The lived experience of nonpsychiatric hospitalization for persons with severe mental illness



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People with severe mental illness experience medical comorbidities to a greater extent than the general population. When hospitalized in general hospital settings, they experience poorer outcomes and are experienced as difficult by nurses. An understanding of the experience of hospitalization from the patient's perspective is important to improving care and outcomes for this population. The purpose of this study was to explore the lived experience of nonpsychiatric hospitalization for persons with severe mental illness. Heideggarian phenomenology provided the philosophical underpinning and informed the methodology employed. Participants were recruited through mental health providers. Ten individuals with severe mental illness participated in minimally structured interviews and described their experience of hospitalization on a medical-surgical unit. Data, including transcribed interviews and field notes, were analyzed within the hermeneutic tradition as described by Cohen et al. (2000). The lived experience of nonpsychiatric hospitalization was expressed in four themes: taking care of me (subthemes: being cared for, not being cared for), it's my life, on my toes (subthemes: needing an advocate, managing my mental health), and being a good patient. Care providers' comportment, perception of the patient's illness, attentiveness, responsiveness, and personalized caring behaviors characterized the participant experience of being cared for or not being cared for. It's my life reflected participants' desire to be informed and involved so they could contribute to their recovery. Participants felt the need to be on my toes in order to look out for and advocate for themselves. The need to be on my toes extended to the management of a chronic illness while hospitalized for an unrelated acute condition. The final theme reflected the perceived patient role obligation to be a "good patient". Findings were consistent with the literature regarding experiences of hospitalization from the perspective of persons without mental illness. Identified themes emphasize the critical importance of the nurse-patient relationship to the patient experience. There are significant implications for how nurses come to know their patients in medical-surgical settings so that they can effectively personalize care. Reflective practices may empower nurses to solicit assistance and support to improve caring practices