Morale is high in acute inpatient psychiatry
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Morale on acute psychiatric wards has been considered to be problematic, and is reported to contribute to low quality patient care. Aim: To assess the relationship of staff morale to patient, service environment, physical environment, patient routines, conflict, containment, staff demographics, and staff group variables.
A multivariate cross sectional study was undertaken collecting data on morale, as measured by the Maslach Burnout Inventory, and other variables on 136 acute admission psychiatric wards in England.
Morale was higher than published comparison samples. Length of time in post was correlated with low morale, and qualified nurses had higher emotional exhaustion but also higher personal accomplishment. The level of verbal abuse on a ward was associated with low morale, as was a higher level of social deprivation among patients. Higher levels of order and organisation correlated with better morale.
Clear policies relating to the management of verbal abuse by patients, high levels of order and organisation, and staff rotation and education, may all support high morale. Acute inpatient psychiatry is generally a happy and rewarding work environment, and identified problems are likely to be due to other factors.
Keywordsin-patient morale verbal aggression social deprivation demography
The data collection on which this paper is based was funded by NIHR SDO, however the views expressed are those of the authors, not the funders.
- 1.Adams J, Whittington R (1995) Verbal aggression to psychiatric staff: traumatic stressor or part of the job? Perspect Psychiatr Care 2:171–174Google Scholar
- 2.Anderson N, West M (1999) Team climate inventory (TCI): user’s guide. NFER-NELSON Publishing, WindsorGoogle Scholar
- 3.Ball J (2007) Untapped potential: a survey of RCN members working in mental health. RCN policy unit & RCN mental health nursing forum. Royal College of Nursing, LondonGoogle Scholar
- 4.Bass B, Avolio B (1995) Multifactor leadership questionnaire. Mind Garden, Redwood CityGoogle Scholar
- 6.Bowers L, Carr-Walker P, Allan T, et al. (2003) The right people for the job: choosing staff that will adjust positively and productively to working in the new personality disorder (PD) services. Report to the home office. City University, LondonGoogle Scholar
- 9.Bowers L, Douzenis A, Galeazzi G, et al. (2005) Disruptive and dangerous behaviour by patients on acute psychiatric wards in three European centres. Soc Psychiatry Psychiatr Epidemiol 40:822–828Google Scholar
- 13.Bowers L, Whittington R, Nolan P, et al. (2007) The city 128 study of observation and outcomes on acute psychiatric wards. Report to the NHS SDO Programme. NHS SDO Programme, LondonGoogle Scholar
- 15.Cahill J, Gilbody S, Barkham M, et al. (2004) Systematic review of staff morale in inpatient units in mental health settings. Report for the national co-ordinating centre for NHS service delivery & organisation R & D (NCCSDO). Leeds, NCCSDOGoogle Scholar
- 16.Clarke S (2004) Acute inpatient mental health care: education, training and continuing professional development for all. 1–61. Department of Health and National Institute for Mental Health England, LondonGoogle Scholar
- 17.Department of Health (2002) Mental health policy implementation guide. Adult acute inpatient care provision. Department of Health, LondonGoogle Scholar
- 20.Garcia I, Kennett C, Quraishi M, et al. (2005) Acute care 2004. A national survey of adult psychiatric wards in England. Sainsbury Centre for Mental Health, LondonGoogle Scholar
- 21.Goodykoontz L, Herrick CA (2003) Evaluation of an inservice education program regarding aggressive behavior in a psychiatric unit. J Contin Educ Nurs 21:129–133Google Scholar
- 24.Maslach C, Jackson S (1981) The Maslach burnout inventory. Consulting Psychologists Press, Palo AltoGoogle Scholar
- 26.McGeorge M, Lelliott P, Stewart J, et al. (2001) Managing violence in psychiatric wards: preliminary findings of a multi-centre audit. Ment Health Care 31:366–369Google Scholar
- 27.Moos R (1974) Ward atmosphere scale manual. Consulting Psychologists Press, Palo AltoGoogle Scholar
- 28.Moos R (1997) Evaluating treatment environments. Transaction Publishers, New BrunswickGoogle Scholar
- 30.Noble M, Wright G, Dibben C, et al. (2004) The English indices of deprivation 2004. OPDM Publications, West YorkshireGoogle Scholar
- 33.Standing Nursing, Midwifery Advisory Committee (1999) Mental health nursing: addressing acute concerns. SNMAC, Department of Health, LondonGoogle Scholar