Exploring student nurses' narratives on nursing mentally ill people in a medical ward in the uMgungundlovu District.

Abstract

The promulgation of the Mental Health Care Act of 2002 in South Africa came with challenges or changes in the nursing of mentally ill people. One of the changes required that mental patients need to be observed and assessed for a period of 72 hours in a general or medical ward before being transferred to a specialist hospital. Sometimes the person remains in the ward for more than the 72 hours. This means that nursing students doing their comprehensive four year diploma (R425) are exposed to nursing people with mental illness in their first, second and third year of training, which is prior to the mental health nursing/psychiatric nursing module undertaken in the last semester of the fourth year. The purpose of this study was to explore student nurses’ narratives on nursing mentally ill people in a medical ward. Narrative inquiry was used as the research methodology. Purposive sampling was used to select 5 participants for this study. The inclusion criteria specified that participants had to be second year students participating in the four year Comprehensive Nursing Diploma Programme (R425) who have nursed, or been in contact with a mentally ill person, for a period of eight weeks. The study was conducted before the participants were exposed to the psychiatric module, which is undertaken in fourth year of the diploma course. Data collection took place through a total of 5 sessions of focus groups which took place in a boardroom. While personal names were excluded, participants were required to fill in certain demographic details. Data analysis was undertaken using narrative data analysis, which looked at narrative strings, which are presenting commonalities and narrative threads which are major emerging themes. The narrative strings or commonalities that were identified were in the area of beliefs, with the dominant beliefs regarding the causes of mental illness being culturally or socially based. Emotions such as fear, sadness and frustration were identified, as well as ignorance which leads to stigmatising attitudes. The narrative threads or emerging themes that were identified were: making sense of experiences; moments of awakenings; breaking free moments; and acceptance of a known person with mental illness. The following themes were identified: moments of awakenings or realisation, where the participants started seeing the mentally ill person in another light; and moments of strengths/unique outcomes, where participants recognised their own strengths in dealing with a mentally ill person.