Challanges Faced by Nurses Providing Psychiatric Care

Challenges Faced by Nurses Providing Psychiatric Care
Institution
Name

ABSTRACT
Nursing is a demanding career that requires gentleness, decisiveness and hard work all in one package. It is a more challenging job for nurses dealing with psychiatric patients unlike ordinary patients since the former cannot express themselves coherently and reliably. Moreover, the patients may tend to be aggressive, thus forcing the nurses to go to extreme lengths to physically restrain the patients. While this is often the agreeable cause of action, it at times results into a legal and civil quagmire that hospitals throughout the country have to deal with continuously. However, the most challenging aspect facing the department psychiatric nurses is the under-staffing. There is an acute shortage of nurses, as very few are willing to pursue the course, as it does not offer the best working conditions. This article explores in depth these and other challenges, the causes, and suggests likely courses of action that can be taken to mitigate these challenges.
Keywords: Nursing, Challenges, Career
Introduction
Caring for patients with mental health issues is a major global challenge for nurses. In most countries especially the developing nations, research concentrates on the experience of nurses in health care system without focusing on the psychiatric unit. The paper will focus on the problem of an increased population of psychiatrists’ patients against unlimited services, environmental challenge influence of work environment on delivery care, issue of diversity, limited resources in the hospitals to take care of complex mental treatments and public bias.

Also, in the acute areas, nurses’ face fails to deliver quality services due to psycho-social and psychological challenges.
Thesis: Nursing is one of the most demanding profession, and nurses often encounter challenges ranging from the increased number of patients, scarcity of resources, changes in the environment, public bias and cultural diversity which may inhibit their performance and ability to deliver quality care.

Literature Review
Currently, the population of patients in need of psychiatric care has drastically increased above the available nursing services. A nurse finds it difficult to deliver quality services due to the high number of patients they handle concurrently. According to Appold (2016), nurses taking care of mentally ill persons in the USA are inadequately trained hence affecting the provision of care. In most cases, the patient fails to comply with the medication, laboratory works and general medical care which make it hard for the limited nurses to provide proper care.
Influence of work environment is a major challenge facing psychiatric nurses. In most psychiatric centers, there are undeveloped and under-resourced mental care systems which make it difficult for the nurses to provide adequate care. Research conducted by Marie, Hannigan & Jones (2017), shows that few studies are conducted to examine the health of nurses dealing with mental care. The hospitals fail to understand the challenges faced by nurses within the system to reduce the difficulties faced by the professions when providing care. Mental health systems need to be improved to lessen the work for the nurses and ensure quality health services for the patients.
According to research conducted by Marsella (2011), mental health professionals are faced with the challenges of working with an ethnoculturally diverse population. There are specific dimensions that professionals need to apply when providing services to culturally diverse patients. Professionals need to understand scope like social class, education, and gender before deciding on the service provision. Also, status and identities like migratory workers, skilled and unskilled international workers, immigrants, refugees, asylum seekers like war victims and international students need to be understood and evaluated. Thus, nurses need to be equipped in an array of cultural issues to prevent ethnoculturally diverse patients which is a burden to the professional nurses.
In America, the mental health care system is not well developed a problem that affects the dissemination of psychiatric care. Sabella & Fay-Hillier (2013) conducted research identifying the challenges faced in mental care nursing. The finding revealed that psychiatric nurses are provided with limited resources and face bias from the public. The society fails to understand the complexity of their works hence shows prejudice and stereotypes which affect their provision of care.
Patients who have mental illness especially those in need of acute psychiatric care require quality care from the professionals. Research conducted in Western Cape Province on nurse’s experience in acute admission shows the difficulty of handling such patients. Nurses need to provide and show passion care and teamwork for the patients (Sobekwa & Arunachallam, 2015). In most cases, the nurses are not equipped with adequate support from the authorities to make their work successful.
The ability of nurses to provide quality services in the acute psychiatric wards is faced with the challenge of psycho-social and psychological issues. Seeing the suffering of the patients and listening to their problems are traumatizing to the care providers. In most cases, the physical and mental well-being of the nurses is affected (Zarea, Fereidooni, Baraz & Tahery, 2018). The authority needs to come up with special care for handling the health of the nurses who work with mentally ill patients to help them manage trauma and other psychological issues.
According to Hendrickson, Schmal, & Ekleberry (2014), there is a direct connection between the use of addictive drugs and substance abuse and mental illness. The trio further reports that patients with mental health disorders consume approximately 40 percent of cigarettes, 44 percent of cocaine, and 38 percent of alcohol which in return, affects their mental status. On the other hand, Smith (2018) claims that dealing with substance abuse, drug addiction, and alcoholism is not an easy task: it, however, becomes more difficult when the patient in question is also battling with mental health problems. In this paper, the effects of substance abuse and mental illness on the nursing profession and industry are discussed.
According to Adams (2015), nurses that battle with substance abuse is afraid to seek medical assistance because of fear of losing their job. Further research by Smith (2018), indicates that nurses with mental health problems and substance abuse are at higher risk of harming their patients, denigrating the nursing profession, injuring themselves, and harming the reputation of the nursing industry. Besides, working under the influence of alcohol and when one is not in their right psychological status affect the quality of work output (Hendrickson, Schmal, & Ekleberry, 2014). A nurse may fail to establish a nurse-to-patient rapport which is useful for collecting patients’ health information that helps for treatment when they are working under the influence of drugs (Adams, 2015). A drunkard and mentally ill health practitioner will, more often than not, fail to win trust and confidence of patients, which in effect, affects the nursing reputation and that of the industry at large (Smith, 2018).

