may dually impede inter-disciplinary teamwork and also lead us away from analysis of the skills which are important in establishing an effective interaction with the client and his family.