How patients and nurses experience the acute care psychiatric environment

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Mona M. Shattell, Associate Professor (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:

Abstract: The concept of the therapeutic milieu was developed when patients‘ hospitalizations were long, medications were few, and one-to-one nurse–patient interactions were the norm. However, it is not clear how the notion of =therapeutic milieu‘ is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, =What stands out to you about this psychiatric hospital environment?‘ Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure and chaos. Although they shared some themes, nurses and patients experienced them differently. For instance, nurses felt caged-in by the Plexiglas-enclosed nursing station, and patients felt caged -in by the locked doors of the unit. The findings from this US study do not support the existence of the therapeutic milieu as described in the literature. Furthermore, although the nurse–patient relationship was yearned for by nurses, it was nearly absent from patients‘ descriptions. The caring experienced by patients was mainly derived from interactions with other patients.

Additional Information

Nursing Inquiry, 15(3), 242-250
Language: English
Date: 2008
acute psychiatric care, mental health nursing, therapeutic milieu

Email this document to