Introduction
According to Hendrickson, Schmal, & Ekleberry, (2014), there is a direct connection between the use of addictive drugs and substance abuse and mental illness. The trio further reports that patients with mental health disorders consume approximately 40 percent of cigarettes, 44 percent of cocaine, and 38 percent of alcohol which in return, affects their mental status. On the other hand, Smith (2018) claims that dealing with substance abuse, drug addiction, and alcoholism is not an easy task: it, however, becomes more difficult when the patient in question is also battling with mental health problems. In this paper, the effects of substance abuse and mental illness on the nursing profession and industry are discussed.
According to Adams (2015), nurses that battle with substance abuse are afraid to seek medical assistance because of fear of losing their job. Further research by Smith (2018), indicates that nurses with mental health problems and substance abuse are at higher risk of harming their patients, denigrating the nursing profession, injuring themselves, and harming the reputation of the nursing industry. Besides, working under the influence of alcohol and when one is not in their right psychological status affects the quality of work output (Hendrickson, Schmal, & Ekleberry, 2014). A nurse may fail to establish a nurse-to-patient rapport which is useful for collecting patients’ health information that helps for treatment when they are working under the influence of drugs (Adams, 2015). A drunkard and mentally ill health practitioner will, more often than not, fail to win trust and confidence of patients, which in effect, affects the nursing reputation and that of the industry at large (Smith, 2018).
Body
Caring for patients with mental health issues is a major global challenge for nurses. In most countries especially the developing nations, research concentrates on the experience of nurses in health care system without focusing on the psychiatric unit. The paper will focus on the problem of an increased population of psychiatrists’ patients against unlimited services, environmental challenge influence of work environment on delivery care, issue of diversity, limited resources in the hospitals to take care of complex mental treatments and public bias. Also, in the acute areas, nurses’ face fails to deliver quality services due to psycho-social and psychological challenges.
Currently, the population of patients in need of psychiatric care has drastically increased above the available nursing services. A nurse finds it difficult to deliver quality services due to the high number of patients they handle concurrently. According to Appold (2016), nurses taking care of mentally ill persons in the USA are inadequately trained hence affecting the provision of care. In most cases, the patient fails to comply with the medication, laboratory works and general medical care which make it hard for the limited nurses to provide proper care.
Influence of work environment is a major challenge facing psychiatric nurses. In most psychiatric centers, there are undeveloped and under-resourced mental care systems which make it difficult for the nurses to provide adequate care. Research conducted by Marie, Hannigan & Jones (2017), shows that few studies are conducted to examine the health of nurses dealing with mental care. The hospitals fail to understand the challenges faced by nurses within the system to reduce the difficulties faced by the professions when providing care. Mental health systems need to be improved to lessen the work for the nurses and ensure quality health services for the patients.
According to research conducted by Marsella (2011), mental health professionals are faced with the challenges of working with an ethnoculturally diverse population. There are specific dimensions that professionals need to apply when providing services to culturally diverse patients. Professionals need to understand scope like social class, education, and gender before deciding on the service provision. Also, status and identities like migratory workers, skilled and unskilled international workers, immigrants, refugees, asylum seekers like war victims and international students need to be understood and evaluated. Thus, nurses need to be equipped in an array of cultural issues to prevent ethnoculturally diverse patients which is a burden to the professional nurses.
In America, the mental health care system is not well developed a problem that affects the dissemination of psychiatric care. Sabella &Fay (2013) conducted research identifying the challenges faced in mental care nursing. The finding revealed that psychiatric nurses are provided with limited resources and face bias from the public. The society fails to understand the complexity of their works hence shows prejudice and stereotypes which affects their provision of care.
Patients who have mental illness especially those in need of acute psychiatric care require quality care from professionals. Research conducted in Western Cape Province on nurses experience in acute admission shows the difficulty of handling such patients. Nurses need to provide and show passion care and teamwork for the patients (Sobekwa & Arunachallam, 2015). In most cases, the nurses are not equipped with adequate support from the authorities to make their work successful. The ability of nurses to provide quality services in the acute psychiatric wards is faced by the challenge of psycho-social and psychological issues. Seeing the suffering of the patients and listening to their problems is traumatizing to the care providers. In most cases, the physical and mental well-being of the nurses is affected (Zarea, Fereidooni, Baraz & Tahery, 2018). The authority needs to come up with special care for handling the health of the nurses who work with mentally ill patients to help them manage trauma and other psychological issues.
In conclusion, nurses face a lot of challenges when disseminating care to the psychiatric patients. Nurses work in a challenging and uncompromised psychiatric unit especially for acute patients which require highly specialized care. Increased number of psychiatric patients exceeds the number of qualified nursing care providers hence affecting the provision of quality care.

