Experiences of ambulance nurses in emergency care for patients with acute manic and/or psychotic symptoms

Abstract

Background Acute manic and/or psychotic symptoms could lead to a psychiatric crisis. Although ambulance nurses have an important contribution in caring for patients in crisis, little is known about their experiences regarding psychiatric emergency care. Objective To explore the experiences of ambulance nurses in emergency care for patients with acute manic and/or psychotic symptoms. Methods An explorative qualitative generic approach was used. Ambulance nurses were recruited from five regional ambulance services in the eastern part of the Netherlands. For data collection, unstructured, non-standardized interviews were conducted. Data were analysed using thematic analysis according to Braun and Clarke. Findings Fourteen ambulance nurses were interviewed. Two main themes were merged. ‘It is not my cup of tea but some like it’ and ‘You never know what you gonna get’. Participants who saw mental health as ‘interesting’, felt competent. In contrast, participants who saw mental health care as a ‘different world’, felt incompetent caused by a lack of education and/or having negative experiences with psychiatric patients. Psychiatric emergency care causes stress to ambulance nurses, created by a lack of information on the patients, being alone with the patient in a small place and the unpredictability of the situation. Conclusion Ambulance nurses indicate that when their need for good collaboration with CRTs, police and psychiatric hospitals fulfilled, the quality of psychiatric emergency care could be improved. Recommendations Stress reduction could be achieved when ambulance nurses are better informed about the patients by others. Thereby, it is important to make agreements about the collaboration and the performance of care with partners in the field.