Issues of Ethics and Care Explored Through an Ethnographic Study of Psychiatric Home Care: Perspectives from Psychiatric Community Health Nurses, Administrators, Social Work, and Pastoral Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/163257
Category:
Abstract
Type:
Presentation
Title:
Issues of Ethics and Care Explored Through an Ethnographic Study of Psychiatric Home Care: Perspectives from Psychiatric Community Health Nurses, Administrators, Social Work, and Pastoral Care
Author(s):
Sturm, Bonnie A.
Author Details:
Bonnie A. Sturm, EdD, RN, Assistant Professor in Nursing, Seton Hall University, Behavioral Sciences, Community, and Health System, South Orange, New Jersey, USA, email: Sturmbon@shu.edu
Abstract:
Purpose: To explore, describe, and document psychiatric community health nurse (PCHN) practices and ethically based care issues faced by nurses and other members of the multidisciplinary health care team at a home care agency. Background: PCHN's in collaboration with multidisciplinary team members, are influenced by an ethic of care in their work to provide services to patients with mental illness residing in the community. Ethical conflict experienced by providers faced with obstacles to high quality care is worthy of further exploration. Methods (Design, Participants, Setting, Data Collection, Analytic approach): Ethnographic study design utilizing the methods of participant observation, interviews, and analysis of agency documents. Data was collected systematically, indexed, and analyzed concurrently. Emerging questions directed further data collection and analysis. Multidisciplinary participants included 9 PCHNs, 1 CHN, 4 supervisors, 2 long term administrators, 2 insurance/HMO coordinators, 1 PSWS, and 1 pastoral CC. All were observed in the agency and PCHN's were accompanied to home visit settings. Results: PCHNs experienced moral distress and were acutely aware that many of their patients were not receiving necessary care. These nurses knew how to make a difference in the lives of individuals with chronic persistent mental illness, but the quality of care they could provide was frequently restricted by stringent regulatory mechanisms imposed by third party insurance payers. Multidisciplinary perspectives on these issues, supported similar concerns, but identified additional considerations related to compliance, safety, autonomy and spiritual values. Conclusions and Implications: Problems including, inadequate coverage of high quality psychiatric home care services, frequent psychiatric hospital re-admissions, and non-parity for psychiatric nursing services as compared with medically related services, require continued research and reform. PCHN's are discussed as an excellent potential provider of integrated services to this population, which includes those with SPMI. The value of interdisciplinary perspectives and services has implications for the enhancement of quality of psychiatric home care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Name:
18th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Cherry Hill, New Jersey
Description:
�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jersey
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleIssues of Ethics and Care Explored Through an Ethnographic Study of Psychiatric Home Care: Perspectives from Psychiatric Community Health Nurses, Administrators, Social Work, and Pastoral Careen_GB
dc.contributor.authorSturm, Bonnie A.en_US
dc.author.detailsBonnie A. Sturm, EdD, RN, Assistant Professor in Nursing, Seton Hall University, Behavioral Sciences, Community, and Health System, South Orange, New Jersey, USA, email: Sturmbon@shu.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163257-
dc.description.abstractPurpose: To explore, describe, and document psychiatric community health nurse (PCHN) practices and ethically based care issues faced by nurses and other members of the multidisciplinary health care team at a home care agency. Background: PCHN's in collaboration with multidisciplinary team members, are influenced by an ethic of care in their work to provide services to patients with mental illness residing in the community. Ethical conflict experienced by providers faced with obstacles to high quality care is worthy of further exploration. Methods (Design, Participants, Setting, Data Collection, Analytic approach): Ethnographic study design utilizing the methods of participant observation, interviews, and analysis of agency documents. Data was collected systematically, indexed, and analyzed concurrently. Emerging questions directed further data collection and analysis. Multidisciplinary participants included 9 PCHNs, 1 CHN, 4 supervisors, 2 long term administrators, 2 insurance/HMO coordinators, 1 PSWS, and 1 pastoral CC. All were observed in the agency and PCHN's were accompanied to home visit settings. Results: PCHNs experienced moral distress and were acutely aware that many of their patients were not receiving necessary care. These nurses knew how to make a difference in the lives of individuals with chronic persistent mental illness, but the quality of care they could provide was frequently restricted by stringent regulatory mechanisms imposed by third party insurance payers. Multidisciplinary perspectives on these issues, supported similar concerns, but identified additional considerations related to compliance, safety, autonomy and spiritual values. Conclusions and Implications: Problems including, inadequate coverage of high quality psychiatric home care services, frequent psychiatric hospital re-admissions, and non-parity for psychiatric nursing services as compared with medically related services, require continued research and reform. PCHN's are discussed as an excellent potential provider of integrated services to this population, which includes those with SPMI. The value of interdisciplinary perspectives and services has implications for the enhancement of quality of psychiatric home care.en_GB
dc.date.available2011-10-27T11:04:13Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:04:13Z-
dc.conference.date2006en_US
dc.conference.name18th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationCherry Hill, New Jerseyen_US
dc.description�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jerseyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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