In as much as psychiatric nursing is an intricate field, one of the most significant questions that always arise is the extent to which patients should be allowed to make decisions for themselves and how much authority the health care provider should take over their choices ‘for their good’. Decisional autonomy is the ability of patients to make decisions over their treatment, while paternalism entails the health care practitioners assuming the rights of patients in decision-making for reasons of the patient’s good. This tension is most evident in a psychiatric context, as patients’ decision-making capacity may be affected by their psychosis. It is therefore important to understand and manage this tension that appropriately exists within psychiatric nursing to deliver proper care while at the same time protecting patients from their irrationality. In this article, the author plans to review the paradigm of the degree of freedom and the degree of control in the process of nursing, based on the findings of the recent studies and the relevant theory.
A Concept Analysis on the Autonomy of Nurses Attending to Patients with Psychiatric Disorders
Patient self-determination is one of the most critical ethical values in health care since a patient’s right to decisional control of his/her treatment is unconditional. In psychiatric nursing, autonomy refers to the patient’s ability to make a reasoned decision as to the management of care or alteration in their daily living. It is critical to use this approach in the management of patients because it strengthens their perceived control over their care and treatment. A sample study of the attempts to increase clients’ self-direction in the process of future long-term mental health clients shows that professionals employ different strategies to increase autonomy, including the dismantling of restraints, training themselves and others in the client’s preferences, and deinstitutionalization of the relationship of the caregivers and the cared.
Understanding the Psychiatric Care Concerning Paternalism
Hence, the tenet of paternalism, while seen in a negative light as a result of controlling and dominating implications, can be at times useful in psychiatric nursing. It entails decisions about patients in conditions in which they cannot make proper decisions for themselves. The concept of protective empowerment in psychiatric-mental health nursing exemplifies how the nurse is obliged to abide by the principle of beneficence and this principle not to inflict any harm, and at the same time is also obligated to respect the patient’s autonomy. This theory is in line with the patient protection policy while enhancing the patient’s involvement in the medical decision-making process.