Exploring intensive care nurses’ experiences and perceptions of patients with a co-morbid mental health disorder

Abstract

Background The prevalence of patients with a mental health (MH) disorder in intensive care units (ICU) is roughly twice that of other general secondary care areas. There is a paucity of research regarding how ICU nurses experience caring for this patient group. However, it has been suggested that stigma, a lack of support, and a perceived lack of skills, might negatively impact on nurses’ abilities to provide safe holistic care to this vulnerable patient group. Aim This study aimed to explore how nurses working in critical care experienced caring for patients with a co-morbid mental health (MH) disorder. Methods Twelve members of registered ICU nursing and advanced practice staff were recruited via social media and professional networks. Participants engaged in online individual semi-structured interviews. The transcripts were checked and then analysed using a seven-stage reflexive thematic analysis process. Results Five themes were identified: 1) Frustration and futility, 2) The impact of a lack of knowledge, 3) Perceptions, 4) Unpredictable and violent, and 5) the ICU environment is unsuitable. Conclusions The study demonstrated that critical care nurses feel that they lack knowledge and support to manage patients with a MH disorder. They described feelings of frustration and futility at poor ongoing MH support. Participants appeared especially uncomfortable when caring for patients who had self-harmed or attempted suicide. A need for further research into the experience of MH patients in ICU is indicated.