Factors influencing psychiatric nursing care in Australian prisons

¶ … psychiatric nursing practice in Australian prisons," Doyle (1999) attempts to discern what factors influence psychiatric nursing care. In particular, the researcher attempted to decide what factors may influence a nurse's ability to work effectively under straining circumstances, in this case working with challenging patients in a prison.

The problem as the researcher states it is that more than 100,000 patients require treatment while living in prison and correctional institutions. The unique client group presents many challenges to nursing staff including mental illness and developmental disabilities. In addition many patients are emotionally unstable. The author clearly identifies problems associated with providing optimal health care to incarcerated offenders. Also noted are the increased mortality rate and disease rate among this population.

Nurses must often face challenging situations. They are often tasked with working with difficult patients. In addition they may face technological obstacles or conflicting values when working in certain settings, or in this case stigma association working with prisoners. It is important nurses overcome these obstacles so they are able to delivery the best quality care to patients regardless of their situation.

Study Purpose

The purpose of the study is to discern what challenges psychiatric nurses face and what factors may influence the quality of care they bestow on patients in a sub-optimal working environment. The aim of the researcher is to point out the obstacles nurses face in delivery high quality care to patients under trying conditions. Whether nurses work in a psychiatric institute or other institution, they are likely to face similar obstacles.

The researcher clearly states the purpose. The author intends to "study issues of concern to nurses delivering mental health care to offenders."

Research Question

While the research question is not directly stated, the researcher does state his intent to study issues that concern nurse's delivery care to criminal offenders. The question allows adequate exploration from a qualitative perspective. The intent of the research is to study a phenomena, especially through observation, which is supported through qualitative research.

Study Design

The researcher suggests use of a praxis qualitative research approach, supported by other researchers (Lather, 1991). This type of research is also called applied research. The research design included a focus group of 10 mental health nurses who were interviewed regarding their concerns with patients. This method is supported by other qualitative studies that suggest focus groups and in depth interviews are appropriate (Street & Walsh, 1996; Massarik, 1981). The researcher also elected to use open-ended questioning. The method is appropriate because it is aligned with qualitative investigation. The questionnaire and interview approach allow the researcher to observe the phenomena occurring in their natural state.

The study design utilized qualitative textual analysis where the researcher clustered themes of questions for nursing participants to answer. A narrative was subsequently produced describing the problems as described by the subjects interviewed.

Subjects and Setting

The researcher selected 30 subjects registered as psychiatric mental health nurses whose job was to deliver care to imprisoned men and women in a central industrial prison. Nurses employed for purposes of this study worked 24 hours care shift. The selection of nursing care staff is representative of the nursing population caring for this group at large, thus adequately represented the situation.

The setting is appropriate as it examines nurses working in a walled and secure 120-bed prison unit.

Data Analysis Procedures

The data analysis procedures correspond to other methods adopted by qualitative researchers in the past. The data analysis procedures are consistent with a qualitative approach as the author is using applied research techniques to gather information from which to draw a narrative conclusion. The two major strengths of the study include the researchers directed approach to selecting a target population and use of open ended questions that allow the researcher to gather as much information as possible about the phenomena being investigated. The primary limitation of the study is the small sample size and single location used. It would be impossible for the researchers to generalize their information to the population at large based on this small sample. While the sample may be representative of most nursing situations where nurses work with inmates, it is difficult to assert this without additional studies.

The author concludes that the environment in which psychiatric mental health nurse's work is often one dominated by surveillance, control and harsh circumstances. The author further concludes that nurses are often compromised and face resistance when attempting to implement routines and set up priorities. The conclusions are appropriate based on the interview data the researcher gathered from nurses working in the field.

Because the nurses directly reported their circumstances and pressures, it is easy for the researcher to draw conclusions. The implications suggests that this research can be used to guide future training and support programs for nurses working in difficult situations. The researcher suggests that the challenges nurse's face in these situations must be acknowledge and recognized so adequate support may be offered nurses working under these conditions in the future.

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