Newly hired nurses’ transitional challenges and coping with caring for schizophrenia patients in a psychiatric training hospital
Background & Aim: This study aimed to explore the transitional challenges of newly hired psychiatric nurses in the care of clients with schizophrenia and the coping mechanisms that they use to overcome their transitional challenges.
Methods & Materials: This descriptive-qualitative study interviewed six purposively selected newly hired psychiatric nurses caring for patients with schizophrenia who work for about six months to two years in a Psychiatric Training Hospital in the Philippines. An interview protocol was used to obtain data with strict observance of relevant ethical considerations. In determining the emerging themes and subthemes from the transcribed data with trustworthiness, thematic analysis was employed.
Results: Two major prior codes were explored, namely, transitional challenges and coping mechanisms. On the one hand, five subthemes emerged under the transitional challenges that include emotional challenges, need for professional growth, nurses’ recognition of the inability to patient care management, need support from more experienced colleagues. Experience/feel the shock in the encounter of people with a mental health condition. On the other hand, four subthemes were unearthed under coping mechanisms that include emotional responses, professional coping strategies (i.e., reliance on the adequate support system, establishing the professional nurse-patient relationship, call to professional advancement, and commitment to evidence-based practice), and institutional coping strategies.
Conclusion: While newly hired nurses experience tremendous transitional challenges, their coping mechanisms continuously emerge and develop. The nursing administration needs to foster sustainable mentoring and resilience programs essential in aiding newly hired nurses’ adaptation and adjustment to the professional work environment.
2. Meleis AI. Transitions theory: Middle range and situation specific theories in nursing research and practice. Springer publishing company; 2010 Feb 17.
3. Hung BJ, Huang XY, Cheng JF, Wei SJ, Lin MJ. The working experiences of novice psychiatric nurses in T aiwanese culture: a phenomenological study. Journal of Psychiatric and Mental Health Nursing. 2014 Aug;21(6):536-43. DOI: 10.1111/jpm.12121.
4. Çam O, Büyükbayram A. Nurses' Resilience and Effective Factors. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi. 2017 Jun 1;8(2):118-26.
5. Varghese A, Khakha DC, Chadda RK. Pattern and type of aggressive behavior in patients with severe mental illness as perceived by the caregivers and the coping strategies used by them in a tertiary care hospital. Archives of psychiatric nursing. 2016 Feb 1;30(1):62-9.
6. Gito M, Ihara H, Ogata H. The relationship of resilience, hardiness, depression and burnout among Japanese psychiatric hospital nurses. Journal of Nursing Education and Practice. 2013 Apr 15;3(11).
7. Dwyer PA, Revell SM. Multilevel influences on new graduate nurse transition: A literature review. Journal for Nurses in Professional Development. 2016 May 1;32(3):112-21. doi:10.1097/nnd.0000000000000265
8. Polit DF, Beck CT. Essentials of nursing research, 7th ed. Lippincott Williams & Wilkins; 2009.
9. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006 Jan1;3(2):77-101. https://doi.org/10.1191/1478088706qp063oa
10. Creswell, JW. Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks, CA: Sage Publications; 1998.
11. Morse, JM. Designing funded qualitative research. In Denizin, N. K. & Lincoln, Y. S., Handbook of qualitative research, 2nd ed. Thousand Oaks, CA: Sage; 1994.
12. Benner P. From novice to expert. Menlo Park. 1984.
13. Patton, MQ. Qualitative Research & Evaluation Methods: Integrating Theory and Practice (4th ed.). USA: Sage Publications, Inc.2015
14. Maher C, Hadfield M, Hutchings M, de Eyto A. Ensuring rigor in qualitative data analysis: A design research approach to coding combining NVivo with traditional material methods. International Journal of Qualitative Methods. 2018 Jul 9;17(1):1609406918786362.
15. Mabala J, van der Wath A, Moagi M. Newly qualified nurses' perceptions of working at mental health facilities: A qualitative study. Journal of psychiatric and mental health nursing. 2019 Jun;26(5-6):175-84. doi:10.1111/jpm.12525.
16. Foster K, Roche M, Delgado C, Cuzzillo C, Giandinoto JA, Furness T. Resilience and mental health nursing: An integrative review of international literature. International journal of mental health nursing. 2019 Feb;28(1):71-85.
