Staff gender ratio and aggression in a forensic psychiatric hospital

Abstract

Gender balance in acute psychiatric inpatient units remains a contentious issue. In terms of maintaining staff and patient safety, 'balance' is often considered by ensuring there are 'sufficient' male nurses present on each shift. In an ongoing programme of research into aggression, the authors investigated reported incidents of patient aggression and examined the gender ratio on each shift over a 6-month period. Contrary to the popular notion that a particular gender ratio might have some relationship with the likelihood of aggressive incidents, there was no statistically significant difference in the proportion of male staff working on the shifts when there was an aggressive incident compared with the shifts when there was no aggressive incident. Further, when an incident did occur, the severity of the incident bore no relationship with the proportion of male staff working on the shift. Nor did the gender of the shift leader have an impact on the decision to seclude the patient or the likelihood of completing an incident form following an aggressive incident. Staff confidence in managing aggression may be influenced by the presence of male staff. Further, aspects of prevention and management may be influenced by staff gender. However, results suggest there is no evidence that the frequency or severity of aggression is influenced by staff gender ratio.

Taking the temperature: attitudes of patients on an all-female psychiatric ward to staff gender

“…8 This accords well with a study by Hatch-Maillette who found that male staff viewed threat situations as significantly less threatening than female staff. 9 In a further study in 2003, the same author highlights similar issues making the link between employee well-being, job satisfaction, morale and organisational productivity.…”

Men and Masculinities in Forensic Psychiatric Care: An Interview Study Concerning Male Nurses' Experiences of Working with Male Caregivers and Male Patients

“…One aspect is how staff described conflicts between staff members and patients and how this was reflected in discussions about rules and routines. This touches upon and confirms what Daffern, Mayer, and Martin (2006) mention with regard to the physical strength of male staff members, which provides staff with the self-confidence to handle difficult situations. In forensic psychiatric care this is nothing unusual.…”

“…Daffern, Mayer, and Martin (2006) question this assumption of a sufficient number of male caregivers to prevent situations of violence and threats at the units. Connell (1993Connell ( , 1995Connell ( , 2000Connell ( , 2003 argues that while attitudes and values of men's physical strength can generate higher status for men, they also can create a difference between men's and women's assignments.…”

Sex differences in aggressive incidents towards staff in secure services

“…Carmel and Hunter (1989) also suggested that male staff may attempt to contain physically patients' aggressive behaviour more than female staff, thus exacerbating aggressive behaviour from the patients towards them. Daffern, Mayer, and Martin (2006) found that staff tended to be more confident in managing aggressive incidents when more male staff were present on shift. However, they found no statistical link between the number of aggressive incidents and the staff sex mix on the ward at the time.…”