Introduction
The interview under investigation provides extensive information about the place and the role of psychiatric nursing in the system of medical sciences and presents the experience and sentiments of that sphere’s prominent manager. The interviewee shares his success stories, analyzes the difficulties that he faced on his career path, reflects on the factors that led to certain achievements, and implicitly or explicitly reveals the skills that helped him. One of the crucial topics that the respondent mentions are the undervalued significance of psychiatric nursing among society members. The existence of such prejudice is what determined an interviewee’s further life, which he dedicated to the cultivation of highly educated and skilled experts in the sphere and improvement of the profession’s image in the eyes of others. In that light, his main objective throughout most of his career has been creating a unique environment for psychiatric nurse practitioners to constantly increase expert knowledge and widely apply new research findings to practice. Therefore, this paper seeks, firstly, to critically discuss the main ideas and issues highlighted by the interviewee; and, secondly, to identify the skills necessary for psychiatric nurse educators, managers, and leaders.
Problems That the Profession Encounter
There is strong evidence that psychological problems can greatly impact a person’s well-being, quality, and longevity. The extent of that effect can vary significantly, and in extreme cases, severe mental illnesses can reduce a subject’s expectancy of life by twenty years compared to the population’s average (Hennessy & Cocoman, 2018). Therefore, the necessity for mental health professionals who can provide adequate treatment is undeniable. Psychiatric nurses being at the forefront of the interaction between healthcare institutions and patients, play one of the most important roles in the curing process. However, despite the fact that there are distinct regulations, codes of behavior, and necessary skills that coin mental health nursing as a separate profession, the latter’s place is ambiguous (Santangelo, Procter & Fassett, 2018). Baldon (2018) notes that workers who choose the career path of psychiatric nursing face dubious identity issues and have low social status. That situation puts psychiatric nurses in a vulnerable position when their everyday duties vary and adapt according to immediate necessities rather than being strictly determined (Graham et al., 2020).
Phoenix (2019) argues that due to such an ambiguous position, services provided by various departments in clinical and hospital settings that involve psychiatric nurses’ work may not be realized to their full potential. On the other hand, specified roles and improved professional identity would significantly increase their productivity and greatly add to their overall well-being. However, two major factors that make the problem persist further and do not allow the situation to improve were identified. They include 1) undervaluing of the psychiatry nursing field due to current views and stigma towards mentally ill people, and 2) the problems with the education of students and professional development opportunities provided for workers.
Stigma as the Reason behind Misperceptions
Graham et al. (2020) argue that medical institutions should adopt the concept of a holistic care approach for patient treatment, that is, to seek therapy both for mental well-being as well as for physical health. However, the therapeutic paradigm is still predominantly skewed towards the latter view, mostly ignoring the former. The respondent in the study by Graham et al. (2020) notes: “I feel the medical world treats the body and often not the person” (p. 397). Indeed, due to such beliefs within the medical world and in society as a whole, less than half of those diagnosed with mental issues seek professional help (Sickel, Seacat & Nabors, 2019). However, the predominance of body care at the expense of spirituality contradicts research suggestions. The reason for that is considered to be the phenomenon known as stigma towards mental illnesses.
Stigma is a negative attitude or discrimination against someone who possesses different qualities from what is perceived as the norm. It can exist on different levels, including individual, institutional and social (Tyerman, Patovirta, & Celestini, 2021). Moreover, a person can have prejudiced attitudes towards oneself if he/she possesses the qualities that are personally perceived as not normal, which is called self-stigma. Both stigmas towards others and self-stigma are believed to be major issues in the mental health sphere that undermine the full potential of care that psychiatric nurses can provide (Graham et al., 2020). Such a vicious circle of biased attitudes, which is strongly embedded in the everyday thinking of society members, is hard to break. Especially that is the problem in Asian societies, where negative attitudes toward mentally sick people are rooted in moral norms and religious views.
However, the stigma toward mental illnesses should be reduced for the sake of humanity’s well-being. It becomes especially obvious during major social crises – such as the recent COVID-19 pandemic outbreak – when the vulnerability of the human psyche is exposed. On an individual level, people who experience psychological difficulties should be encouraged to seek help. On an institutional level, medical professionals should acknowledge the importance of mental health workers beyond specialized organizations and consider brain-related issues when making a diagnosis. Finally, on a societal level, broader knowledge, and understanding of mental disorders, as well as compassion and care towards psychologically ill people, should be promoted. Therefore, even though it may look easy on paper but difficult to realize in practice, such a holistic approach to stigma fighting should eventually succeed.
