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Accounting for Accountability: A Discourse Analysis of Psychiatric Nurses’ Experience of a Patient Suicide

机译:问责制:精神科护士患者自杀经历的话语分析

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摘要

Whilst the experience of a patient suicide is likely to have a significant impact upon the nurses who had been providing care, little work has actually explored this experience in any depth. In this article we explore how two psychiatric nurses construct and orient to accountability when talking of their experiences of a patient suicide. Discourse analysis was used to explore particular phases that the nurses oriented to in their accounts: scene setting; risk assessment; attributing for the suicide. Findings highlight the different, sometimes contradictory, ways the nurses attended to interactional concerns relating to implicit accountability and potential inferences of blame. Analysis of the nurses’ talk can make a valuable contribution to understanding the nature and the impact of ‘accountability’ in a mental health setting and so help nurses and other professionals gain an insight into their practice. The results from this study suggest that as a consequence of internalising fundamentally unrealisable expectations regarding suicide prevention, nurses can hold themselves to blame raising significant concerns around their needs in terms of support, which may not be recognised. This paper also makes a valuable contribution to our methodological understanding and the value of using discourse analysis in this setting.
机译:虽然患者自杀的经历可能会对一直提供护理的护士产生重大影响,但实际上很少有工作可以深入探讨这种经历。在本文中,我们将探讨两名精神科护士在谈论患者自杀经历时如何构建和定位问责制。话语分析被用来探索护士在他们的报告中所针对的特定阶段:场景设置;风险评估;归因于自杀。调查结果突显了护士处理与隐性责任制和潜在的责任推论有关的互动问题的不同方法,有时是相互矛盾的。对护士谈话的分析可以为理解“问责制”在心理健康环境中的性质和影响做出宝贵的贡献,因此可以帮助护士和其他专业人员深入了解自己的做法。这项研究的结果表明,由于将对自杀预防的根本上没有说服力的期望内在化,护士可以责怪自己在支持方面对自己的需求提出了重大关切,这一点可能未被认识。本文还为我们的方法论理解和在这种情况下使用话语分析的价值做出了宝贵的贡献。

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