Abstract
Caring for patients with mental disorders can be a challenging practice, especially during the pandemics and given the peculiarities of the mental illnesses symptoms. Nurses in inpatient care facilities may face hardships due to increased stress and dangers related to the mentioned aspects. In particular, there is evidence that in Saudi Arabia there are higher levels of stress and burnout among psychiatric nurses. As a rule, training on self-care, assertiveness, and learning stress-coping strategies is recommended by scholars to overcome the problems.
Improving communication and increasing the levels of nurses ‘engagement with their patients and their job responsibilities are also among the most favorable pieces of advice suggested by scholars. In particular, the scientists in the nursing field refer to the fact that improved communication is positively related to the patient and nursing care outcomes. Therefore, this research proposal suggests improving the processes of psychiatric nurses’ communication with their patients in Saudi Arabia hospitals by developing the corresponding training programs and approving the need for such training in hospitals throughout the country.
Background
In the context of the coronavirus pandemic and forced measures limiting direct communication, caring for patients with mental disorders may feature the increased level of barriers. In addition, the initial situation of communicating with such patients is ambivalent thanks to the contributing factors like patients ’aggression and nurses’ working stress and burnout due to high workloads and limited resources. The described situation requires immediate action such as implementing the compulsory training sessions for psychiatric nurses, as suggested by the international scholars and the scientists who study the situation in Saudi Arabia.
In general, the broader scope of the research suggests that psychiatric nurses in Saudi Arabia face challenges that are similar to those the psychiatric nurses face internationally. However, one distinctive feature of research focused on Saudi Arabia is that such pieces of knowledge mainly discuss the nurses’ stress and discomfort and pay less attention to the patient outcomes and patient safety. Therefore, there is a research gap in this field that should be overcome in further scholarly researches concerning the issue of psychiatric nurses caring for patients with mental disorders.
Review of Literature
The research strategy used to compile the literature review implemented the use of keywords such as psychiatric nurses, stress, communication, patients with mental disorders. The university database and free international nursing science databases were used to find the relevant articles. The articles published in 2017-2021 were considered since the presented research aimed to focus on the most recent findings in the field of psychiatric nursing, particularly in Saudi Arabia.
The main strengths of the research articles analyzed lie in the clear and distinct conceptualization of the most essential problems related to working with patients with mental disorders. For instance, the necessity of providing training and empowering nurses was determined as the key aspect of improved patient outcomes. The main weaknesses of the analyzed articles were the lack of attention to categorized patients ’and nurses’ needs and the satisfaction of the requirements for the patients’ safety and ethical requirements for the safe working environment for the psychiatric nurses. The gap in the studied literature was the lack of qualitative studies that could provide a better perspective on peculiarities and the most painful problems prevailing in the nursing facilities.
Articles on the Safety of the Nursing Work Environment
Most authors consider the nece4ssity to develop strategies that will be helping nurses to cope with patient-related problems. For example, Son and Kim (2020) assert that “empowering interventions” should be created to improve the performance of psychiatric nurses with low communication ability, since these two factors determine the overall success in patient care (p. 177). Then, Jacobs and Mkhize (2021) examine the prevailing nurses ‘views on their patients and conclude that there is a need to “advance the psychiatric nurses’ education curriculum” to eliminate the prevalence of negative views and stereotypes regarding the patient with mental disorders among the nurses (p. 1646). At the same time, Osman et al. (2018) discuss the need to “teach empathic communication skills” to “model empathy in nursing education” (p. 1). In particular, the scholars are concerned with the tendency that psychiatric nurses usually lack empathy when communicating with their patients and in their patients’ perceptions.
However, the scholars report, that after the training 3-month program was implemented in the nursing facility in Saudi Arabia, 87.5% showed high levels of empathic skills, which is a positive argument indicating that the problem can be solved through adequate intervention… Interestingly, Abdelaziz et al. (2020) who studied the work engagement and psychological wellbeing among novice nurses in Saudi Arabia suggested introducing assertiveness training for nurses to improve their reported self-efficacy. Finally, Hamaideh (2017) concluded that “healthcare managers and policymakers should encourage educational interventions and open communication” in psychiatric nursing settings (p. 476). In general, most articles present quantitative studies that provide evidence on the necessity for various types of nursing training to improve communication.
Articles Regarding the Necessity of Training
There is also a wide range of research that discusses the peculiarities of the nurses’ work environment in psychiatric facilities. Donner and Gustin (2020) study the tendency of patients with mental illnesses to be quiet or express themselves verbally very rarely, which may create communication difficulties. Joubert and Bhagwan (2018) report that psychiatric nurses often “express the feelings of anger and frustration,” which requires the corresponding training (p. 49). Interestingly, Mani and Abutaleh (2017) also add to the argumentation that the stressful work environment requires stress-coping, communication, and other training for the psychiatric nurses in Saudi Arabia.
