An ethnographic study of forensic nursing culture in an Australian prison hospital

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. * 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.

‘Going into the unknown’: Experiences of male patients in secure settings during environmental transition

“…However, where there was the 'sudden' unexpected introduction of policy changes to daily routines, the patients did experience both anxiety and behavioural changes, which had the potential to result in conflict. Overall, the findings of this study demonstrate that the residents of secure institutions with their familiar 'strict routines, regimes, and regulations' (Cashin et al 2010), which they have grown to regard as 'home', still require individual assessments of psychological vulnerability, adequate preparation, and ongoing social support before, during, and after any transitional experience. This in turn highlights the need for the development of supportive patient-inclusion strategies, consistent and transparent communication processes, and a published timeframe during the planning and implementation phases of all types of transitional moves, including the side-to-side transfer of residents between accommodation buildings.…”

Toward the Establishment of a Forensic Nursing Specialty in Brazil

“…Also in Australia, Cashin et al (2010) used ethnographic methods to explore the experience of providing nursing care in a forensic setting, where the routines, regimes, and regulations of the custodial environment dominate. Through participant observation, semistructured interviews, and artifacts, the authors sought to understand "cultural migration" (changes in nursing culture over time) in a forensic hospital.…”

Evaluation of service users' experiences of participating in an exercise programme at the Western Australian State Forensic Mental Health Services

“…Forensic mental health professionals must navigate different work cultures in a system where the therapeutic role that promotes hope, empathy, respect, and trust, which are embedded in the recovery philosophy, intersects with the role focused on treatment, security, and safety (Cashin et al 2010;Weiskopf 2005). As part of the recovery process, patients must be engaged in meaningful activities, such as the formal exercise programme that facilitates the increased use of coping skills (Vasilli 2000) and the decreased use of seclusion and other methods of containment (O'Hagan et al 2008).…”