Subordinated masculinities: A critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care

Eivergård, Kristina; Enmarker, Ingela; Livholts, Mona; Aléx, Lena

doi:10.1111/jocn.15456

Cited by 7 publications

(3 citation statements)

References 35 publications

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“…The consequences include physical and psychological damage to fellow patients and carers, poor therapeutic relationships, low job satisfaction, and increased sickness absence among staff [10,11]. Dealing with patients' physical and verbal outbursts is considered a part of nurses' everyday work in forensic care [12] and makes them vulnerable to burnout [13]. Being exposed to stressful situations, characterized by threats, violence, and harassment by patients, over long periods means that nurses often have to deal with emotions of frustration, fear, humiliation, disappointment, etc.…”

Section: Introductionmentioning

confidence: 99%

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Hammarström,

Hellzén,

Devik

2023

Healthcare

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The aim of this study was to describe the phenomenon of “fleeing the encounter when facing resistance” as experienced by carers working in forensic inpatient care. Qualitative analysis, namely reflective lifeworld research, was used to analyze data from open-ended questions with nine carers from a Swedish regional forensic clinic. The data revealed three meaning constituents that describe the phenomenon: shielding oneself from coming to harm or harming the other, finding one’s emotional balance or being exposed, and offering the patient emotional space and finding patience. The carers described their approaches in the encounters with the patients as alternating between primitive instincts and expectant empathy in order to gain control and deal with the interaction for their own part, for that of the patient, and for that of their colleagues. The phenomenon of fleeing the encounter when facing resistance was intertwined with carers’ self-perception as professional carers. Negative encounters with patients evoked feelings of shame and self-blame. A carer is a key person tasked with shaping the care relationship, which requires an attitude on the part of the carer that recognizes not only the patient’s lifeworld but also their own.

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Section: Introductionmentioning

confidence: 99%

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Hammarström,

Hellzén,

Devik

2023

Healthcare

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“…Encounters between carers and patients in a forensic setting are mostly spontaneous during daily activities and involve openings for dialogue and opportunities to provide support (Rytterström et al, 2020 ). However, these encounters could also mean dealing with physical and verbal outbursts from patients, being forced into conditions in which setting limits is considered a part of everyday work (Eivergård et al, 2020 ) and dealing with uncomfortable situations, sometimes alone (Rytterström et al, 2020 ). At the same time, establishing a fruitful relationship (Rydenlund et al, 2019 ) is perceived as emotional labour, meaning that it is necessary to deal with one’s emotions to care for another person (Edward et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Meanings of carers’ lived experience of “regulating oneself” in forensic psychiatry

Hammarström

Devik

Häggström

2022

International Journal of Qualitative Studies on Health and Well

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Purpose This study aimed to illuminate the essential meanings of carers’ lived experience of regulating themselves when caring for patients with mental illnesses in forensic inpatient care. Methods Qualitative analysis was used to analyse data from narrative interviews with open-ended questions conducted with nine carers, which were analysed using a phenomenological-hermeneutic approach. Results Findings revealed three themes, “preserving oneself as a carer,” “building an alliance with the patient” and “maintaining stability in the community.” Carers not only regulated emotions related to patients but also the ward to facilitate a caring climate. For carers, encounters with patients meant facing expressions of suffering that evoked unwanted emotions. Regulating one’s emotions also meant being emotionally touched and facing one’s vulnerability. Conclusion Regulating oneself was a strategy used by carers to get closer to the patient and establishing a trusting relationship. Regulating oneself meant becoming aware of one’s shortcomings, not projecting them onto others, which may impair establishing relationships with patients and fulfilling the aim and caring task of forensic psychiatry. This study stresses the importance of carers being guided to manage their conflicting emotions and vulnerabilities and finding courage and an approach that allows a permissive climate of self-reflection.

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“…Studies that focus on the topic of language used in professional meetings and gender in psychiatric practice are limited but have been conducted by Eivergård et al (2020). Such studies in relation to people with psychiatric disabilities are even more limited but have been conducted by Olin (2017).…”

Section: Introductionmentioning

confidence: 99%

Disciplined into good conduct: Gender constructions of users in a municipal psychiatric context in Sweden

Eivergård

Enmarker

Livholts

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long‐term municipality psychiatric care. Focus is on the staff's use of language in relation to gender constructions. Background Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users' needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long‐term psychiatric care in municipalities have problematised the care and how staff, through language, construct users' gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users. Design The content of speech derived from audio recordings was analysed using Foucauldian discourse analysis. The COREQ checklist was used in this article. Results The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, and Doing different femininities. Conclusion The community psychiatric context generates a discourse of conduct in which staff via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.

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Subordinated masculinities: A critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 7 publications

References 35 publications

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Meanings of carers’ lived experience of “regulating oneself” in forensic psychiatry

Disciplined into good conduct: Gender constructions of users in a municipal psychiatric context in Sweden

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