Julia Amanda Bjorklund

Abo Akademi University, Finland

Nurse leaders’ perspectives on unethical conduct in psychiatric care

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Biography

Julia Amanda Bjorklund, RN, MSc and Senior Lecturer in Nursing at Centria-UAS. She completed her master’s degree in health sciences in 2023 at Åbo Akademi University. Since,  she have worked as a senior lecturer but also been conducting research together with her professor and supervisor, PhD Jessica Hemberg from Åbo Akademi. Her research interests are within the field of psychiatry and mental health since most of her professional career is from this area before moving to education. Now she get to educate future nurses, and she is on the path to PhD studies as she is writing her research plan.

Abstract

Background

Mental healthcare is a unique practice due to its ethical characteristics, and an awareness of ethics is crucial when working in a mental health setting. Several ethical challenges exist, and professionals may not always recognize the ethical aspects of psychiatric care. Research on psychiatric care from nurse leaders’ perspective is scarce, but important because nurse leaders can impact workplace culture. The study aim was to explore unethical conduct in a psychiatric in-patient context from nurse leaders’ perspectives.

Methods

A qualitative exploratory study was undertaken using semi-structured interviews as method, and a qualitative content analysis was used to analyse the data. Eight nurse leaders from healthcare organizations in Finland participated.  

Results

Six main categories emerged: Unethical conduct and violations against patients, Unethical conduct and violations against staff, Unethical conduct and violations by staff against other staff, Unethical conduct and violations against leaders, Reasons underlying unethical conduct, and Consequences of unethical conduct and positive development of psychiatric care.

Conclusions

Unethical conduct was seen to be a multifaceted phenomenon, and patients and staff alike can experience and engage in unethical conduct. Unethical conduct against patients was linked to power imbalance and a focus on rules based in historical precedent. Unethical conduct against staff was linked to the nature of involuntary care and patient ill-health. Unethical conduct by staff against other staff was linked to a lack of understanding for others’ work, interpersonal chemistry, work experience, and staff character. Unethical conduct against leaders was linked to leaders being perceived as the organization.