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

Abstract

Patients in forensic psychiatric settings are likely to suffer not only from their mental illness but also from memories of criminal activities and, furthermore, from being involuntarily hospitalized. The aim of this study was to explore how nurses in forensic psychiatric care understand and approach patients' suffering. Data was generated by semi-structured interviews with psychiatric nurses from two different forensic psychiatric care units in Ascribing meaning to suffering, and 4) Being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering patients means that nurses are confronted with patients' suffering as well as their own reactions while being present for those patients. If suffering is not seen or encountered, there is a risk that even actions taken with the best of intentions will hurt the patient.

Controlling emotions—nurses’ lived experiences caring for patients in forensic psychiatry

“…According to Løgstrup (1983), interpretation is in the movement between perception and understanding. Our findings clearly indicate that nurses' perception were affected, which was also seen in other studies (Vincze et al, 2015). According to Løgstrup (1978), understanding can also create a distance and is linked to our preconceptions, where cultures and knowledge are embedded.…”

“…This indicates that the caring encounter is formed by patients' needs. The nurses described that facing patients' suffering sometimes required that the nurse take a step back-not to abandon, but rather to come closer, which is also described by Vincze, Fredriksson, and Wiklund Gustin (2015).…”

Getting to know the person behind the illness – the significance of interacting with patients hospitalised in forensic psychiatric settings

“…Thus, nurses might distance themselves from patients to cope with such challenges (Jacob, Holmes & Buus, ; Vincze et al . ). Furthermore, Salzmann‐Erikson et al .…”

“…Vincze et al . () conducted a study to explore nurse–patient interactions within FMHN to understand and approach patients’ suffering. Vincze and colleagues found that some FMH nurses asserted the relevance of nurses’ emotional presence to ease the patients’ suffering as well as their genuine interest in the patients’ life worlds.…”

“…As presented above, nurse–patient interactions can be especially challenging in forensic settings, and in line with Vincze et al . (), it can be concluded that forensic nurses sometimes fail to ‘do good’, even when they have good intentions. Therefore, it is important to further explore what FMH nurses describe as significant when establishing relationships with patients who are hospitalised in forensic psychiatric settings.…”