REALITY ON THE PSYCH UNIT: THE ADAPTATION OF PSYCHIATRIC NURSES IN AN ACUTE CARE SETTING (NURSING MANAGEMENT, MEDICAL ANTHROPOLOGY).
Contributors: University of California, San Francisco.
Published: 1986
Number of pages: 511
Subjects: Education, Health.
Description: Attrition, burnout, turnover, management problems, and job dissatisfaction are frequently encountered among Registered Nurses (RNs). The majority of nurses, however, do not leave the discipline. The focus of this study is the manner in which some RNs modify nursing and themselves to achieve workable balances between the public (work) and private aspects of their lives.

Data pertaining to the experience of practicing occupational nursing were elicited with an emphasis on those aspects perceived by the nurses and/or observed by the researcher to be stress-provoking and/or associated with coping and adaptation. Participant observation and in-depth, focused interviewing were the primary research methods used for an ethnographic study focused on adaptation. The qualitative strategies were supplemented with demographic statistics, attitudinal questionnaires, and network analyses.

The research setting was the psychiatry department of a large, urban, American, general hospital referred to as City and County. In this public facility, psychiatric in-patient units provide intensive care and brief hospitalizations for suicidal, homicidal, or gravely disabled adults. Staffing and resources are chronically limited. Rewards for seniority are more prominent than those for experience, competence, or education. Hierarchical and communication systems are complex and constraining. Pay is camparable with other facilities in the area, on the other hand, and above average for nursing.

Nursing of acutely ill patients is demanding. In addition to the intensive emotional involvement associated with psychiatric nursing roles, hospital-based RNs must integrate nursing's health-oriented ideology with psychiatry's orientation toward disease. Lay and professional belief systems are adapted to formulate workable explanatory models allowing operationalization of nursing roles. Explanatory models used by the nursing staff were elicited. Roles of therapists, administrators, and non-RN nursing personnel were examined in relation to those of the nurses.

Nurses are usually studied as occupants of health care provider roles and not as people who also have private lives. In this study the informants were viewed as individuals with activities, roles, and interests beyond the boundaries of their occupations and the facility by which they are employed. Ways in which psychiatric nurses at City and County integrate their public, occupational careers with their private careers were explored. Of particular interest are relationships with others in the work setting and in private life.
Notes: Source: Dissertation Abstracts International, Volume: 47-10, Section: A, page: 3671.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1986.

School code: 0034.