ACUTE CARE PSYCHIATRIC NURSING INTERVENTIONS                                                  i 
           
           
           
           
           
           
           
           
                              
                              
                  Acute Care Psychiatric Nursing Interventions: 
                     The Experience of Expert Nurses 
                              
                              
                              
                              
                              
                            By 
                     Andrea E. Thomson, BScPN, RPN 
                              
                              
                              
                              
                              
        
                 A Thesis Submitted to the Faculty of Graduate Studies 
                 in partial fulfilment of the requirements for the degree of 
                      Master of Psychiatric Nursing 
                      Department of Health Studies 
                        Brandon University 
                        Brandon, Manitoba 
        
        
        
        
        
       Thesis Committee:  
       Dr. Fran Racher, Chair  
       Professor Karen Clements  
       Ms Sherry Sawatzky-Dyck  
                     
                                                   
           
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                                         Abstract 
           Psychiatric nursing interventions are integral to the health and care of mental health clients. 
           These interventions are embedded into every day nursing practice. The purpose of this research 
           was to explore psychiatric nurses’ lived experiences providing nursing interventions to adult 
           clients in acute care settings. Hermeneutic phenomenology, as outlined by van Manen, was 
           utilized. Six expert psychiatric nurses, with many years of acute care practice in providing care 
           to clients with complex problems through the use of critical skill provision, were recruited 
           through purposive and snowball sampling. Data were collected through the use of open-ended, 
           semi-structured research questions delivered through conversational interviews. 
            
           Data analysis illuminated integrated themes of awareness and person-centered care (PCC). 
           Awareness was further categorized into subthemes of self-awareness, awareness of the client, 
           and situational awareness. PCC involved subthemes of delivering PCC plans; determining goals; 
           fostering empathy, support, and hope; listening in one-to-one interactions; person-centered 
           teaching; and enhancing coping strategies. Awareness and PCC interventions were harmonious 
           and reciprocal in practice. Awareness was required to provide PCC and through the practice of 
           PCC awareness grew. Use of the interventions involved a complex interplay of skills that were 
           embodied into the caring responses provided by psychiatric nurses. 
            
                Keywords: Psychiatric nursing, interventions, acute care, mental health, hermeneutic 
           phenomenology, awareness, person-centered care, presence, coping strategies 
                                 
                                                                               
                 
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                                      Acknowledgments 
                I truly am a psychiatric nurse at heart. This study began with a desire to contribute 
           valuable knowledge to a profession that I hold dear. My goal was to contribute research that 
           would ultimately benefit client care. Acute care psychiatric nurses are front-line professionals 
           whose care and compassion impact the recoveries of the people served. The scope of inquiry was 
           narrowed down to focus on expert practice in order to hear from those who were providing 
           exceptional care and give language to the interventions delivered. I have much gratitude towards 
           everyone who offered their support and encouragement during a time that was both challenging 
           and rewarding. 
                First and foremost, I would like to thank my thesis advisor Dr. Fran Racher. Fran 
           provided a phenomenal amount of support throughout this journey. I was fortunate to have had 
           an opportunity to work with Fran and bask in her wisdom. She was available whenever I needed 
           her and provided constructive feedback and insight along the way. She helped me focus and 
           refine my inquiry into a piece of work that I am proud of. I could not have imagined a better 
           mentor and support. 
                I would like to extend my gratitude to my thesis committee, Karen Clements and Sherry 
           Sawatzky-Dyck. Thank-you. Although writing took longer than I had expected I always knew 
           that my committee members were waiting patiently for completion of the thesis work. The 
           committee provided me with awesome insight and unique perspectives that enhanced the 
           findings and understanding of this phenomenon. 
                A special thanks goes out to the six participants who agreed to participate in the study. 
           Thank-you for taking the time to openly and honestly share your knowledge of psychiatric 
           nursing interventions. I will be forever grateful. Your voices have contributed to the psychiatric 
                                                                               
                 
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           nursing knowledgebase and your practice has made a difference. 
                Last but not least I need to thank my family and friends for their support throughout the 
           process. I spent many days in front of my computer immersed in writing. My family and friends 
           gave me space when I was absorbed in research and were always there when I decided to return 
           to the outside world. My mother, Rosalie Thomson, and good friend, Dana Cale, deserve special 
           acknowledgement for their assistance along the way. Everything that I accomplished was due to 
           the love and support provided by those close to me.  
                Thank-you all for your part in my journey.