Forensic nurses are faced with unique challenges in their attempt to deliver nursing care in a custodial environment. * The impact of such challenges on the cultural dynamic of forensic nursing and consequently on healthcare delivery is largely unknown. * The aim of this ethnographic study was to explore the nursing culture within an Australian prison hospital and the migration of the culture over a 12-month period. * At the end of the study, the nursing culture was found to be one of hope, although with no clearly articulated vision of nurse-hood or patient-hood and model within which to practice nursing. * The ability to articulate practice is central to the development of mental health nursing in any context. Abstract Forensic nurses are faced with unique challenges in their attempt to deliver nursing care in a custodial environment. The impact of such challenges on the cultural dynamic of forensic nursing and consequently on healthcare delivery is largely unknown. The aim of this ethnographic study was to explore the nursing culture within an Australian prison hospital and the migration of the culture over a 12-month period. At the end of the study the nursing culture was found to be one of hope, although with no clearly articulated vision of nurse-hood or patient-hood and model within which to practice nursing.
Background: Correctional health and forensic mental health (FMH) staff may experience vicarious trauma (VT) as a result of cumulative and repeated exposure to traumatic material in their professional roles. Aim: This study aimed to determine the incidence of VT in a sample of correctional health and FMH staff. Methods: A cross-sectional survey including 135 correctional health and FMH staff participating in a VT management program was conducted. Survey respondents completed the Vicarious Trauma Scale and Impacts of Events Scale-Revised. Findings: Most respondents had moderate or high VT (n = 78, 57.8%, and n = 40, 29.6%, respectively). Low psychological distress was reported, with posttraumatic stress disorder symptoms being experienced either mildly or not at all by most respondents. A significant relationship between total Vicarious Trauma Scale score and total Impacts of Events Scale-Revised score (r = 0.471, p = 0.000) was found, indicating that a higher level of VT was associated with an increased risk of posttraumatic stress disorder symptoms. A higher level of VT was also associated with increased reports of avoidance, intrusion, and hyperarousal (r = 0.382, p = 0.000; r = 0.489, p = 0.000; and r = 0.440, p = 0.000, respectively). Conclusion: Correctional health and FMH staff are at risk of developing VT and associated psychological distress. Implications for Clinical FMH Nursing Practice: Correctional health and FMH organizations have the responsibility to ensure nurses are aware of the effects of VT and to provide opportunities for nurses to participate in VT education and management programs.
Methods that facilitate executive and senior nursing staff consensus in the development and review of position descriptions should be considered in nursing management.
Background Although it is known that forensic mental health nurses (FMHNs) work in a stressful environment, their experience of stress and burnout remains largely unexplored. Aim The study aimed to measure levels of burnout and workplace stressors experienced by FMHNs. Methods A survey of 205 FMHNs was undertaken. Respondents completed the Maslach Burnout Inventory and the Nursing Stress Scale. Findings Fifty-seven FMHNs completed the survey, representing a response rate of 27.8%. Only five respondents (8.8%) experienced high levels of burnout across all three Maslach Burnout Inventory subscales. The most reported workplace stressors were related to “workload,” “conflict with other nurses,” and “conflict with physicians.” A correlation between total Nursing Stress Scale score and both “emotional exhaustion” and “cynicism” were found (r = 0.45, p < 0.001, and r = 0.34, p < 0.011, respectively), indicating that FMHNs who reported higher workplace stress are at an increased risk of burnout. Conclusion Most FMHNs in the current study experienced moderate levels of burnout, although they continued to feel self-assured in their practice and found their work rewarding. Consistent with other nursing populations, the FMHNs in this study reported feeling stressed by their workload and as the result of conflict with other nurses and physicians. Implications for Clinical Forensic Nursing Practice Reduced well-being, associated with stress and burnout, may lead to increased absences from work and the delivery of poor-quality forensic mental health consumer care. The implementation of staff well-being strategies is recommended to address stress and burnout in FMHNs.
Background: Clinical supervision may support forensic mental health nurses with personal and professional growth in a work environment characterized by therapeutic, ethical, and practical challenges. Aim: The aim of this study was to describe the experiences of forensic mental health nurses participating in a clinical supervision program. Methods: Seven forensic mental health nurses and two allied health professionals, working in a high-security forensic mental health hospital, were interviewed regarding their experiences of participating in a clinical supervision program. Findings: Participants expressed a need for clinical supervision and were motivated to participate in the program. Benefits of clinical supervision experienced by participants included improved communication with their colleagues, being supported in their career development, and developing habits and techniques to reflect on practice issues. Participants described being able to connect with their supervisor, enabled by both trust and confidence in the supervisor's expertise. Conclusion: Staff showed engagement in the clinical supervision process and expressed experiencing positive outcomes related to personal and professional growth and development. Implications for Clinical Forensic Nursing Practice: To support nurses with the forensic mental health context-specific challenges they face, organizations should enable and promote access to clinical supervision. Considerations for forensic mental health organizations to increase uptake and effectiveness of clinical supervision include use of externally based clinical supervisors with adequate skills and experience with providing clinical supervision to clinical staff who work in a secure environment.
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