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Nursing Ethics
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The First Nurse-Patient Encounter in a Psychiatric Setting: discovering a moral commitment in nursing

Elisabet Sjöstedt

Karolinska Institute, Stockholm, Sweden, elisabetsjostedt{at}hotmail.com

Anita Dahlstrand

Karolinska Institute, Stockholm, Sweden

Elisabeth Severinsson

Hedmark College, Elverum, Norway

Kim Lützén

Karolinska Institute, Stockholm, Sweden

The aim of this study was to deepen nurses’ understanding of the importance of carefully managing the first nurse-patient encounter in a psychiatric setting according to each patient’s suffering and future hopes. The study was carried out using an action research approach. The action planned was the implementation of a conceptual model reflecting Eriksson’s caring theory. Data were collected by interviews with nurses and observational notes kept in a research diary. The data analysis followed the procedure of qualitative content analysis. A generalization of the entire learning process shows the first nurse-patient encounter to be a moral commitment in nursing. A theoretical framework of nursing assessment conveying knowledge about the patient as unique and being a whole person can support the nurse in encouraging the patient to enter into a relationship. This insight stimulated the nurses in this study to reflect on the moral responsibility of continuing the relationship and initiating an ongoing nursing process. Awareness of this responsibility made them reflect more on the possibility of nurses taking autonomous actions in order not to abandon the patient and to avoid feeling guilty.

Key Words: action research • first nurse-patient encounter • moral commitment • psychiatric setting

Nursing Ethics, Vol. 8, No. 4, 313-327 (2001)
DOI: 10.1177/096973300100800404
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