‘Safe Enough in Here?’:Patients’ Expectations and Experiences of Feeling Safe in an Acute Psychiatric Inpatient Ward

To understand the experience of being a patient on an acute psychiatric inpatient ward.\ud \ud 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.\ud \ud 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.\ud \ud 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.\ud \ud 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.\ud \ud 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.\ud \ud 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

‘Fix the issues at the coalface and mental wellbeing will be improved’:A framework analysis of frontline NHS staff experiences and use of health and wellbeing resources in a Scottish health board area during the COVID-19 pandemic

Abstract Background Frontline healthcare staff working in pandemics have been reported to experience mental health issues during the early and post-peak stages. To alleviate these problems, healthcare organisations have been providing support for their staff, including organisational, cognitive behavioural and physical and mental relaxation interventions. This paper reports the findings of a study commissioned by a Scottish NHS health board area during the initial outbreak of COVID-19. The study aimed to understand the experience of NHS staff relating to the provision of wellbeing interventions between March and August 2020. Methods Data were gathered from free-text comments of eight surveys completed by a wide range of staff across sites within one NHS health board in Scotland. We conducted a framework analysis of the data. Results Our findings show that despite the provision of relaxational and cognitive behavioural interventions to support staff wellbeing during the early months of the COVID-19 pandemic, there were barriers to access, including heavy workload, understaffing, inconvenient locations and the stigma of being judged. Organisational factors were the most frequently reported support need amongst frontline staff across sites. Conclusions While relaxational and cognitive behavioural interventions were well received by staff, barriers to accessing them still existed. Staff support in the context of organisational factors, such as engagement with managers was deemed as the most important for staff wellbeing. Managers play a key role in everyday organisational processes and therefore are in the right position to meet increasing frontline staff demands due to the pandemic and removing barriers to accessing wellbeing support. Healthcare managers should be aware of organisational factors that might increase job demands and protect organisational resources that can promote wellbeing for frontline staff

Exploring the compassion deficit debate

Several recent high profile failures in the UK health care system have promoted strong debate on compassion and care in nursing. A number of papers articulating a range of positions within this debate have been published in this journal over the past two and a half years. These articulate a diverse range of theoretical perspectives and have been drawn together here in an attempt to bring some coherence to the debate and provide an overview of the key arguments and positions taken by those involved. In doing this we invite the reader to consider their own position in relation to the issues raised and to consider the impact of this for their own practice. Finally the paper offers some sense of how individual practitioners might use their understanding of the debates to ensure delivery of good nursing care

Recruitment, Selection and Retention of Nursing and Midwifery Students in Scottish Universities

Background: High attrition rates from pre-registration nursing and midwifery programmes have been reported in both the UK and in other countries.\ud Objectives: A study was conducted to identify best practice in recruitment, selection and retention across\ud Scottish Universities providing pre-registration programmes.\ud Design: A survey of all universities providing pre-registration programmes in Scotland was conducted.\ud Semi-structured interviews were conducted with key personnel in each university. Documentary evidence\ud was collected to supplement interview data and evidence recruitment, selection and retention practices.\ud Settings: All universities in Scotland providing pre-registration nursing and/or midwifery programmes.\ud Participants: All 10 identified universities agreed to take part and a total of 18 interviews were conducted.\ud Methods: Semi-structured face to face and telephone interviews were conducted. Relevant documentary\ud evidence was collected. All data were subject to thematic analysis.\ud Findings: Universities are predominantly concerned with recruiting to the institution and not to the professions.\ud Interviews are widely used, and are a requirement in the United Kingdom. However, there is no evidence base\ud within the literature that they have predictive validity despite creating scales and scoring systemswhich are largely\ud unvalidated.\ud The study identified initiatives aimed at addressing attrition/retention, howevermost had not been evaluated often\ud due to the multi-factorial nature of attrition/retention and difficulties with measurement.\ud Conclusions: Recruitment selection and retention initiativeswere rarely evaluated, and if so, adopted a relatively superficial\ud approach. Evidence from existing studies to support practices was mostly weakly supportive or absent.\ud The study highlights the need for a coordinated approach, supporting the development of a robust evidence\ud base through the evaluation of local initiatives, and evaluation of new strategies. Evaluation strategies must take\ud account of the local context to facilitate transferability of findings across different setting