“…One potential reason for this is the lack of readily identifiable activities in mental health nursing that may be influenced by the work environment (Forchuk, 1996; Tummers, Houkes, Janssen, & Landeweerd, 2001). Indeed, although a wide range of mental health nursing activities may be found in the literature (Cleary, 2004; Deacon, 2003; Mullen, 2009), the focus remains on the therapeutic relationship, a concept that in nursing has proven to be difficult to define and measure (Barker & Buchanan‐Barker, 2008; Forchuk). Further, in general nursing, patient outcomes have been clearly defined and linked to nurse activities (Needleman et al, 2002).…”