Extreme Stress Events in a Forensic Hospital Setting: Prevalence, Impact, and Protective Factors in Staff

Ireland, Carol A.; Chu, Simon; Ireland, Jane L.; Hartley, Victoria; Ozanne, Rebecca Louise; Lewis, Michael

doi:10.1080/01612840.2021.2003492

Cited by 7 publications

(13 citation statements)

References 56 publications

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“…While participants in this study acknowledged prior expectations regarding security and patients' past offences, the reality of this exposure was still initially confronting for some. Though an ability to separate patients from their history is essential in establishing therapeutic relationships (Hammarström et al, 2019), in practice, processing and working with potentially distressing knowledge is challenging (Ireland et al, 2022; Oates et al, 2020). Additionally, working with patients with sensitive and serious offence histories has been shown to adversely impact interpersonal engagement (Marshall & Adams, 2018) and lead to vicarious trauma (Newman et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Why do nurses seek employment in forensic mental health and what are their first impressions of the clinical environment? A mixed methods study

Kinghorn

Thomas

Froggatt

et al. 2023

Journal of Advanced Nursing

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AimThe aim of the study was to investigate why registered nurses seek forensic mental health employment and explore their initial impressions of this setting.DesignExplanatory sequential mixed methods.MethodsRegistered nurses employed in a forensic mental health hospital completed an online survey about their reasons for seeking work in forensic mental health and their transition into the setting. To fully explore findings, semi‐structured interviews were conducted with a sub‐group of survey respondents. Descriptive statistics were used to analyse survey data, and thematic analysis was used to analyse the interviews.ResultsSixty‐nine respondents completed the survey, and 11 interviews were conducted. Prior interest in forensic mental health and encouragement from hospital staff were considered important influences in seeking forensic mental health employment. New knowledge, changes in clinical responsibility, exposure to patients' background offences and security processes overwhelmed some participants initially. However, participants reported that the initial challenges of their transition revealed opportunities to develop genuine connections with patients.ConclusionThis study provides a new understanding of the reasons why nurses seek employment in forensic mental health and the challenges and opportunities experienced when first working in this setting. Such professional and personal elements need to be considered by organizations to strengthen recruitment strategies and support future nurses' transition into forensic mental health settings.ImpactThis study provides new knowledge about recruiting and supporting nurses' transition into forensic mental health employment. As such, it informs policymakers, clinical services and managers about strategies needed to attract and retain this workforce.Patient or Public contributionNo public or patient involvement.

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Section: Discussionmentioning

confidence: 99%

Why do nurses seek employment in forensic mental health and what are their first impressions of the clinical environment? A mixed methods study

Kinghorn

Thomas

Froggatt

et al. 2023

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…Deterioration of mental health over a period of time may represent a cumulative effect of exposure to patient aggression, where nurses exposed to multiple incidents of patient aggression are more likely to experience disproportionately greater levels of psychological distress (Tonso et al, 2016). Nurses subjected to cumulative impacts of exposure to patient aggression are likely to experience helplessness, fear of re-assault, feel unsafe in the workplace and have heightened vulnerability (Ireland et al, 2021).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Nurses who work in forensic mental health inpatient settings can be exposed to various types of patient aggression in the workplace (Ireland et al, 2021), including verbal abuse, physical or sexual violence and patient self‐harming behaviours (Newman et al, 2021). Patient aggression has the potential for an adverse effect on nurses' well‐being, workplace satisfaction and performance (Foli & Thompson, 2019; Kafle et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of patient aggression in forensic mental health varies and is likely influenced by patient characteristics. The paucity of research related to the nature and extent of exposure to patient aggression for forensic mental health nurses has been identified (Ireland et al, 2021; Newman et al, 2021). While it is known that exposure to patient aggression impacts on forensic mental health nurses' mental health, less is known about its impact on physical health and related absences from work.…”

Section: Introductionmentioning

confidence: 99%

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Exposure to patient aggression and health outcomes for forensic mental health nurses: A cross‐sectional survey

Newman,

Roche,

Elliott

2023

Journal of Advanced Nursing

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AimsThe aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences.DesignCross‐sectional survey conducted January to April 2020.MethodsAll 205 nurses working in an Australian high‐security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF‐36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored.ResultsSixty‐eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self‐harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non‐acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self‐harming behaviour was associated with poorer physical health.ConclusionsNurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well‐being. Nurses who are victim of, or witness, physical violence are most likely to take time off work.ImpactThis study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses.No patient or public contribution.

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Staff Experiences of Working with Children and Adolescents Engaging in Behaviours That Challenge in Mental Health and Paediatric Inpatient Environments: A Qualitative Exploratory Study across Four European Countries

Goodwin,

O'Malley,

O'Donovan

et al. 2024

Child Care in Practice

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Extreme Stress Events in a Forensic Hospital Setting: Prevalence, Impact, and Protective Factors in Staff

Cited by 7 publications

References 56 publications

Why do nurses seek employment in forensic mental health and what are their first impressions of the clinical environment? A mixed methods study

Why do nurses seek employment in forensic mental health and what are their first impressions of the clinical environment? A mixed methods study

Exposure to patient aggression and health outcomes for forensic mental health nurses: A cross‐sectional survey

Staff Experiences of Working with Children and Adolescents Engaging in Behaviours That Challenge in Mental Health and Paediatric Inpatient Environments: A Qualitative Exploratory Study across Four European Countries

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