Constant supervision in psychiatric care entails that a carer has constant watch over a patient. It is based on a medical order but is also an important act of caring, with potential for close contact between carer and patient. This study investigates both patients' and carers' perspectives of constant supervision with focus on the aspect of caring. It aims to compare similarities and differences in order to understand how constant supervision can be an act of caring. Seven patients and six carers were interviewed about their personal experiences of constant supervision. Their statements were interpreted using a life world hermeneutic method and three main themes emerged; constant supervision against the patient's will, against the carer's will and as an alliance for collaboration. One main interpretation points at parallel processes and that the constant supervision requires a health care organization that values caring relations. The findings are discussed with help from Foucault's ideas on power and powerlessness.
JonesJ.WardM.WellmanNHallJ. & LoweT. (2000). Psychiatric inpatients' experience of nursing observation a United Kingdom perspective. Journal of Psychosocial nursing, 38, 10–20.
2.
StewartD.BowersL & WartburtonF. (2009). Constant special observation and self-harm on acute psychiatric wards: A longitudinal analysis. General Hospital Psychiatry, 31, 523–530.
3.
Salzmann-ErikssonM & ErikssonH. (2011). Latent or Manifest Observers: Two Dichotomous Approaches of Surveillance in Mental Health Nursing. Nursing Research and Practice, 1–7.
4.
Salzmann-ErikssonM.LützenK.IvarssonA-B & ErikssonH. (2011). Achieving Equilibrium within a Culture of Stability — Cultural knowing in Nursing Care on Psychiatric Intensive Care Units. Issues in Mental Health Nursing, 32, 255–265.
5.
Salzmann-ErikssonM. & ErikssonH. (2012). Panoptic Power and Mental Health Nursing — Space and Surveillance in Relation to Staff, Patients and Neutral Places. Issues in Mental Health Nursing, 33, 500–504.
6.
StewartD.BowersL. & RossJ. (2011). Managing risk and conflict behaviors in acute psychiatry: The dual role of constant special observation. Journal of Advanced Nursing, 68(6), 1340–1348.
7.
BrowesL.GournayK. & DuffyD. (2000). Suicide and self-harm in inpatient psychiatric units: A national survey of observation policies. Journal of Advanced Nursing, 32, 437–444.
8.
DennisS. (1997) Close observation: How to improve assessments. Nursing Times, 93, 54–55.
DuffyD. (1995) Out of the shadows: A study of the special observation of suicidal psychiatric in-patients. Journal of Advanced Nursing, 21, 944–950.
11.
CarlssonG.DahlbergK.LützenK. & NyströmM. (2004). Violent encounters in psychiatric care — A phenomenological study of embodied caring knowledge. Issues in Mental Health Nursing, 25(2), 191–217.
12.
ClearyM.JordanR.HorsfallJ.MazoudierP. & DelaneyJ. (1999). Suicidal patients and special observation. Journal of Psychiatric and Mental Health Nursing, 6, 461–467.
13.
VråleG.B.SteenE. (2005). The dynamics between structure and flexibility in constant observation of psychiatric inpatients with suicidal ideation. Journal of Psychiatric and Mental Health Nursing, 12, 513–518.
14.
ReidW. & LongA. (1993). The role of the nurse providing therapeutic care for suicidal patient. Journal of Advanced Nursing, 18, 1369–1376.
15.
NeilsonP. & BrennanW. (2001). The use of special observations: An audit within a psychiatric unit. Journal of Psychiatric and Mental Health Nursing8, 147–155.
16.
MacKayI.PatersonB. & CassellsC. (2005). Constant or special observations of inpatients presenting a risk of aggression or violence: Nurses' perceptions of the rules of engagement. Journal of Psychiatric and Mental Health Nursing12, 464–471.
17.
DahlbergK.SegestenK.NyströmM.SuserudB-O., & FagerberghI. (2003). Att förstå vårdvetenskap. Lund: Studentlitteratur.
ÖdmanP-O. (1994). Tolkning, Förståelse, Vetande — Hermeneutik i Teori och Praktik. Stockholm: AWE/GEBERS
20.
NyströmM. (2008). Hermeneutik. Kapitel i: GranskärM. & Höglund-Nielsen (red.) Tillämpad Kvalitativ Forskning inom Hälso- och Sjukvård. Lund: Studentlitteratur.
21.
FoucaultM. (2003). Övervakning och straff. Lund: Arkiv Förlag
22.
HörbergU. (2008). Att vårdas eller fostras: Det rättpsykiatriska vårdandet och traditionens grepp. (Doktorsavhandling). Acta Wexionensia, no. 133. Växjö: Institutionen för vårdvetenskap och socialt arbete, Linnéuniversitetet.
23.
CarlssonG.DahlbergK.EkeberghM. & DahlbergH. (2006). Patients longing for authentic personal care: A phenomenological study of violent encounters in psychiatric settings. Issues in Mental Health Nursing, 27(3), 287–305.
24.
GustinWiklund L. (2010). Att balansera mellan värdighet och skam. I WiklundL.Gustin Vårdande vid psykisk ohälsa — på avancerad nivå. Lund: Studentlitteratur.
25.
FribergF.AnderssonPilhammar E.BengtssonJ. (2007). Pedagogical encounters between Nurses and patients in a medical ward — A field study. International Journal of Nursing Studies, 44, 534–544.
26.
EldhA-C.EkmanI.EhnforsM. (2010). A Comparison of Patient Participation and patients' Descriptions as Related to Healthcare Definitions. International Journal of Nursing Terminologies and Classifications, 21,(1), 1–8.
27.
RoweJ. (2003). The suffering of the Healer. Nursing Forum, 34,(4), 1–5.
28.
EkeberghM. (2011). A Learning Model for Nursing Students during Clinical Studies. Nurse Education in Practice, 11, 384–389.
29.
NyströmM. (2013). Reflekterande team — en arbetsmodell för evidensbaserad vård. Vård i Norden, 33 (2), 42–44.
30.
CarlssonG.HantilssonU., & NyströmM. (2014) (in press). Reflective team — a Clinical Intervention for Care Improvement. Reflective Practice.
31.
JonassonL-L.CarlssonG. & NyströmM. (submitted). Prerequisites for Sustainable Care Improvement — Reflective Team Leaders' Perceptions. International Journal of Qualitative Studies on Health and Wellbeing.
