Guidance for breaking bad news should encompass the whole process of doing this and acknowledge the challenges nurses face in the inpatient clinical area. Developments in education and support are required that reflect the challenges that nurses encounter in the inpatient care setting.

Within the neurosciences, many patients display challenging behaviours. This study set out to gain an understanding of registered nurses' experiences of caring for this patient group. One-to-one qualitative interviews were conducted with four nurses. The sample was drawn from a neuroscience department including neuromedical, neurosurgical and critical care wards. Data were analysed using Ritchie and Spencer's framework (1994). The experiences described fell into four main categories: the context of neurosciences (patient group and behaviours), understanding the causes and impact of challenging behaviour, informal and structured tactics and strategies in dealing with challenging patients, and utilization of support from colleagues and mental health professionals. Nurses felt frustrated at their lack of mental health skills. They described impact on time and feelings of resentment, but also reported enjoying the challenge of delivering care. The need for mental health skills training was highlighted.

No abstract