Psychiatric nursing in troubled environmental contexts

During 1985-1991 state, federal and media investigations uncovered widespread fraud, patient abuse, and unethical conduct in investor-owned psychiatric hospitals. The purpose of this research study was to determine how nurses who were employed in these settings during this time experienced their work situations. Inquiry centered on ethical misgivings, sensemaking, and patient advocacy. The experiences discussed in this article are the results of interviews with a theoretical sample of 30 Texas nurses. Their experiences have research, policy, education, and practice implications in that health care settings are becoming increasingly corporatized and are under great pressures to maximize profits to increase returns on investors' equity.