Accounting for Accountability: A Discourse Analysis of Psychiatric Nurses’ Experience of a Patient Suicide



Maggie Robertson*, Brodie Paterson, Billy Lauder, Rosemary Fenton, John Gavin
Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA, Scotland, UK


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© Robertson et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA, Scotland, UK; Tel: 01786 466282; E-mail: maggie.robertson@stir.ac.uk


Abstract

Whilst the experience of a patient suicide is likely to have a significant impact upon the nurses who had been providing care, little work has actually explored this experience in any depth. In this article we explore how two psychiatric nurses construct and orient to accountability when talking of their experiences of a patient suicide. Discourse analysis was used to explore particular phases that the nurses oriented to in their accounts: scene setting; risk assessment; attributing for the suicide. Findings highlight the different, sometimes contradictory, ways the nurses attended to interactional concerns relating to implicit accountability and potential inferences of blame. Analysis of the nurses’ talk can make a valuable contribution to understanding the nature and the impact of ‘accountability’ in a mental health setting and so help nurses and other professionals gain an insight into their practice. The results from this study suggest that as a consequence of internalising fundamentally unrealisable expectations regarding suicide prevention, nurses can hold themselves to blame raising significant concerns around their needs in terms of support, which may not be recognised. This paper also makes a valuable contribution to our methodological understanding and the value of using discourse analysis in this setting.

Keywords: Patient suicide, accountability, psychiatric nurses, Potter and Edwards’s discursive action model, discourse analysis..