Finally, although it is evident that stigma towards psychological issues and mental health professionals exists, it is not self-evident whether psychiatry nursery as a special and separate occupation is necessary. In order to prove its vital part in the medical sphere, it is important to emphasize the unique skills that mental health nurses possess. It is well-known that there is more diversity and richness in inner-world human structures in comparison with the body’s architecture, and thus, it is harder to consider all the causal links that affect illness. Moreover, due to their specificity, psychological problems usually cannot be observed using special instruments or machinery; rather, the diagnosis is based on what the patient says and how he/she behaves. Therefore, Santangelo, Procter & Fassett (2018) contend that the most important skill that psychiatric nurses should possess is the ability to establish intimate and trusting relations with people under treatment. On the other hand, they also should be able to maintain certain boundaries. Such a balancing between two extremes is not a trivial case and necessitates special skills.
As a result, Graham et al. (2020) argue that mental health nurses are able to lead productive conversations with patients concerning sensitive matters like self-harm, suicide, and fears. Additionally, their empathy and empathic listening training allow them to treat patients with less stigma than the nurses of other specializations would do. On the other hand, special skills like making intravenous and muscular injections, wound care, physical illness screening, etc., as well as constant availability to patients, is what distinguishes psychiatric nurses from psychiatrists and psychologists. Therefore, it is clear that mental health assistants should be a necessary part of any medical institution dealing with people who encounter brain-related issues as they possess a unique set of skills and experience.
Educational Issues
The second identified the reason for the underappreciated role of psychiatric nurses in education. The interviewee states that others have a bad perception of the profession due to the low competence of workers in their sphere. The problem, according to him, lies both in the quality and in the quantity of available training and schooling. Indeed, the shortage of good teachers who would pass their knowledge and experience, as well as institutions that offer psychiatric nursing majors, is quite evident. For instance, Vargas et al. (2017) found that the majority of nurses working in the psychiatric urgency and emergency healthcare sphere received their specialization in fields different from mental health. One of the gravest consequences of such a condition is the lack of sufficient skills among the workers, which means that patients’ treatment is not delivered at its best. Vedana et al. (2017) discovered that Brazilian nurses do not possess sufficient knowledge when dealing with patients with suicidal behavior. The respondents note the lack of understanding towards self-murderers, inability to control one’s own emotions (e.g., pity or anger), and even feelings of fear.
On the contrary, Ciydem & Avci (2021) found that short-term educational courses can significantly reduce students’ misperceptions of mental illnesses and psychiatric nursing as a career. However, Demir & Ercan’s (2018) study shows that solely theoretical knowledge is not sufficient to break stigma; thus, students should receive practical experience as well. The latter would also help students gain more confidence and increase clinical skills, but guidance from experienced mentors is needed (Graham et al., 2020). Therefore, in order to improve the educational situation in the psychiatry nursing sphere, decision-makers should balance theoretical and practical studies and make specialized education more available. Moreover, at the very core, the leader should be very determined and willing to change the misperception of the profession, similar to the example of the interviewed expert.
Skills Necessary for Psychiatric Nursing Leaders
When answering the researcher’s questions, the participant implicitly or explicitly discussed which skills are necessary for advanced psychiatric nurses to build a successful career. Firstly, it is the ability to reflect and summarize one’s own experience to be able to train and retrain the workers. Additionally, a manager should not only be a good teacher but also seek to create the proper environment that will inspire workers to constantly continue self-education. Secondly, the leaders should constantly be informed about the latest scientific findings in their proper field and be able to realize the research-proven methods in practice. Moreover, it is necessary to motivate employees to do the same. Thirdly, the expert mentions that the ability to improve one’s self and the working methods helped him to solve many problems. Indeed, scientific studies prove that point of view, asserting that flexibility and the choice of non-conventional methods help people to succeed in whatever sphere they work in. Fourthly, the manager should be inspirational and aware of various motivational techniques. That is especially important for such undervalued spheres as psychiatric nurseries.
