Valoración nutricional

Often undervalued in the South African mental health community, intellectual disability nurses hold invaluable yet unrecognised knowledge on psychiatric intellectual disability care. Continuous rewarding-frustrating care interactions require an ability to hold ambiguity and take what consolation nursing interventions can offer. Intellectual disability nurses guard against physical and emotional exhaustion, but also against system fatigue – needing the system in which to do their work, but battling the same system so that they can do their work. A significant finding from this research suggests that system fatigue contributed more to

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nurses’ negative experience of providing intellectual disability care than did working with often difficult to care for patients.

Ultimately, South African psychiatric intellectual disability nursing is a sub-specialty deserving of respect and, in acknowledgement of its practitioners’ specific knowledge, skills, and expertise, might do well to gain recognition as a specialty in its own right. The identified necessary resources for managing its demands requested for the sake of patient care must be attributed managerial attention, gravitas, and budget – at the very least, equitable distribution of these. Should patient needs and intellectual disability nurses’ efforts at meeting them remain marginalised, the care drain might persist. Additionally, training should attend to preparation for the realities of psychiatric intellectual disability work (Stenfert Kroese et al. 2013a) whist care institutions should seriously consider nurses’ self-identified coping resources against burnout and system fatigue.

Since nurses seemingly experience more relational reciprocity from patients with intellectual disability than they do from institutional management, results suggest that nurses should have more input in ways institutional controls above them are implemented, and be engaged with in a non-exploitative and non-exclusionary way. Findings underscore the necessity of modifying institutional processes so as to better accommodate intellectual disability nurses’ care needs and improve nurses’ well-being in an attempt to retain their expertise, knowledge, and service amidst a global care crisis.

Author contributions: All authors have agreed on the final version and meet the following

criteria [recommended by the ICMJE (http://www.icmje.org/ethical_1author.html)]: • substantial contributions to conception and design, acquisition of data, or analysis and

interpretation of data

• drafting the article or revising it critically for important intellectual content

Conflict of interest: No conflict of interest has been declared by the author(s).

Funding: This research has been made possible, together with personal funding, by financial

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