Discussion
The increase in the number of patients in need of medical assistance had placed immense pressure on nurses. This can be attributed to the high nurse-patient ratio in most health facilities. More nurses ought to be trained and deployed to help patients. However, this comes at a time when there have been numerous critics regarding how some psychiatrists are trained. Respective accreditation bodies ought to intervene and propose the metrics that will be used to gauge if someone is qualified to deliver care. Nurses are likely to face challenges adapting to a new working environment especially if the workmates or the superiors are not supportive.
Some health facilities have minimal resources which make delivery of healthcare services challenging. Sabella & Fay-Hillier (2013) proposes that psychiatrist nurses have to cope with the problem of limited resources. Both the federal and state government should consider increasing the healthcare budget to ensure that everyone has access to quality and affordable healthcare services. Nowadays, there are more complex medical conditions which require the intervention of sophisticated medical gadgets and equipment. Healthcare providers should be prepared to treat patients from various ethnicities. Furthermore, anyone can fall ill regardless of their gender, age, country of origin and race.
Psychiatrist nurses may also face criticism and bias from members of the public. This can be attributed to the fact not everyone will be content with the quality of services offered at each health facility. However, psychiatrist nurses should strive to ensure that they deliver quality services at all times. Psychiatrist nurses are also vulnerable to various psychosocial and psychological challenges within the nursing profession. Nurses have to strive to balance their career with family without compromising any. At times, this may be challenging and may predispose them to mental disorders which in the long run can affect their performance and the reputation of the nursing profession.
In conclusion, nurses face a lot of challenges when disseminating care to psychiatric patients. Nurses work in a challenging and uncompromised psychiatric unit especially for acute patients which requires highly specialized care. Increased number of psychiatric patients exceeds the number of qualified nursing care providers hence affecting the provision of quality care.

Conclusion
In addition to the challenges that every other nurse face, such as overworking, lack of proper equipment, nurses in psychiatric care face as a particular class of obstacles that make their careers even more challenging. The relevant authorities: the government, hospital administration, and other such stakeholders have a responsibility of trying to solve these problems. It is essential to look after the welfare of these nurses because if the existing the existing challenges are not seriously considered, then the mental health of the patients they seek to treat will only deteriorate (Marsella, 2011).
Some of the possible solutions include providing nurses with specialized psychiatry therapy: this is to help them deal with the emotional turmoil of having to see their patients undergo mental and physical suffering. Also, these stakeholders can also provide incentives to nursing students to persuade them to pursue a study in psychiatry to alleviate the problem of the shortage of nurses in the sector. Finally, the hospitals’ management personnel can provide in-service training to the already existing nurses to broaden their scope of knowledge of psychiatry, and well as equip them with soft skills- such as team-work to make their work more bearable. If these and such other solutions are implemented, there will be a healthier, and more mentally stable population and the public will restore its faith in the mental institutions.

References
Appold, K. (2016, March). Experts suggest ways to deal with challenges surrounding care of psychiatric patients. Retrieved from The Hospitalist: https://www.thehospitalist.org/hospitalist/article/121834/experts-suggest-ways-deal-challengessurrounding-care-psychiatric
Marie, M., Hannigan, B., & Jones, A. (2017). Challenges for nurses who work in community mental health centres in the West Bank, Palestine. International Journal of Mental Health Systems, 1-10.
Marsella, A. J. (2011, October). Twelve critical issues for mental health professionals working with ethnoculturally diverse populations. Retrieved from American Psychological
Association: http://www.apa.org/international/pi/2011/10/critical-issues.aspxSabella, D., & Fay-Hillier, T. (2013). Challenges in mental health nursing: current opinion. Dove Medical Press, 2014(4), 1-6.
Sobekwa, Z. C., & Arunachallam, S. (2015). Experiences of nurses caring for mental health care users in an acute admission unit at a psychiatric hospital in the Western Cape Province. AOSIS, 38(2), 1-11.
Zarea, K., Fereidooni-Moghadam, M., Baraz, S., & Tahery, N. (2018). Challenges encountered by nurses working in acute psychiatric wards: a qualitative study in Iran. Issues in Mental Health Nursing, 39(3), 244-250.

