The experience of being a psychiatric nurse in South Africa: a qualitative systematic review

Abstract

Background: The African continent can be a challenging working environment for nurses. Understanding the experiences of African psychiatric nurses can assist in improving the quality of care and the overall support of South African nurses. Purpose: The purpose was to summarize the experiences of African psychiatric nurses in their workplace by examining the findings of existing qualitative studies. Methods: A systematic review incorporating meta-synthesis. Seven databases were searched between 1998–2016. All qualitative studies in English, Portuguese, and Spanish were included that explored psychiatric nurses’ experiences in Africa. Meta-aggregation was performed to synthesize the findings of the included studies. Results: After removing duplicates, 18 full-text articles were reviewed. Eleven qualitative studies met the inclusion and quality criteria. All studies were conducted in South Africa. Five key findings were identified: a) organization and management; characterized by the lack of resources and institutional support, the presence of work dissatisfaction and the difficulties of applying quality care, b) the perception of insecurity; characterized by an unsafe environment for the nurse and the patient, the presence of violence and aggressiveness and the blaming of the assaulted nurses, c) the relationship with the psychiatric patient; characterized by both a lack of training and lack of knowledge concerning the management of the psychiatric patient, d) emotional experiences; highlighting feelings of fear, anger, anxiety, mental and physical exhaustion, and e) proposals for improvement; needs for greater training opportunities, institutional support and inter-professional collaboration. Conclusions: Measures to increase the job satisfaction of psychiatric nurses are needed in order to improve the service they provide.