Nursing Department, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece.
Psychiatric Liaison Unit, General State Hospital "Evagelismos", Athens, Greece.
Adv Exp Med Biol. 2021;1337:127-135. doi: 10.1007/978-3-030-78771-4_15.
Social distancing and the recent lock down due to COVID-19 has increased the feeling of disconnection, isolation, and suffering in vulnerable individuals and has brought forward questions regarding open acute care psychiatric units that cannot be answered by the literature. In Greece, there is no available research on how open ward environments are perceived and experienced by mental health professionals. The aim of the present study was to illuminate nurses' experiences of working in a public psychiatric hospital which traditionally operates with open doors. Eleven nursing care providers were interviewed, and thematic analysis was employed to explore their experiences of working in locked psychiatric acute care units. Participants described nursing care in units with an open door policy as "acceptance," "availability of staff," "real respect for the person," "ensuring patients' rights," "listening to the person," and "negotiation and not imposition." Trust in therapeutic relationships was perceived as greatly dependent on the trust being given to patients indirectly by the open door policy. Being trusted enhanced patients' self-determination and self-confidence leading to their empowerment. Containment of an acute mental health crisis took place through medication and meaningful discussions with patients and significant others rather than locking the door of the unit. Overall, meaningful care led to professional emancipation, but compassion fatigue narratives emphasized the need for continuous education, support and clinical supervision as necessary support for mental health nurses in a system of mental health provision often reduced to the point of crisis.
社交距离和最近因 COVID-19 而实施的封锁措施增加了弱势群体的脱节感、孤立感和痛苦感，并提出了一些关于无法通过文献回答的开放式急性精神科病房的问题。在希腊，没有关于精神卫生专业人员如何感知和体验开放式病房环境的可用研究。本研究的目的是阐明护士在一家传统上采用开放式门政策运作的公立精神病院的工作经验。对 11 名护理服务提供者进行了访谈，并采用主题分析来探讨他们在封闭式精神科急性护理病房工作的经验。参与者将开放式门政策下的护理描述为“接受”、“员工可用性”、“对人的真正尊重”、“确保患者权利”、“倾听他人”和“协商而非强制”。他们认为，对治疗关系的信任在很大程度上取决于开放式门政策间接给予患者的信任。被信任增强了患者的自我决定和自信，从而赋予他们权力。通过药物和与患者及重要他人进行有意义的讨论来控制急性心理健康危机，而不是关闭病房的门。总的来说，有意义的护理导致了专业解放，但同情疲劳的叙述强调了为精神科护士提供持续教育、支持和临床监督的必要性，这是在精神卫生服务系统中提供的必要支持，该系统经常简化为危机点。
