What Psychiatric Nurses Say about Constant Care

As part of a qualitative research project on constant care, 8 psychiatric nurses described their perceptions of the constant care experience and its purposes and values. One of the major domains that emerged from the interviews was "nursing"; it consisted of nine themes, some of which indicated that constant care alters the passage, meaning, and use of time, is a dynamic rather than a static relationship, and enhances a nurse's sense of powerfulness. The findings showed that constant care is a dynamic, and to some, distorting, experience. It demands extra work from the nurses, yet constrains them from doing counseling or other higher-order interventions. Having more nursing experience was seen as an advantage in preparing for constant care, controlling angry feelings, and discriminating for potentially dangerous situations. Also, due to the interactive nature of constant care, a nurse could not merely guard a patient because the nurse is also on constant care. These findings have implications for making patient assignments, teaching novice nurses how to do constant care, of firming current practice even though it is against hospital policies, and illustrating how nurses can be aware of and resourceful when constant care is stressful.