Mental Health NursingAuthor(s): Kayla Nixon
The treatment of people with mental illness through institutionalisation and into contemporary psychiatric nursing practises has been influenced by the discourse on safety. Confinement developed out of concerns for public safety, societal stigma, and benevolently paternalistic efforts to keep people from harming themselves. In this essay, we contend that risk management serves as the cornerstone of nursing care in current mental inpatient contexts, where safety is maintained as the primary value. Despite evidence disputing their efficacy and patient opinions revealing harm, practises that uphold this ideal are justified and maintained through the safety discourse. We offer four examples of risk management techniques used in psychiatric inpatient settings—close observations, isolation, door locking, and defensive nursing practice—to show this developing issue in mental health nursing care. The implementation of these techniques illustrates the need to change nursing care's viewpoints on safety and risk. We propose that nurses should provide tailored, flexible care that takes safety precautions into account in order to recenter meaningful support and treatment of clients. They should also fundamentally reevaluate the risk management culture that fosters and justifies dangerous practises .