The psychiatric nurse's experience and meaning of caring in hospitals, a grounded theory of protective empowering

grantor: University of TorontoThis study explored with psychiatric nurses their experience and meaning of "caring" with patients in the hospitals. Seventeen registered nurses were interviewed from three general acute care psychiatric units, in two general hospitals and one psychiatric hospital. Using grounded theory qualitative methodology, it was discovered that "caring" occurred through a process called protective empowering, and a grounded theory of protective empowering was formulated. The nurses accomplished protective empowering of patients through six categories as evidenced through: (1) keeping the patient safe; (2) encouraging the patient's health; (3) authentic relating; (4) interactive teaching; (5) respecting the patient; and (6) not taking the patient's behaviour personally. Each of the six main categories of protective empowering were defined by specific subcategories. All six main categories appeared throughout the process of protective empowering, except that each category represented a different feature of protective empowering. The two main categories of respecting the patient and not taking the patient's behaviour personally were the antecedent and sustaining conditions of protective empowering. The other four categories keeping the patient safe, encouraging the patient's health, authentic relating, and interactive teaching represented the actions and contexts through which protective empowering changed. The consequence of protective empowering was manifested by the patient's ability to access their ability to act or accomplish their activities of daily living. The results suggest a practical and grass-roots theory of protective empowering that could be used as a valuable guide for articulating and reflecting on what psychiatric nurses do in their caring with patients on general psychiatric units; and, could be useful for both the clinical and political purposes of affirming and/or challenging the way in which psychiatric nurse "caring" with patients is articulated and allocated in hospitals.Ed.D