The Experience and Meaning of Recovery-oriented Practice for Nurses Working in Acute Mental Health Services: A Hermeneutic Phenomenological Study
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New Zealand mental health policy and service provision has shifted from a focus on the management of symptoms and risk to a broader focus on the recovery of psychological, social, cultural, and physical well-being. However, there has been growing concern that people accessing mental health services are not receiving an inclusive, recovery focused service; despite a recovery-orientated vision being integrated within national and regional service policies. There is much evidence to suggest barriers to recovery-focused service provision continue to exist. Current research indicates these barriers include the attitudes, skills, and knowledge of frontline staff, as well as issues with the system in which they work. This study aimed to explore the experience and meaning of recovery-oriented practice for 10 nurses working in an acute mental health service. A phenomenological and hermeneutic lens was used to explore the nurses’ experience of working in a recovery-focused manner with service users in the inpatient setting. Stories of practice were collected from the participants using an open-ended and conversational interview style. The transcribed narratives were then analysed to explore taken-for-granted aspects of working in acute mental health care and to uncover the meaning of being recovery-oriented in this setting. The findings revealed that recovery-orientated practice is a challenge for nurses working within acute mental health wards. Although the experience and meaning of recovery-focused care varied from nurse to nurse, there were some common elements in the practice accounts. The accounts revealed the nurses’ role in creating different therapeutic spaces to promote safety, relational commitment and healing for service users. However, the nurses faced challenges to recovery-oriented care, within the team culture and the broader service systems. The nurses were at times fearless in advocating for service-users and recognised that this was essential for developing recovery-focused services. The findings have implications for nursing practice, as well as training and service development.