17. Song Y, Ebenezar M, Haastrup K. Coping mechanisms of mental health nurses in work related stress situations: Literature Review. 2018. Availale from:
18. Haslinda A, Tyng CL. Job stress and coping mechanisms among nursing staff in a Malaysian private hospital. International Journal of Academic Research in Business and Social Sciences. 2016 May;6(5):471-87.
19. Sari DH, Erwina I. Relationship between Job Stress and Coping Mechanism in Psychiatric Nurse in National Mental Health Hospital. Elevate: The International Journal of Nursing Education, Practice and Research. 2018 Jul 1;1(1):76-9.
20. Hasan AA, Elsayed S, Tumah H. Occupational stress, coping strategies, and psychological‐related outcomes of nurses working in psychiatric hospitals. Perspectives in psychiatric care. 2018 Oct;54(4):514-22. doi:10.1111/ppc.12262
21. Çelik Ince S, Partlak Günüşen N, Serçe Ö. The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: a qualitative study. Journal of Psychiatric and Mental Health Nursing. 2018 May;25(4):245-57. doi:10.1111/jpm.12456
22. Harrison CA, Hauck Y, Ashby R. Breaking down the stigma of mental health nursing: A qualitative study reflecting opinions from western australian nurses. Journal of Psychiatric and Mental Health Nursing. 2017 Sep;24(7):513-22. doi:10.1111/jpm.12392.
23. Pazargadi M, Fereidooni Moghadam M, Fallahi Khoshknab M, Alijani Renani H, Molazem Z. The therapeutic relationship in the shadow: Nurses’ experiences of barriers to the nurse–patient relationship in the psychiatric ward. Issues in Mental Health Nursing. 2015 Jul 3;36(7):551-7. doi:10.3109/01612840.2015.1014585
24. Valente SM. Managing professional and nurse–patient relationship boundaries in mental health. Journal of psychosocial nursing and mental health services. 2017 Jan 31;55(1):45-51. doi:10.3928/02793695-20170119-09
25. Vahidi M, Ebrahimi H, Areshtanab HN, Jafarabadi MA, West S, Foong A, Cleary M. Providing a safe environment in a psychiatric ward: Nurses and vigilance in Iran. Issues in mental health nursing. 2019 Jan 2;40(1):65-72. doi:10.1080/01612840.2018.1463326
26. Penman J, Martinez L, Papoulis D, Cronin K. Voices from the Field: Regional Nurses Speak About Motivations, Careers and How to Entice Others to Pursue Mental Health Nursing. Int J Nurs Educ Scholarsh. 2018;15(1):/j/ijnes.2018.15.issue-1/ijnes-2017-0056/ijnes-2017-0056.xml. Published 2018 30 January. doi:10.1515/ijnes-2017-0056
27. Zarea K, Fereidooni-Moghadam M, Baraz S, Tahery N. Challenges encountered by nurses working in acute psychiatric wards: A qualitative study in Iran. Issues in Mental Health Nursing. 2018 Mar4;39(3):244-50. doi:10.1080/01612840.2017.1377327
28. Tsaras K, Daglas A, Mitsi D, Papathanasiou IV, Tzavella F, Zyga S, Fradelos EC. A cross-sectional study for the impact of coping strategies on mental health disorders among psychiatric nurses. Health psychology research. 2018 May 8;6(1). doi:10.4081/hpr.2018.7466
29. Matsumoto Y, Yoshioka SI. Factors Influencing Psychiatric Nurses’ Job Satisfaction Levels: Focusing on Their Frequency of Experiencing Negative Emotions Toward Patients and Support at Their Workplaces. Yonago Acta Medica. 2019;62(4):293-304.
30. Zhou H, Jiang F, Rakofsky J, Hu L, Liu T, Wu S, Liu H, Liu Y, Tang YL. Job satisfaction and associated factors among psychiatric nurses in tertiary psychiatric hospitals: Results from a nationwide cross‐sectional study. Journal of Advanced Nursing. 2019 Dec;75(12):3619-30. doi:10.1111/jan.1420.
|Issue||Vol 8 No 1 (2021): Winter|
|transitional challenges; coping mechanisms; psychiatric nurse; qualitative research|
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