‘Safe enough in here?’: patients' expectations and experiences of feeling safe in an acute psychiatric inpatient ward

Rosemary C. Stenhouse

    Research output: Contribution to journalArticlepeer-review

    34 Citations (Scopus)

    Abstract

    Aims and objectives
    To understand the experience of being a patient on an acute psychiatric inpatient ward.

    Background
    Acute psychiatric inpatient care is an integral part of the mental health system. A key driver for admission to acute wards is risk. Previous research indicates that people do not always feel safe when in an acute ward. Understanding the patient experience of safety can influence nursing practice, as well as policy and service development.

    Design
    A qualitative approach was used. Patient experience was conceptualised as represented through narrative as data. Sociolinguistic theories linking narrative structure with meaning informed the development of the analytic framework.

    Methods
    Thirteen patients with a variety of diagnoses were recruited from an acute ward. Unstructured interviews were carried out in participants' homes two and six weeks postdischarge. Holistic analysis of each individual's data set was undertaken. Themes running across these holistic analyses were then identified and developed.

    Results
    Participant narratives were focused around themes of help, safety and power. This study presents findings relating to the experience of safety. Participants expected to be safe from themselves and from others. Initially, they experienced a sense of safety from the outside world. Lack of knowledge of their fellow patients made them feel vulnerable. Participants expected the nurses to keep them safe, and felt safer when there were male nurses present.

    Conclusions
    Participants talk about safety in terms of psychological and physical safety. A key issue was the perception of threat from other patients, highlighting the need to consider patient safety as more than physical safety.

    Relevance to practice
    Nurses need to be sensitive to the possibility that patients feel unsafe in the absence of obvious threat. Institutional structures that challenge patients' sense of safety must be examined.
    Original languageEnglish
    Pages (from-to)3109–3119
    Number of pages11
    JournalJournal of Clinical Nursing
    Volume22
    Issue number21-22
    Early online date22 Jul 2013
    DOIs
    Publication statusPublished - Nov 2013

    Keywords

    • Acute psychiatric inpatient care
    • Narrative
    • Nurse–patient relationship
    • Patient experience
    • Patient safety

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