Staff support procedures in a low-secure forensic service

Abstract

Purpose Staff working in forensic inpatient settings are at increased risk of harm perpetrated by patients. Support offered in response to such incidents can have a significant impact on how staff recover. The purpose of this paper is to explore how staff support procedures implemented in one low-secure forensic service impacted on staff recovery. Design/methodology/approach In total, 11 members of staff who had direct patient contact volunteered from an opportunity sample. Semi-structured interviews were conducted with each participant, asking about experiences of abuse at work and subsequent staff support procedures. Interviews were analysed using thematic analysis. Findings Four overarching themes were identified; experiences of harm, supported recovery, missed opportunities and therapeutic relationships. This led to a better understanding of how staff coped with incidents of abuse at work and how support procedures impacted on their recovery. Research limitations/implications The service evaluation was limited by transferability of the findings. The process of sampling may have meant there were biases in those who volunteered to take part. Further projects such as this are required to develop the themes identified. Practical implications Findings led to the development of a new integrated model of staff support. Originality/value This was one of the first studies in the UK to formally evaluate a staff support procedure in forensic low-secure services and include experiences of both clinical and non-clinical staff who are regularly exposed to potentially harmful events.

Nurses' experiences of racism in mental health settings through patient and family interactions: A systematic review

“…Further, there were references to both overt racism as well as covert/subtle racism. The more explicit expressions of racism included verbal comments, threats, discrimination and patients from certain ethnicities demonstrating a superiority complex in their verbal and non‐verbal behaviours (Chen et al., 2008, 2009; Cooper & Inett, 2018; Flannery et al., 2001; Ferns & Meerabeau, 2008; Stewart & Bowers, 2013; Zwane & Poggenpoel, 2000) and physical violence (Lawoko et al., 2004; Sullivan & Yuan, 1995). On the other hand, the expressions of subtle/covert racism ranged from microaggressions and general disrespect for ethnic minorities (Tonso et al., 2016) to data indicating higher rates of burnout, and violent incidents in staff belonging to certain ethnic groups (Isaiah et al., 2019; Jacobowitz et al., 2015; Lawoko et al., 2004).…”

“…Some participants reported a general sense of acceptance of harmful incidents and the distress they had caused (Cooper & Inett, 2018; Kavanagh, 1991). The normalisation of racism led to nurses experiencing a lack of support and feeling let down by management.…”

“…As coping strategies, nurses utilised personal support from family and friends, having time away from the ward, informal support from colleagues and formal support from senior management colleagues (Cooper & Inett, 2018). Some participants reported a general sense of acceptance of harmful incidents and the distress they had caused (Cooper & Inett, 2018;Kavanagh, 1991). The normalisation of racism led to nurses experiencing a lack of support and feeling let down by management.…”

“…Primarily when racism was covered it was included under umbrella terms such as violence, workplace violence and aggression (verbal, psychological, physical) directed against staff working in mental health care settings. One of the studies mentioned racial abuse as an example in the context of 'staff experiences of harm' but then provided no additional analysis of harm related to racialised experiences (Cooper & Inett, 2018). In addition, various terms were used to directly refer to racism, for instance, racial harassment, racial abuse, racial comments, personal racism and discrimination.…”

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

“…Similarly, Zhao et al 23 reported that participants received support from colleagues, family and friends following an exposure to violence but a lack of support from management. Staff support procedures following a violent incident were noted by Cooper et al 24 as a concern. The timing of follow-up was hindered by staff members being off duty after the incident.…”