Exploring Nurses' Experiences in Caring for Medical-Psychiatric Comorbid Patients: A Qualitative Interview Study

Approximately one-third of patients who visit general hospitals have a mental disorder, which is associated with poorer outcomes and higher costs. Caring for these patients can be challenging for nurses, particularly when behaviours such as aggression, wandering, or lack of cooperation occur. To explore how nurses experience caring for patients with medical-psychiatric comorbidities in general hospital wards a qualitative study using semi-structured interviews was conducted. Sixteen registered nurses with varying experience from eight wards in a Dutch university medical centre participated. Data were analysed inductively using Braun and Clarke's thematic analysis. Nurses' experiences were captured in three themes: managing emotions, adapting to contextual factors and building competence. Managing emotions reflected feelings ranging from frustration to compassion, and strategies such as peer support and rationalisation to cope. Adapting to contextual factors highlighted challenges including time pressures, competing demands and environments ill-suited to mental health needs. Building competence involved learning through experience and emphasised the need for education and multidisciplinary collaboration. Nurses' challenges in caring for patients with medical-psychiatric comorbidities stem less from the patient's behaviour itself than from limited training, organisational structures and systemic barriers. Caring for these patients requires more than individual coping strategies; organisational, educational and interprofessional support are essential to improve care delivery and nurse well-being. Simulation-based training, structured reflection and interprofessional collaboration may strengthen competence and confidence, while organisational adjustments could foster safer and more person-centred care.