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Achieving equilibrium within a culture of stability: cultural knowing in nursing care on psychiatric intensive care units
Örebro University, School of Health and Medical Sciences. School of Health and Sciences, Dalarna University , Falun, Sweden.ORCID iD: 0000-0002-2610-8998
Karolinska institutet, Stockholm, Sweden.
Örebro University, School of Health and Medical Sciences.
Mälardalens University, Eskilstuna, Sweden.
2011 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 32, no 4, p. 255-265Article in journal (Refereed) Published
Abstract [en]

This article presents intensive psychiatric nurses' work and nursing care. The aim of the study was to describe expressions of cultural knowing in nursing care in psychiatric intensive care units (PICU). Spradley's ethnographic methodology was applied. Six themes emerged as frames for nursing care in psychiatric intensive care: providing surveillance, soothing, being present, trading information, maintaining security and reducing. These themes are used to strike a balance between turbulence and stability and to achieve equilibrium. As the nursing care intervenes when turbulence emerges, the PICU becomes a sanctuary that offers tranquility, peace and rest.

Place, publisher, year, edition, pages
New York, United States, 2011. Vol. 32, no 4, p. 255-265
National Category
Health Sciences Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-20585DOI: 10.3109/01612840.2010.549603PubMedID: 21355761Scopus ID: 2-s2.0-79952156012OAI: oai:DiVA.org:oru-20585DiVA, id: diva2:467053
Available from: 2011-12-18 Created: 2011-12-18 Last updated: 2018-05-03Bibliographically approved
In thesis
1. Caring in intensive psychiatry: rhythm and movements in a culture of stability
Open this publication in new window or tab >>Caring in intensive psychiatry: rhythm and movements in a culture of stability
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to describe and explore the concept of caring in intensive psychiatry. An initial inventory was made of nursing care activities in a PICU, based on an analysis of critical incidents. This inventory resulted in four categories: supporting, protecting and use of the structured environment (Study I). Caring in intensive psychiatry was also studied through ethnographic fieldwork that that led to the conceptualization of the PICU staff as projecting a culture of stability. Within this culture, the overall goal was to prevent, maintain and restore stability as turbulence occurred. Cultural knowing, as expressed through nursing care, was further described in terms of providing surveillance, soothing, being present, trading information, maintaining security, and what has been termed reducing (Study II). A focused approach was applied to study the staff’s different approaches to observing patients in relation to the practice of surveillance in psychiatric nursing care. PICU staff moved flexibly between a latent and a manifest approach to surveillance (Study III). Having conceptualized the culture as one of stability, a concept analysis was conducted upon the concept of stability. The analysis revealed that stability is by no means a static condition; it fluctuates and can be distorted. Intervening with nursing care when turbulence occurs, can involve both the use of active and passive stability systems (Study IV). Further, I argue that caring in intensive psychiatry can be accurately described as the projection of rhythm and movements. Nursing care in terms of movements creates fluctuations in stability as it entails a rhythm of caring in intensive psychiatry. In conclusion, physical boundaries and incorporated control along with tactful sensibility involve rhythm and movements within limited structures and closeness in care. This thesis contributes to articulating advanced nursing practice within intensive psychiatry 

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 81
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 47
Keywords
Acute psychiatric care, concept analysis, critical incident technique, ethnography, intensive psychiatry, nursing staff, psychiatric care, psychiatric hospitals, psychiatric nursing
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-30069 (URN)978-91-7668-956-1 (ISBN)
Public defence
2013-10-03, 09:15
Opponent
Supervisors
Available from: 2013-07-30 Created: 2013-07-30 Last updated: 2017-10-17Bibliographically approved

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Salzmann-Erikson, MartinLützén, KimIvarsson, Ann-Britt

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