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Psychiatric nursing in troubled environmental contexts

W K Mohr1

  • 1University of Pennsylvania, Philadelphia 19104, USA.

Archives of Psychiatric Nursing
|August 1, 1996
PubMed
Summary

Nurses in for-profit psychiatric hospitals faced ethical dilemmas due to profit pressures. Their experiences highlight concerns about patient care and advocacy in a corporatized healthcare environment.

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Area of Science:

  • Healthcare Management
  • Nursing Ethics
  • Medical Sociology

Background:

  • Investor-owned psychiatric hospitals (1985-1991) faced investigations for fraud, patient abuse, and unethical conduct.
  • Increasing corporatization in healthcare creates pressure to maximize profits, potentially impacting patient care.
  • Understanding healthcare professionals' experiences is crucial in evaluating the effects of market-driven healthcare models.

Purpose of the Study:

  • To explore the work experiences of nurses employed in investor-owned psychiatric hospitals during a period of intense scrutiny.
  • To investigate nurses' ethical misgivings, sensemaking processes, and patient advocacy efforts within these settings.
  • To identify the implications of these experiences for healthcare research, policy, education, and practice.

Main Methods:

  • Qualitative study utilizing interviews with a theoretical sample of 30 nurses.
  • Focus on nurses' lived experiences in Texas-based investor-owned psychiatric facilities between 1985 and 1991.
  • Analysis centered on themes of ethical concerns, sensemaking, and patient advocacy.

Main Results:

  • Nurses reported significant ethical challenges and moral distress stemming from profit-driven operational demands.
  • Sensemaking strategies were employed by nurses to navigate conflicting professional values and organizational pressures.
  • Patient advocacy was often compromised by systemic issues and the pursuit of financial returns.

Conclusions:

  • The findings underscore the ethical vulnerabilities of nurses in profit-oriented psychiatric care settings.
  • The study highlights the need for policies that protect both patient welfare and professional nursing ethics amidst healthcare corporatization.
  • Recommendations are provided for nursing education and practice to address the complexities of working in market-driven healthcare environments.

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