Psychiatric nursing described : an investigation of the role of the psychiatric nurse using Flanagan's critical incident technique
The major aim of this thesis was to describe the work of six grades of ward-based psychiatric nurses. The major data collection tool used was Flanagan's critical incident technique. Four thousand, four hundred and seventy seven incidents were collected from 1,637 staff and patient respondents in eleven Scottish psychiatric hospitals. 58% of the incidents related to effective nursing activity, 42% related to ineffective activity. Critical incidents were inductively classified into a three-level system consisting of areas, categories and sub-categories constructed by the writer. The classified critical incidents were used to describe the work of the psychiatric nurse and to examine the differences and similarities among the six nurse grades, day and night shifts and among geriatric, long-stay ambulant and acute nursing sub-specialities. Difference among grades, shifts and specialities were found to be minimal and in terms of emphasis only. A second type of data was collected, namely training programmes, job descriptions and assessment schedules. These were compared with each other for consistency of content, and with the description of the work of the psychiatric nurse derived from the critical incidents. Comparisons showed considerable differences between what nurses actually did, what they were trained to do, the content of their job descriptions and the criteria on which their clinical assessment was made. The implications of the above findings are discussed in relation to nurse education, practice and professionalism. A framework is presented for use in relation to: (i) patients' potential nursing needs (ii) evaluation of nursing care (iii) educational needs of ward based psychiatric nurses (iv) assessment of ward based psychiatric nurses
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