Experiences of advanced psychiatric nurses on their practice in an occupational specific dispensation hospital setting

Abstract

In South Africa, the Occupational Specific Dispensation (OSD) for professional nurses provides a structure for training and career progression in the Public Health Sector. It necessitates the urgency for professional nurses who are working in specialty units at hospitals, to study further in advanced post-graduate nursing sciences programmes, e.g. advanced psychiatric nursing. Professional nurses were not informed about the implications of the OSD for practice, prior to implementation. It was unclear how advanced psychiatric nurses were experiencing their practice in an OSD hospital setting. In this study, the experiences of advanced psychiatric nurses who were practising at an OSD psychiatric public hospital led to the description of guidelines for supporting these nurses during their practice in an OSD ward. A qualitative, exploratory, descriptive and contextual design was followed. The study population consisted of advanced psychiatric nurses (N = 50). Purposive sampling was conducted until data saturation was reached. Eight participants were included in the sample. In-depth unstructured individual interviews were conducted with each of these participants. Field notes were kept and voice recordings of all interview sessions were captured. The researcher conducted a pilot study with one participant in order to detect possible flaws that could occur during the data collection process. The data analysis where themes were identified was based on Tesch‟s method of qualitative analysis. A literature control supported the findings of this study. Subsequently, guidelines were described from the findings according to the method of Muller (2001:204-205). Trustworthiness was maintained by using the criteria of Guba‟s model; that is credibility, transferability, confirmability, and dependability. The ethical principles of the right to self-determination, withdrawal from the research study, privacy, autonomy and confidentiality, fair treatment, protection from discomfort and harm, and obtaining informed written consent was adhered to. Four themes emerged from the data that indicated: the under-utilisation of the full scope of advanced nursing skills, role conflict and overload, organisational structural barriers that delayed viii the implementation and practice of advanced nursing skills, and failure to conceptualise / clarify advanced nursing role that resulted in unrealistic and / or unmet expectations.