Abstract:
The purpose of this ethnographic study was to understand how nurses construct their
practice in an acute inpatient psychiatric unit in light of the current challenges, demands and
influences brought about by service reform. During a 5-month period, fieldwork observations,
interviews and discussion groups occurred in a 22-bed acute inpatient mental health facility in New
South Wales, Australia. The findings demonstrate how the current role of acute care has resulted in
nurses working in increasingly complex environments characterized by competing priorities and new
demands. Nurses struggled to fit the changed service philosophy with traditional models of practice
within this fluid and changing environment. The findings are relevant within the context of current
debates and can be used to enhance the understanding of contemporary acute mental health nursing
practice and inform the continued development of mental health nursing in these settings.
