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Therapeutic relationships: Making space to practice in chaotic institutional environments
Mark A Kingston1, Sallie Greenwood2
1Mount Isa Mental Health Service, Mount Isa Hospital, Mount Isa, Queensland, Australia.
Journal of Psychiatric and Mental Health Nursing
|February 16, 2020
Summary
Mental health nurses strive for therapeutic relationships despite managerial pressures. Systemic changes are crucial to support nurses and enhance client recovery in mental healthcare settings.
Area of Science:
- Nursing
- Mental Health
- Healthcare Management
Background:
- Therapeutic relationships are vital for mental health nursing and patient recovery.
- Increased managerialism and risk-focus have negatively impacted nurses' therapeutic practices.
- Limited research exists on nurses' experiences of therapeutic engagement within current healthcare contexts.
Purpose of the Study:
- To explore mental health nurses' experiences of engaging in therapeutic relationships within their current practice environment.
- To understand how managerial processes influence therapeutic engagement in mental healthcare.
- To identify constraints on therapeutic practice and potential responses.
Main Methods:
- Qualitative research utilizing an interpretive phenomenological approach.
- Interviews conducted with mental health nurses.
Main Results:
- Managerial processes significantly constrained nurses' ability to foster therapeutic relationships.
- Nurses struggled to create space for therapeutic engagement amidst a chaotic environment.
- Austerity, high staff turnover, and staff shortages contributed to the challenging milieu.
Conclusions:
- Managerial demands often overshadow therapeutic engagement, impacting client recovery.
- Nurses' commitment to therapeutic work can lead to burnout due to systemic barriers.
- Structural changes, professional organization strengthening, and partnerships with consumer groups are essential to support therapeutic practice.
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