Psychiatric community nursing: a study of a working situation
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A descriptive account is presented of a community psychiatric nursing service based at a psychiatric teaching hospital in Edinburgh. The object of the study was to contribute to the identification and analysis of the role and functions of community psychiatry nurses. The study was focused mainly on nurse-patient contact and on the process and content of nurse—patient interaction. The fieldwork for the study was carried out in 1972-73- The main instruments used were self-administered record schedules reporting nurses' contacts with patients and their families and interviews to obtain background information on factors which influenced the nurses' activities. It was found that the service was functioning mainly as an after-care agency. A high proportion of the work of the service took place in a hospital context; the case-load had close connections with hospital care, and the nurses mainly called on hospital resources and staff in support of their work. It was concluded that the staff were acting primarily as intermediaries between the patient and the hospital, and that their direct care functions were secondary to this. Factors which influenced the activities of the nurses included role concepts, role—relationships (which presented some problems) and the needs of the patient and his family. A combination of clinical-psychiatric and psycho-social needs were observed and it was inferred from the evidence that the former were better catered for than the latter. Particular problems in family relationships were recognised. It was concluded that the situation demanded enhanced skills which could be developed through supervised practice. It was also suggested that the functions and case-loads of community psychiatric nursing services were profoundly influenced by their location and organisation, and that these should, therefore, be decided in the light of an explicit formulation of desired objectives.