Abstract
Nursing has incorporated many aspects of the medical model in forming nursing practice.I argue that this conception has not resulted in an effective approach for patients with mental illness, especially those with chronic mental illness. In attempting to formulate practice, nurses are impeded by the constraints of this almost universally accepted model, perhaps in ways that have evaded conscious awareness. Patients, also, must try to live their lives within limited options imposed by professional people who supposedly have their best interest at heart. This article identifies the assumptions of the psychiatric medical model and shows how using this narrow, received format is inconsistent with nursing practice. The author delineates the process of her awakening to its undermining effect on her relationships with patients and offers suggestions for more appropriate practice in chronic mental illness.