The scholars add that novice nurses should receive special support and that the “hospital orientation programs” should be developed for them (Mani and Abutaleh, 2017, p. 1). Noteworthy, Elsayed et al. (2017) indicate such work environment and nurses’ health problems like work-related stress and depression due to “a wide range of stressful events, evolving from the care of violent, aggressive patients, recurrent relapse and poor prognosis of mental disorders” (p. 157). Basfr et al. (2019) study the problem of workplace violence (WPV) among nurses in Saudi Arabia and say there is a need for training on how to respond to “violent psychiatric patients” (p. 19). In general, the listed articles pay particular attention to how nurses cope with the stressful environment when working with patients with mental disorders, but less attention is paid to the patient-related problems. In other words, there is a need for the patient-centered perspective, since there is a lack of research with such focusing.
Methodology
Aim and Objectives
The research proposal suggests developing a patient-centered educational or practical training program for psychiatric nurses to improve communication with their patients, eliminate negative perceptions and stereotypes, and teach nurses stress-coping strategies.
The proposal utilizes the PICO format as follows:
- There is a need to develop patient-centered training for the benefit of patients with mental disorders in Saudi Arabia’s nursing facilities (P).
- These types of training should be obligatory for all nursing facilities and hospitals that treat patients with mental disorders and implies further patient-centered interventions, which is the increased quality of nurses’ communication with patients (I).
- When developing the training, the healthcare managers should consider the globally accepted Patient Safety Standards (C).
- As a result, it is anticipated that the patient outcomes will improve, the stress levels in nurses will be lowered, and the patient safety conditions will improve as well (O).
Research Design
The research proposal suggests applying the analytical research, that is to base the training on the facts that have been proved already, and provide the critical evaluation of the researched material. This attitude is appropriate to the research problem since it allows creating a sufficient and proper program for future nurses’ training. Nursing theories and the most recent evidence will strengthen the research background for the newly developed practical and educational training program.
Procedure
Firstly, the facts on patient safety and a safe work environment will be compiled in a table for future analysis. Secondly, a similar table will be created that will consider the research on the most adequate types of communication with patients with mental disorders. The third step will be developing the presentation of the studied facts with the application of the most relevant nursing theories. The fourth step will be seeking the approval of the Saudi Ministry of Health for the further dissemination of leaflets and guidelines for nursing training in the nursing facilities throughout Saudi Arabia.
References
Abdelaziz, E. M., Diab, I. A., Ouda, M. M. A., Elsharkawy, N. B., & Abdelkader, F. A. (2020). The effectiveness of assertiveness training program on psychological wellbeing and work engagement among novice psychiatric nurses. Nursing Forum, 55(3), 309-319. Web.
Basfr, W., Hamdan, A., & Al-Habib, S. (2019). Workplace violence against nurses in psychiatric hospital settings: perspectives from Saudi Arabia. Sultan Qaboos University Medical Journal, 19(1), e19. Web.
Donner, L., & Wiklund Gustin, L. (2020). Navigating between compassion and uncertainty–psychiatric nurses’ lived experiences of communication with patients who rarely speak. Issues in Mental Health Nursing, 42(4), 307-316. Web.
Elsayed, S., Hasan, A. A., & Musleh, M. (2018). Work stress, coping strategies, and levels of depression among nurses working in mental health hospital in Port-Said city. International Journal of Culture and Mental Health, 11(2), 157-170. Web.
Hamaideh, S. H. (2017). Mental health nurses’ perceptions of patient safety culture in psychiatric settings. International Nursing Review, 64(4), 476-485. https://doi.org/10.1111/inr.12345
Jacobs, E. P., & Mkhize, S. W. (2021). Multidisciplinary team members’ perceptions regarding advanced psychiatric nurses’ attitudes on mental healthcare. Health SA Gesondheid, 26, 1-16. Web.
Joubert, P. D., & Bhagwan, R. (2018). An empirical study of the challenging roles of psychiatric nurses at in-patient psychiatric facilities and its implications for nursing education. International Journal of Africa Nursing Sciences, 9, 49-56. Web.
Mani, Z. A., & Abutaleb, M. (2017). Communication skills of novice nurses at the psychiatric hospital in Saudi Arabia. Journal of Nursing Care, 6(407), 2167-1168. Web.
Osman, F. E. S., Sherif, Z. A. G. E., Shalaby, M. H., & Shaheen, S. H. A. M. (2018). Evaluate the effect of an empathy-based training program on psychiatric nurses’ communication skills. IOSR Journal of Nursing and Health Science, 7(3), 32-41. Web.
Son, M., & Kim, S. (2020). The mediating effect of empowerment on the relationship between communication ability and nursing performance in psychiatric nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 29(2), 177-184. Web.