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Why you should read this article: • To consider what constitutes effective therapeutic engagement between mental health nurses and service users • To understand how therapeutic engagement can have a positive effect on the overall ward environment and service users’ dignity, as well as providing them with a voice regarding their care pathway • To appreciate the value of collaborative care plans that can support service users when they become unwell. Background: Effective therapeutic engagement between mental health nurses and service users is associated with enhanced service user satisfaction and clinical outcomes and reduced rehospitalisation rates, and is essential to support service users’ recovery. Aim: To measure therapeutic engagement in adult acute inpatient wards in Finland from the perspectives of service users and nurses using the Therapeutic Engagement Questionnaire (TEQ) and to identify areas where the quality of this engagement may be enhanced. Method: Nurses (n =47) and service users (n=123) from 13 acute inpatient wards in two healthcare organisations in Finland – Helsinki University Hospital (which oversees 23 hospitals in different locations) and Aurora Hospital, a municipal psychiatric hospital in Helsinki – completed the TEQ. The TEQ is designed specifically for use in acute mental health inpatient settings to objectively measure nurses’ therapeutic contribution to service users’ recovery, as perceived by both groups, and to give service users an active voice regarding their care pathway. Respondents rate a series of statements, two on a visual analogue scale and 40 on a four-point Likert scale. Higher scores indicate better therapeutic engagement. Statements with the greatest number of ‘strongly disagree’ responses indicate potential areas for improvement. Results: Both groups of respondents highly rated the effects of nursing staff and named nurses on service users’ recovery through therapeutic engagement, overall ward environment and atmosphere, preserving service users’ dignity and nurses’ professional behaviour. Low ratings were awarded by both groups to nursing staff’s and named nurses’ support with planned care risks and stepping out of their (service users’) comfort zone, and fostering service users’ confidence to create practical and realistic care plans for achieving their goals. Statements with the greatest number of ‘strongly disagree’ ratings by service users included that ‘[my named nurse] works with me to plan my care in advance of me being unwell’ and ‘[the nursing staff] help me to have control over my care plan’. Conclusion: Service users and nurses regard therapeutic engagement as important in supporting service users’ recovery. However, nurses should be supported to develop collaborative, practical and realistic care plans that support service users with planned care risks, expand their care comfort zone and incorporate advance care planning should the service user become unwell. [ABSTRACT FROM AUTHOR]

Background. Severe challenges in recruiting and retaining healthcare workers exist on a global level and are especially noticeable in elderly care services. Previous studies have not assessed how the attractiveness of a job is related to wellbeing at work among licensed practical nurses (LPNs) even though these professionals are vital in providing care to the elderly. Objective. The purpose of this study is to define factors that affect LPNs' attractiveness of work and wellbeing at work. Design. A cross‐sectional survey study. Participants. A large‐scale nationwide sample of 10 848 licensed practical nurses (LPNs) working in Finland. Methods. An online survey for LPNs working in Finland was conducted. Criteria for a good workplace (CFGW), measuring the attractiveness of work and wellbeing at work, were utilized. Descriptive and comparative analyses were performed. Cronbach's alpha values were tested to assess internal consistency (α = 0.739–0.915). An ANOVA or t‐test result which indicated a statistically significant between‐group difference (which was in line with difference ≥0.1) was considered as both statistically significant and significant in practice. Results. The core group, LPNs' wellbeing at work (m = 4.36), is extremely important factor of attractiveness of work. Regarding the subgroups high quality of care (m = 4.61), reconciling of work and private life (m = 4.59) and well‐functioning practices (m = 4.55) were most important. Well‐functioning practices associated with several background variables, e.g., with working for full‐time (p ≤ 0.001, mean = 3.10) and age (p < 0.001). LPNs over 56 years old, especially, regard well‐functioning practices important (p = 3.17). LPNs' who were 56 years old or older (m = 3.12) and those who had work experience 1 year or less (m = 3.19) stated rewarding work most important. Conclusions. The core group, wellbeing, is an exceptionally important for the LPNs attractiveness of work. The LPNs' wellbeing at work is supported by the quality of care and reconciliation of work and private life. [ABSTRACT FROM AUTHOR]

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Accessible summary: What is known on the subject: As‐needed medication is commonly used for psychiatric inpatients' acute psychiatric and physical symptoms. Both patients and staff can initiate such medication.Earlier studies have focused on what and how as‐needed medication has been used for psychiatric reasons. Little is known about how patients participate in planning, administration and evaluation of as‐needed medication and its alternatives. Nursing documentation provides an insight into these practices. What this paper adds to existing knowledge: Long‐term inpatients have an active role in initiating as‐needed medication. However, patients and staff may have divergent opinions on the need for medication.Alternatives to medication are mostly proposed by staff, and the feedback on as‐needed medication events is usually provided from nurses' point of view. What are the implications for practice: Patients' views on decision‐making and evaluation should be noticed and documented more.Patient participation can be promoted by planning as‐needed medication and its alternatives beforehand. Introduction: Pro re nata (PRN) medication is unscheduled and used for acute physical and psychiatric symptoms. Previous studies have focused on the what and how of psychotropic PRN administration. Initiators of PRN events and occasions in which PRN was denied have rarely been studied. Thus, knowledge of patient participation in PRN is fragmented. Aim: We aimed to describe and explain long‐term psychiatric inpatients' participation in relation to planning and initiation of, as well as decisions and feedback on their PRN medication treatment. Methods: We retrieved data from patients' (n = 67) nursing documentation in a Finnish forensic psychiatric hospital in 2018. Data were analysed using statistical methods. Results: All patients were prescribed PRN, and they initiated half of the 8,626 PRN events identified, in a 1‐year period. Non‐pharmacological strategies were rarely (6%) documented, and most of them were initiated by staff (76%). Feedback on PRN was usually from a nurse's viewpoint (71%). Nurses' feedback was positive (80%) more often than patients' (50%). Discussion: Patient participation needs to be recognized throughout the PRN process. Future research could continue to explore patient participation in planning and evaluating their PRN medication. Implications for practice: Patients participate in PRN by requesting medication. Their participation can be developed by supporting patients to communicate their choice of non‐pharmacological methods, take the initiative for medication when needed and disclose their viewpoint on the effects of PRN. [ABSTRACT FROM AUTHOR]