Theoretical View of Leadership Style
From all the traits that the interviewee exhibits, it can be concluded that he belongs to the type of transformational leader (Al Khajeh, 2018). The theory distinguishes several leadership styles that are distinct from each other. Classically they include transformational, charismatic, transactional, democratic, autocratic, and bureaucratic ways to manage people. Although not all styles lead to better achievements, transformational leadership is associated with increased performance and innovation (Al Khajeh, 2018). The managers that belong to that type put the mission and the purpose above attaining personal goals (Yaslioglu & SelenayErden, 2018). They are interested in the training and development of their followers and usually seek to motivate the latter through inspiration (Top, Abdullah & Faraj, 2020). Moreover, they trigger an innovational approach to work that necessitates constant adaption of personal views on work and professional routines (Kraft & Bausch, 2016).
Conclusion
The current study provided a critical view of the present condition of psychiatric nurseries based on an interview with one of the advanced managers in the sphere. Indeed, it was found that there is a strong misperception of the profession in the medical world and society. Two major reasons for such prejudices were determined. The first reason includes the existence of stigma and discrimination against mentally sick people, as well as the role of psychiatric nurses. The second factor encompasses learning issues. It was determined that the quantity and quality of provided education are not sufficient for creating skillful professionals. Finally, the practices and skills that the interviewee applied during his career were identified. It was found that the management method that the expert practices theoretically aligns with the transformational leadership style.
References
Al Khajeh, E. H. (2018). Impact of leadership styles on organizational performance. Journal of Human Resources Management Research, 2018, 1-10.
Ciydem, E., & Avci, D. (2021). Effects of the psychiatric nursing course on students’ beliefs toward mental illness and psychiatric nursing perceptions in Turkey. Perspectives in psychiatric care.
Demir, S., & Ercan, F. (2018). The first clinical practice experiences of psychiatric nursing students: A phenomenological study. Nurse education today, 61, 146-152.
Graham, J. M., Waddell, C., Pachkowski, K., & Friesen, H. (2020). Educating the educators: determining the uniqueness of psychiatric nursing practice to inform psychiatric nurse education. Issues in mental health nursing, 41(5), 395-403.
Hennessy, S., & Cocoman, A. M. (2018). What is the impact of targeted health education for mental health nurses in the provision of physical health care? An integrated literature review. Issues in mental health nursing, 39(8), 700-706.
Kraft, S. P., & Bausch, A. (2016). How do transformational leaders promote exploratory and exploitative innovation? Examining the black box through MASEM. Journal of Product Innovation Management, 33(6), 687-707.
Phoenix, B. J. (2019). The current psychiatric mental health registered nurse workforce. Journal of the American Psychiatric Nurses Association, 25(1), 38-48.
Santangelo, P., Procter, N., & Fassett, D. (2018). Seeking and defining the ‘special’in specialist mental health nursing: A theoretical construct. International journal of mental health nursing, 27(1), 267-275.
Sickel, A. E., Seacat, J. D., & Nabors, N. A. (2019). Mental health stigma: Impact on mental health treatment attitudes and physical health. Journal of health psychology, 24(5), 586-599.
Top, C., Abdullah, B. M. S., & Faraj, A. H. M. (2020). Transformational leadership impact on employees’ performance. Eurasian Journal of Management & Social Sciences, 1(1), 49-59.
Tyerman, J., Patovirta, A. L., & Celestini, A. (2021). How stigma and discrimination influences nursing care of persons diagnosed with mental illness: a systematic review. Issues in mental health nursing, 42(2), 153-163.
Vargas, D., Soares, J., Ponce, T. D., & Oliveira, B. B. (2017). Psychiatric urgency and emergency care nurses: an analysis of their professional and educational profile. Cogitare Enferm, 22(4), e50704.
Vedana, K. G. G., Magrini, D. F., Miasso, A. I., Zanetti, A. C. G., de Souza, J., & Borges, T. L. (2017). Emergency nursing experiences in assisting people with suicidal behavior: a grounded theory study. Archives of psychiatric nursing, 31(4), 345-351.
Yaslioglu, M. M., & SelenayErden, N. (2018). Transformational leaders in action: Theory has been there, but what about practice?. IUP Journal of Business Strategy, 15(1).