Vulnerability is a human condition and as such a constant human experience. However, patients and professional health care providers may be regarded as more vulnerable than people who do not suffer or witness suffering on a regular basis. Acquiring a deeper understanding of vulnerability would thus be of crucial importance for health care providers. This article takes as its point of departure Derek Sellman's and Havi Carel's discussion on vulnerability in this journal. Through different examples from the authors' research focusing on the interaction between health professionals and patients, existential, contextual, and relational dimensions of vulnerability are illuminated and discussed. Two main strategies in the professionals' interactions with patients are described. The strategy that aims at understanding the patients or families from the professional's own personal perspective oftentimes ends in excess attention to the professional's own reactions, thereby impairing the ability to help. The other strategy attempts to understand the patients or families from the patients' or families' own perspective. This latter strategy seems to make vulnerability bearable or even transform it into strength. Being sensitive to the vulnerability of the other may be a key to acting ethically.

BackgroundMilieu therapists’ relationships with patients with severe mental illnesses are viewed as challenging. Elucidating vulnerability from their perspective in daily face-to-face encounters with patients might contribute to extending our knowledge about milieu therapists’ vulnerability and the dynamics of the interaction between patients in mental health services and expertise in building caring and therapeutic relationships. The aim of this project was to study educated milieu therapists’ experiences of their own vulnerability in their interactions with patients in mental health services.Materials and methodsThe data collection method was focus-group interviews. Thirteen part-time master’s in mental health students (eight nurses, three social workers, two social educators) participated. All participants had experience with community or specialized mental health services (2–8 years).ResultsThe milieu therapists mainly related their experiences of vulnerability to negative feelings elicited by challenging work conditions, disclosed as two main themes: 1) “overloaded”, by the possibility of being physically and mentally hurt and the burdens of long-lasting close relationships; milieu therapists were extremely vulnerable because of their difficulty in protecting themselves; and 2) “shortcomings”, connected to feelings of despair associated with not acting in concordance with their professional standards and insecurity about their skills to handle challenging situations, which was a threat to their professional integrity. There seemed to be coherence between vulnerability and professional inauthenticity. A misunderstanding that professionalism refers to altruism seems to increase milieu therapist vulnerability.ConclusionVulnerability in health care is of interest to multiple disciplines, and is of relevance for knowledge development in higher education. Extended knowledge and understanding about milieu therapists’ vulnerability might strengthen their personal and professional integrity in professional practice in mental health services. Health care managers’ focus on the supervision of individual professionals in practice and practical training is important. Further research on the coherence between vulnerability and professionalism is recommended.

Implementation of a research-based bachelor thesis in nursing -process and experiences Background: Ability to ensure quality and to evaluate own practice of nursing, is essential in order to practice a research based health care.

Aims and objectives To gain insight into how the workplace influences milieu‐therapists’ vulnerability in the mental healthcare context. Background Mental health services have experienced substantial changes. Reduced institutional treatment capacity is replacing the development of locally based treatment. Changes in external conditions in mental health services have influenced the working conditions of nurses and milieu‐therapists. Design Qualitative design. The study complied with the COREQ checklist. Methods Focus group interviews. Results “Vulnerability due to unpredictable and threatening working context” was the common key theme that emerged in both contexts. Two key themes were different and opposite. In municipal mental health care, “Alone and unprotected” and in institutional care, “Together and protected.” Conclusion The participants from both specialized and community mental health care, experienced vulnerability at different levels interpreted as a contradictory relationship between the healthcare system and their own ideals of what professional practice ought to be. Relevance to clinical practice This study contributes to extended knowledge and understanding about the experienced influence of the working environment on professional vulnerability of nurses and milieu‐therapists` in mental health services. The impact of contextual conditions on health professionals’ working conditions has multi‐professional relevance for milieu‐therapists and managers of mental health services, and it is an important topic in health and social higher education.