Forensic and non‐forensic psychiatric nursing skills and competencies for psychopathic and personality disordered patients

Bowen, Matt; Mason, Tom

doi:10.1111/j.1365-2702.2011.03970.x

Cited by 26 publications

(22 citation statements)

References 51 publications

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“…This becomes evident when nurses try to motivate patients in a way that could be perceived as giving an ultimatum, or that gives patients the impression of having a choice, whereas the only possible choice is to adjust to the demands of the nurse and conform to the culture. Even though this could be understood as nurses striving to keep order in the unit (Bowen & Mason 2012) and obtain equilibrium within a turbulent environment (Salzmann-Eriksson et al 2011), it could also be a threat to patients' dignity. Thus, if normality is defined from the perspective of the staff (Gildberg et al 2012), nurses' intentions to do good might hurt the patient.…”

Section: Discussionmentioning

confidence: 99%

To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings

Vincze¹,

Fredriksson

Gustin

2015

Int J Mental Health Nurs

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Patients in forensic psychiatric settings are likely to suffer not only from their mental illness but also from memories of criminal activities and, furthermore, from being involuntarily hospitalized. The aim of this study was to explore how nurses in forensic psychiatric care understand and approach patients' suffering. Data was generated by semi-structured interviews with psychiatric nurses from two different forensic psychiatric care units in Ascribing meaning to suffering, and 4) Being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering patients means that nurses are confronted with patients' suffering as well as their own reactions while being present for those patients. If suffering is not seen or encountered, there is a risk that even actions taken with the best of intentions will hurt the patient.

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Section: Discussionmentioning

confidence: 99%

To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings

Vincze¹,

Fredriksson

Gustin

2015

Int J Mental Health Nurs

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show abstract

“…For this reason, effective communication, listening skills, empathy, and the ability to monitor the person's emotional responses are viewed as essential skills for nurses to maintain safe and effective therapeutic relationships (Bowen & Mason ; Martin ). Behaviours such as being judgemental, confrontational, and over‐reacting are undesirable qualities for nurses working in this setting (Bowen & Mason ). This is particularly important in a clinical environment where patients may be provided treatment against their will (Maguire et al .…”

Section: Introductionmentioning

confidence: 99%

Promoting positive and safe care in forensic mental health inpatient settings: Evaluating critical factors that assist nurses to reduce the use of restrictive practices

Barr

Wynaden

Heslop

2019

Int J Mental Health Nurs

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Reducing and eliminating the use of restrictive practices, such as seclusion and restraint, is a national priority for Australia's mental health services. Whilst legislation, organization and practice changes have all contributed to a reduction in these practices, forensic mental health services continue to report high rates. This paper details the findings of research that examined the experiences of nurses working in the inpatient forensic mental health setting. The research aimed to (i) document the experiences of nurses working in the forensic mental health setting, (ii) articulate their perceived unique skill set to manage challenging patient behaviours, and (iii) determine how their experiences and skill set can inform practice changes to reduce the use of restrictive practices. Thirty‐two nurses were recruited from one Australian forensic mental health service. Data were collected using semi‐structured interviews and analysed using inductive content analysis. Four categories were identified that influenced practice experiences: (i) working in a challenging but interesting environment, (ii) specialty expertize, (iii) exposure to aggression and resilience as a protective factor, and (iv) the importance of effective teamwork and leadership. Forensic mental health care is complex, highly specialized, and often delivered in an unpredictable environment. Whilst high rates of restrictive practices may be linked to the unique characteristics of forensic patients, training, teamwork, and leadership are critical factors influencing their use in this setting. Nurses working in this area need to be educated and supported to work confidently and safely with this high‐risk patient cohort.

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“…Nurses often expressed being frustrated by not being able to reach patients or make progress in their treatment. A major part of forensic nursing is being firm, setting limits, and defining boundaries, which affect the nurse-patient relationship (Bowen & Mason, 2011). There is always a risk that the encounters are viewed as paternalistic (Hörberg et al, 2012;Norvoll & Pedersen, 2016;Selvin, Almqvist, Kjellin, & Schröder, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Not feeling safe also fosters hopelessness, and it can be an obstacle to understanding patients' views on health, wellbeing, and existence. A state of being non-judgemental, present, and open towards the patient is desirable for forensic nurses (Bowen & Mason, 2011).…”

Section: Discussionmentioning

confidence: 99%

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

Hammarström

Häggström

Devik

2019

International Journal of Qualitative Studies on Health and Well

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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.

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Forensic and non‐forensic psychiatric nursing skills and competencies for psychopathic and personality disordered patients

Cited by 26 publications

References 51 publications

To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings

To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings

Promoting positive and safe care in forensic mental health inpatient settings: Evaluating critical factors that assist nurses to reduce the use of restrictive practices

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

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