Annotated bibliography.
Appold, K. (2016, March). Experts suggest ways to deal with challenges surrounding care of
psychiatric patients. Retrieved from The Hospitalist: https://www.thehospitalist.org/hospitalist/article/121834/experts-suggest-ways-deal-challengessurrounding-care-psychiatric
This article brings together ideas from different health experts in psychiatry to outline the challenges surrounding care of psychiatric patients. Appold points out to the challenges of a high population of patients in need of psychiatric care against the limited services, which make the delivery of quality care difficult. The article cites Dr. Bianco who stated that the widespread downsizing and shuttering of psychiatric hospitals in the 1990s reduced the ratio of psychiatric beds to Americans to one to 3,000 Americans. The article argues that psychiatric nurses are inadequately trained, and care is highly affected by inadequate staff to manage psychiatric patients. Further, the article cites the higher noncompliance with imaging, medication, laboratory work, and general medical care by psychiatric patients as a major challenge facing nurses in the provision of care. It outlines many other challenges including patient behavioral changes, outbursts, and violent cases among others as major challenges.
Marie, M., Hannigan, B., & Jones, A. (2017). Challenges for nurses who work in community mental health centres in the West Bank, Palestine. International Journal of Mental Health Systems, 1-10.
Marie et al. (2017) discuss the major challenges facing nurses who work offer mental health care in West Bank. The journal article highlights the challenges environment and the influence of the work environment on the delivery of care. It points out the impact of an underdeveloped and under-resourced mental health care system on the well-being of the health professionals and the quality of care. The authors argue that understanding the challenges within the system and facing the health professional in a particular context is fundamental for decreasing the challenges for the health professionals and enhancing the mental health system.
Marsella, A. J. (2011, October). Twelve critical issues for mental health professionals working with ethno-culturally diverse populations. Retrieved from American Psychological Association: http://www.apa.org/international/pi/2011/10/critical-issues.aspx
Marsella outlines the issues and dimensions that health professionals, especially psychologists, must apply when providing services to a culturally and ethnically diverse population. The author identifies diversity as a major challenge facing mental health professionals. The article offers a discussion of twelve critical issues whose consideration would help mental health professionals deliver high-quality and effective care.
Sabella, D., & Fay-Hillier, T. (2013). Challenges in mental health nursing: current opinion. Dove Medical Press, 2014(4), 1-6.
The authors discuss the mental health care system in the US and outline the challenges facing the system and the health care professionals. According to the journal article, the US continues to experience significant challenges in providing adequate high-quality mental health care. It outlines limited resources, biases from other health care professionals, bias from the public, and the complexity of mental health treatment among others as critical challenges. Psychiatric nurses are affected by the limited resources, the biases, and complexities in their roles significantly.
Sobekwa, Z. C., & Arunachallam, S. (2015). Experiences of nurses caring for mental health care users in an acute admission unit at a psychiatric hospital in the Western Cape Province. AOSIS, 38(2), 1-11.
This article outlines the experiences of psychiatric nurses providing care to patients in need of acute psychiatric care. It discusses the depth of the mental illnesses and the need for quality care while highlighting the unique challenges influencing the care. According to the authors positive experiences such as passion for caring, recovery of patients, and teamwork influence care significantly. Moreover, they highlighted that nurses in South Africa feel unappreciated, face bias, and experience minimal support from authorities.
Zarea, K., Fereidooni-Moghadam, M., Baraz, S., & Tahery, N. (2018). Challenges encountered by nurses working in acute psychiatric wards: a qualitative study in iran. Issues in Mental Health Nursing, 39(3), 244-250.
Zarea and the co-authors discuss the challenges psychiatric nurses face in acute psychiatric wards. The study states that a challenging environment influences the ability of the psychiatric nurses to deliver quality and impactful care to people suffering from psychiatric disorders. The article identifies themes such as psycho-social challenges, catalysts causing challenges, and psychological challenges as contributing to the challenges. It highlights the physical and mental wellbeing of the psychiatric nurses as essential in ensuring the delivery of quality mental health care.