Respect in forensic psychiatric nurse-patient relationships: A practical compromise

Abstract

The context of forensic psychiatric nursing is distinct from other psychiatric settings as, it involves placement of patients in secure environments with restrictions determined by the courts. Previous literature has identified that nurses morally struggle with respecting patients who have committed heinous offences, which can lead to the patient being depersonalized and dehumanized. Although respect is fundamental to ethical nursing practice, it has not been adequately explored conceptually or empirically. As a result, little knowledge exists that identifies how nurses develop, maintain, and express respect for patients. The purpose of this study is to analyze the concept of respect systematically, from a forensic psychiatric nurse's perspective using the qualitative methodology of focused ethnography. Forensic psychiatric nurses were recruited from two medium secure forensic rehabilitation units. In the first interview, 13 registered nurses (RNs) and two registered practical nurses (RPNs) participated, and although all informants were invited to the second interview, six RNs were lost to follow-up. Despite this loss, saturation was achieved and the data were interpreted through a feminist philosophical lens. Respect was influenced by factors categorized into four themes: (1) emotive-cognitive reactions, (2) nonjudgmental approach, (3) social identity and power, and (4) context. The data from the themes indicate that forensic psychiatric nurses strike a practical compromise, in their understanding and enactment of respect in therapeutic relationships with forensic psychiatric patients.

To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings

“…This requires, however, the nurse to be able to deal with his/her own cognitive-emotive reactions and be non-judgemental regardless of patients' behaviour (Rose et al 2011). …”

“…Thus they place themselves not only in a non-judgemental position (cf Rose et al 2011), but in a 'notknowing' position, in order to be able to see the person and acknowledge his/her uniqueness and individual needs.…”

To be Strategically Struggling against Resignation: The Lived Experience of Being Cared for in Forensic Psychiatric Care

“…Also, respect is an important phenomenon in forensic psychiatric care settings that are embedded with constraint and power. Rose, Peter, Gallop, Angus, and Liaschenko (2011) show that reciprocal respect in the nurse-patient relationship is complex, dynamic, and limited by contextual factors, and that nurses balance the normative expectations with the "caring reality" in order to find a practical compromise. Even if nurses and other professional carers aim at providing patients with good, respectful, and caring care it is not, however, that kind of care that is actually practiced.…”

Scientometric analysis of research from a feminist perspective.

“…Following the analysis by geographic region and sex, for the Canadian subgroup with 7 articles, there were only two male authors of a total of 19, including one researcher leader of a group of four female researchers (Rose, Peter , Gallop, Angus & Liaschenko , 2011) in a study of forensic nursing, and another one participating as a third author in a study of state policies in Iraq (Buck , Gallant & Nossal, 1998).…”