The feelings and thoughts of mental health nurses concerning the management of distressed and disturbed in-patients: a comparative qualitative European study

High levels of distress and disturbance amongst those experiencing acute mental illness can be a major problem for mental health nurses. The feelings experienced by these nurses when caring for and supporting disturbed and/or distressed patients along with their concurrent thoughts is not well described in the literature. To date, this complex issue has not been explored within a comparative European context. The objective of this qualitative study was to explore the feelings and thoughts of mental health nurses when supporting and caring for distressed and/or disturbed patients in 6 European countries. Methods: Focus groups were used to collect data from 130 mental health nurses working in acute inpatient psychiatric settings. Results: Data were analysed using content analysis. Findings highlighted 6 broad themes: (1) Mixed emotions: expressive and responsive (2) Procedure for caring for and supporting disturbed and/or distressed patients, (3) Use of guidelines for caring and supporting disturbed and/or distressed patients, (4) Team and organisational support, (5) Ethical concerns: cogntive dissonance and (6) Education and training. Commonalities and differences were found across all themes. Approaches to care, nurses’ role and education, clinical guidelines and/or standards vary from country to country therefore the care, treatment and management of distressed and/or disturbed patients’ varies. As a result mental health nurses have different experiences, various emotional quandaries concurrent with cognitive dissonance and different coping strategies when caring for and supporting distressed and disturbed patients. Conclusions: More emphasis needs to be given to the emotional quandaries and concurrent cognitive dissonance experienced by mental health nurses caring for distressed and/or disturbed inpatients in acute psychiatric settings. Increased access to education and training with particular attention to interpersonal communication and relationship building within clinical teams needs to be a priority given the experiences described by mental health nurses.