Navigating consensus, interprofessional collaboration between nurses and psychiatrists in hospital care for patients with deliberate self-harm.

Abstract

We aimed to explore how specialist nurses and psychiatrists perceive and conceptualize their own responsibility and autonomy in relation to interprofessional colleagues when caring for inpatients with deliberate self-harm. Eight psychiatrists and 10 nurses were interviewed. The interviews underwent thematic analysis by an interdisciplinary group of experts in ethics, law, mental health nursing, and psychiatry. Three themes were found. The first theme focused on role-specific tasks and perceived responsibility. Psychiatrists more often emphasized the legal perspective and specialist nurses the ethical perspective. The second theme was to adapt to other professionals' opinions. When someone else had made a decision, autonomy was perceived to decrease, whereas responsibility increased. The third theme was renunciation of autonomy for achieving cooperation. It was considered important to strive for consensus in the team. Both nurses and psychiatrists believed they had a high degree of autonomy and responsibility when their roles were well-defined. The respondents considered clear roles, good communication, shared expectations, and mutual respect to be prerequisites for interprofessional collaboration in hospital care of patients with deliberate self-harm.