Individual and organisational challenges for personalised care on an inpatient ward: the staff team perspective

Criticism of NHS acute psychiatric care has been high within patient experience research, compounded by critical press coverage of inpatient wards. Government policy requires staff to deliver compassionate, personalised care, but there is little research considering staff’s perspectives and experiences of the work.
This study aimed to construct a grounded theory of acute psychiatric staff’s experiences, with particular attention to what might facilitate or block compassionate patient care.
Semi-structured interviews were conducted with ten ward staff (three men, seven women) across a range of disciplines. Data were analysed using constructivist grounded theory.
The model constructed captures the dynamic interactions between eleven categories: Being in a chaotic environment, Feeling limited, Struggling to improve without support, Building patient relationships, Enjoying the work, Staying vigilant, Taking an emotional toll, Putting up a barrier, Supporting each other, Seeing tensions and differences, and Acting as one team.
The study concluded that staff described feeling motivated to engage with patients but restricted by practical and emotional demands. While support was provided by colleagues and formal structures, staff could not always make full use of them. Suggestions for future research and clinical practice include changes to practical demands on staff, as well as attitudes towards reflective practice.