The experience of working on a locked acute psychiatric ward

Accessible summary•  Acute psychiatric wards, many of which are locked, are challenging work environments. This study explores the experience of health‐care staff working on such a ward. •  The study shows that the health‐care staff have to manage a changing and demanding work environment. A need for security and control is indicated. •  Some positive experiences from work are described, such as meaningfulness and personal development, which counterbalance the burden of working in this environment. •  The forces that drive health‐care staff and their motivation for working on acute psychiatric wards need to be studied further.Abstract This study's aim was to elucidate health‐care staff experience of working on a locked acute psychiatric ward. In many countries changes in health care has contributed to fewer beds available in inpatient care, and a concentration of patients with severe psychiatric conditions. This implies a changing work environment in acute psychiatric care. Qualitative interviews with health‐care staff ( n = 10) were carried out on a ward for patients with affective disorder and eating disorder in a Swedish hospital. Qualitative content analysis was used. Four themes were identified from the data: ‘undergoing changes in care delivery’, ‘feeling a need for security and control’, ‘managing the demands at work’ and ‘feeling a sense of responsibility’. This study adds to earlier research into how a sense of responsibility can place a significant burden on health‐care staff working on a locked psychiatric ward and also contribute to increased control of patients. This study also shows that relationships and power structures among health‐care staff need to be addressed when organizational changes are made in care delivery. Further research is needed to reach a comprehensive understanding of care on locked acute psychiatric wards, including a development of nursing and medicine as knowledge domains in one common context.