Experience of violence, coping and support for nurses working in acute psychiatric wards

Abstract

Background: Acute psychiatric wards are stressful working environments because of the nature of the mental illness of patients admitted. These patients present with a variety of complex psychiatric problems and social control that require skilled and competent nurses to manage them. The shortage of nurses, especially with advanced psychiatric qualifications or necessary experience, may create challenges for nurses as they navigate this stressful working environment.Aim: The aim of this study was to explore and describe nurses’ experience of patient violence, coping strategies and received support whilst working in acute wards in psychiatric hospitals.Setting: This study was conducted in six acute wards of the three psychiatric hospitals in Cape Town, South Africa.Methods: A qualitative, explorative, descriptive design was conducted using semi-structured interviews to obtain data from 14 nurses working in acute wards in three psychiatric hospitals in the Western Cape.Results: Five themes were generated using thematic analysis: violence perceived to be ‘part of the job’, contributing factors to patient violence, physical and psychological effects on nurses, adaptive and maladaptive coping strategies and perceived support from stakeholders.Conclusion: Participants normalised patient violent behaviour as being part of the job to minimise the physical and psychological effects of the traumatic experience. Adaptive and maladaptive coping strategies were used to cope with the traumatic experiences of being assaulted by patients. Recommendations allude to practising self-care and attendance of training in the management of aggressive patients for nurses, to enhance a variety of adaptive coping strategies.

Psychological impact of violence on male nurses in forensic units in Gauteng, South Africa

“…Similar to other studies (Bekelepi & Martin 2022 :3; Harris et al 2015 :134), the findings of this study confirm that male psychiatric nurses exposed to violence perceive the environment as unsafe. This experience made them fearful when caring for state patients (Bekelepi & Martin 2022 :4).…”

“…A fair number of qualitative studies on the experience of violence in maximum-security forensic units exist (Dickens et al 2013 :532–544; Harris et al 2015 :130–138). While most studies have reported on the incidence and physical impact of violence in forensic units, fewer studies have adequately explored the psychological impact thereof (Bekelepi & Martin 2022 :3; Lantta et al 2016 :2; Odes et al 2021 :28). There has been no primary focus on male psychiatric nurses and violence experienced in maximum-security forensic units in South Africa.…”

Daily experiences of non‐psychiatric nurses in acute psychiatric wards

“…Similarly, in their studies Joubert and Bhangwan (2018) recommended developing a psychiatric training programme to address the identified challenges of non‐psychiatric nurses. However, Timor and Suryani Sutini (2019) and Bekelepi and Martin (2022) reported that some nurses expressed their need for psychiatric emergency training to master the technique of dealing with acute psychiatric people. It could reduce the risk of injury when faced with people who display violent behaviour.…”

“…In-service training is carefully organized and is part of ongoing education(Booyens & Bezuidenhout, 2015).Similarly, in their studiesJoubert and Bhangwan (2018) recommended developing a psychiatric training programme to address the identified challenges of non-psychiatric nurses. However,Timor and Suryani Sutini (2019) andBekelepi and Martin (2022) reported that some nurses expressed their need for psychiatric emergency training to master the technique of dealing with acute psychiatric people.It could reduce the risk of injury when faced with people who display violent behaviour.As a result,Heim et al (2020) noted that non-psychiatric nurses lacked training in specialized clinical and communication skills, except for one study that showed a favourable impact of interview skills training on attitudes. However,Timor and Suryani Sutini (2019) support these findings to ensure patient safety and high-quality treatment by stating that the primary goal of nursing education is to give nursing professionals the required level of competency.…”

Exploration of the Organisational Conditions that Influence the Utilization of Student Support Services in South African Nursing Colleges

“…Sadly, nurses were not immune to death as high mortality rates were reported across the globe during COVID-19 in both developing and developed countries (Vera-Alanis et al, 2022). In a South African context with a shortage of qualified nurses, it becomes important to support student nurses (Bekelepi & Martin, 2022;Malatji et al, 2022). Student attrition and poor progression significantly affect the country's planned nursing and midwifery workforce projections (Mudlaly & Mtshali, 2018).…”