Forensic psychiatric nursing: a literature review and thematic analysis of role tensions

Abstract

This literature review was undertaken to explore the emergent issues relating to the difficulties encountered in forensic psychiatric nursing. The rationale for the study revolved around the paucity of research undertaken to identify the constituent parts of this professional practice. The aims included both a thematic analysis of the literature and the construction of a theoretical framework to guide further research. The method was a snowballing collection of literature and a computerized database search. The results were the identification of a series of major issues, which were broadly categorized as negative and positive views, security vs. therapy, management of violence, therapeutic efficacy, training and cultural formation. From this the six binary oppositions, or domains of practice, emerged as a theoretical framework to develop further research. These were medical vs. lay knowledge, transference vs. counter-transference, win vs. lose, success vs. failure, use vs. abuse, and confidence vs. fear. Further research is currently underway.

A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

“…Owing to the long contact time and being the closest to patients -compared with other professions -nurses are the professional group engaging most in caring interactions and ensuring that patients' treatment goals are met. 60,61 Forensic psychiatric nursing differs significantly from general psychiatric nursing for a number of reasons. 62 First, forensic psychiatric nurses face a dual obligation of 'custody' and 'caring'.…”

Experiences and Perceptions of Nursing Staff Working With Long-Stay Patients in a High Secure Psychiatric Hospital Setting

“…institutions, the only close relationships they have are with the staff members and these relationships are the most secure relationships they have probably ever experienced. This finding is supported by studies that suggest that forensic patients fo rm constructive rel ationships of which they have had very little experience in the past (Caplan, 1993;Mason, 2002). While the development of positive relationships with staff is essential, over-attachm ent can be negative for the patient's progress.…”

“…The experiences of forensic-psychiatric nurses have been researched before (Caplan, 1993: Harrison et al, 2014: Kramer et al, 1987: Lu et al, 2005: Mason, 2002: Peternelj-Taylor, 1999), however, not in relation to long-stay patients. It might be expect ed that the challenges faced by this group of professionals catering for one of the most challenging patient group are ampli fied when considering long-stay offender patients.…”

“…According to Harrison et al (2014) the profession is chosen by people who are ardently seeking to make a difference in someone's life and are looking for opportunities that are centered on the patient. Due to the long contact time and being the closest to patients -compared to other mental health professionals -forensi c nurses are the professional group that are most involved in caring interactions with the patients (Caplan et al, 1993;Mason, 2002).…”

Challenges in Residential Treatment for Prisoners With Mental Illness: A Follow-up Report

“…Each of these problems relate directly or indirectly to what has been eloquently described as a "custody-care" dilemma (Holmes, 2005;Mason, 2002;Martin, 2003): the perceived or real tensions between often competing and always compelling demands, including an overwhelming emphasis on security and control as paramount concerns for prison administrators and staff.. This conflict also reflects administrative decisions and resulting changes to the infrastructure, organization, and delivery of the program itself.…”