Controlling emotions—nurses’ lived experiences caring for patients in forensic psychiatry

ABSTRACT

Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care.

Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach.

Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context.

Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs.

KEYWORDS:

• Encounters
• forensic nursing
• forensic psychiatry
• lived experience
• nurse-patient relationship
• nursing
• phenomenological-hermeneutic approach

Acknowledgments

The researchers express our gratitude to those who participated and contributed to this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Lars Hammarström

Lars Hammarström, PhD student at Mid Sweden University, research focused on encounters in forensic psychiatry.

Marie Häggström

Dr Marie Häggström, PhD, is assistant professor at the Department of Nursing science at Mid Sweden University. Häggström’s doctoral research focused on ICU transitional care.

Siri Andreassen Devik

Dr Siri Andreassen Devik, PhD, is assistant professor at department of health science at Nord university, and centre for care research Mid Norway, and her doctoral research focused on home nursing care In rural areas.

Ove Hellzen

Prof Ove Hellzen, PhD, is Professor at the Department of Nursing science at Mid Sweden University. Hellzen’s doctoral research focused on mental health care.