ABSTRACT

The purpose of this study was to describe primary nursing in practice at an adolescent psychiatric ward and to yield information about the prerequisites of the implementation of primary nursing as assessed by primary care nurses. An additional goal was to examine the need for support felt by primary care nurses. The objective was to gather empirical data about the implementation of primary nursing for practical psychiatric nursing and depict the development challenges posed to the implementation of primary nursing.

The thesis was qualitative in nature. The material was collected by interviewing the nurses at the adolescent psychiatric ward of the Oulu University Hospital (OYS). The interviews were conducted as group interviews in the autumn of 2010. The material was analysed with the inductive content analysis method.

According to the results, implementation of primary nursing was based on team work of two nurses one of whom was responsible for creating and maintaining an interactive therapeutic relationship with the patient and the other for implementing primary nursing by coordinating practical mat-ters related to patient care. The results showed that the interactive therapeutic relationship between the primary care nurse and the patient was an essential part of patient’s holistic treatment. The therapeutic relationship consisted of four categories: meeting the patient, confidentiality, responsibility, and autonomy.

The study showed that nurses received support for primary nursing from their work community and supervisors of work. Factors promoting primary nursing were: various training courses, adequate resources at the ward, and the nurses’ own experience on primary nursing. As factors that hinder primary nursing, the nurses mentioned the lack of adequate training, experience, and time. The study revealed that the most important development challenges in primary nursing were pro-viding more training especially to new nurses, increasing the nurses’ power of decision, and obtaining adequate experience on primary nursing.