Institutionalized nursing staff: planning and developing a specialized educational framework that enhances psychiatric nurses' roles and promotes de-institutionalization

Accessible summary • Mental health hospitals promoted an ‘institutionalized’ mode of work and attitudes. • The transfer to community mental health services requires a re‐conceptualization of nurses' roles. • Education can be a basic mechanism for eradicating the institutionalized ways of work. For centuries psychiatric services were provided by mental health hospitals, which were operating upon bureaucratic principles: strict hierarchies, slow processes and segmentation of duties. Research has shown that psychiatric nursing, as exercised in these traditional settings, has dealt with several problems in relation to: the amount and quality of time spent with patients, the type of duties performed, the lack of autonomy etc. The closure of many psychiatric institutions and their substitution with community‐based settings, signified that health professionals should perform a variety of new duties, exhibit new skills and develop new perceptions about their work and the patients. In order for such alterations to occur, education can play a vital role in the re‐conceptualization of psychiatric nursing and in the practical preparation of students for their future work. The present paper focuses on the contradiction between nursing as practised in Greek mental health hospitals and the current trends and demands placed upon nurses, to exhibit a new ‘face’. The purposes of this paper are: first, to review the research on psychiatric nurses' behaviours in mental health hospitals. Second, to present the outcomes of bureaucracy on employees and finally, to propose an educational scheme that could reinforce the shift from institutionalized work to de‐institutionalized.