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压力下的优雅:精神科护士在实践中展现韧性的故事。

Grace under pressure: Mental health nurses' stories of resilience in practice.

作者信息

Foster Kim, Evans Alicia, Alexander Louise

机构信息

School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.

NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Victoria, Australia.

出版信息

Int J Ment Health Nurs. 2023 Jun;32(3):866-874. doi: 10.1111/inm.13130. Epub 2023 Feb 21.

Abstract

Mental health nurses experience both organizational and practice-related stressors in their work. Resilience is an interactive process of positive adaptation following stress and adversity. There is limited evidence on how personal resilience is applied to mental health nursing practice. The aim of this interpretive narrative study was to explore mental health nurses' stories of resilience in their practice for the purpose of gaining an understanding of resilience resources they draw on when dealing with challenging workplace situations. A storytelling approach was used in semistructured phone interviews with 12 mental health nurses who measured high on resilience (Workplace Resilience Inventory) and caring behaviours (Caring Behaviours Inventory). Within and across case narrative analysis produced stories of resilient practice within four themes: proactively managing the professional self; sustaining oneself through supportive relationships; engaging actively in practice, learning and self-care; and seeking positive solutions and outcomes. Nurses displayed poise in stressful situations and grace under pressure in demanding and emotionally challenging interactions, holding dignity and respect for self and others, with the aim of achieving positive outcomes for both. Resilient practice is the responsibility of organizations as well as individuals. To develop practice and support staff retention, we recommend organizations use tailored professional development to cultivate a growth mindset in new and experienced staff, develop organizational strategies to build positive team cultures, and prioritize strategies to reduce workplace stressors and strengthen staff psychological safety and well-being. The use of narrative techniques in reflective practice and clinical supervision may help build nurses' resilience and practice.

摘要

心理健康护士在工作中会经历组织层面和与实践相关的压力源。复原力是在压力和逆境后积极适应的互动过程。关于个人复原力如何应用于心理健康护理实践的证据有限。这项解释性叙事研究的目的是探索心理健康护士在实践中的复原力故事,以便了解他们在应对具有挑战性的工作场所情况时所利用的复原力资源。采用讲故事的方法,对12名在复原力(工作场所复原力量表)和关爱行为(关爱行为量表)方面得分较高的心理健康护士进行了半结构化电话访谈。在案例叙事分析中,在四个主题内和跨案例分析产生了复原力实践的故事:积极管理职业自我;通过支持性的关系维持自我;积极参与实践、学习和自我护理;寻求积极的解决方案和结果。护士们在压力情况下表现出沉着,在要求苛刻且情感上具有挑战性的互动中在压力下展现出优雅,维护自己和他人的尊严与尊重,目的是为双方都取得积极成果。复原力实践既是组织的责任,也是个人的责任。为了发展实践并支持员工留任,我们建议组织采用量身定制的专业发展来培养新员工和有经验员工的成长心态,制定组织战略以建立积极的团队文化,并优先考虑减少工作场所压力源以及加强员工心理安全和幸福感的战略。在反思性实践和临床督导中使用叙事技巧可能有助于培养护士的复原力和实践能力。

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