Mental health nurses in non-uniform: Facilitator of recovery process?

J Psychiatr Ment Health Nurs. 2020 Oct;27(5):509-520. doi: 10.1111/jpm.12599. Epub 2020 Feb 24.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Many Western countries have abandoned the wearing of nurse uniforms on inpatient mental health wards. The adoption of a non-uniform policy in Hong Kong was recently introduced in select rehabilitation units to align with the philosophy of the recovery model. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The findings suggest that nurses perceived wearing non-uniform might help to reduce the self-stigma of service users and develop better self-esteem. The perceived potential benefits of the introduction of a non-uniform policy seemed to outweigh the perceived drawbacks. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results further acknowledge the potential positive effects of nurses wearing non-uniform on facilitating psychiatric service users' recovery process. However, further research on service users' perspectives is required. The wearing of non-uniform may be considered to be extended to other psychiatric wards in Hong Kong and other similar Asian settings in order to potentially help promote patient's recovery and to reduce emotional distance between staff and service users. ABSTRACT: Introduction A non-uniform policy was recently adopted in selected Hong Kong rehabilitation wards to align with the philosophy of the recovery model. The change in policy is relatively novel in Asia, where no previous studies have reported how this may influence nursing care and service users' recovery. Aim To explore Hong Kong Mental Health Nurses' views about wearing non-uniform within an inpatient rehabilitation unit in regard to facilitating service users' recovery process. Method A qualitative descriptive study was conducted, utilizing individual in-depth semi-structured research interviews. Results A total of 12 interviews were conducted with nurse participants. The analysis process identified 3 main themes and 9 subthemes. Main themes were "building up rapport with service users," "non-uniform helps deinstitutionalization" and "different approaches to maximize the benefit and to minimize the risk." Discussion Despite some concerns, the majority of nurse participants positively viewed the policy of wearing non-uniform and felt it was potentially beneficial to service users' recovery process. Implications for practice Nurses perceived that wearing non-uniform may facilitate meaningful therapeutic engagement, and may help to reduce the self-stigma and develop the self-esteem of service users. Other inpatient units in Hong Kong and similar Asian settings might consider adopting the policy.

Keywords: nursing role; patient experience; qualitative methodology; recovery; user involvement.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clothing*
  • Female
  • Hong Kong
  • Humans
  • Male
  • Mental Disorders / nursing
  • Mental Disorders / rehabilitation
  • Mental Disorders / therapy*
  • Middle Aged
  • Nurse-Patient Relations*
  • Nursing Staff, Hospital*
  • Psychiatric Department, Hospital*
  • Psychiatric Nursing*
  • Qualitative Research
  • Self Concept
  • Social Stigma
  • Young Adult