Thesis (D.Nurs)

The experiences of mental health nurses who have been assaulted by patients in medium secure mental health settings


Background: The prevalence of assaults on mental health nurses in inpatient settings is high and research has identified negative outcomes including depression and anxiety, PTSD, burnout and intention to leave. Quantitative approaches to researching this subject have dominated, with there being very few studies exploring mental health nurses’ personal experiences of being assaulted by patients, and none focussing on secure settings. Aim: The aim of this exploratory study was to develop understanding of the experiences of mental health nurses who are assaulted by patients in secure settings. Methods: Sixteen registered mental health nurses working in secure services across the UK were interviewed, and the data were analysed using Reflexive Thematic Analysis. Ethical approval for the study was granted by Oxford Brookes University Research Ethics Committee. Results: Three themes were generated: ‘We know the risks, but being assaulted is not ‘normal’’; 'Keep emotions under wraps and crack on' and 'The response to assault can make or break’. The themes each speak to the enduring narrative that assaults on mental health nurses are normal. Whilst nurses explicitly rejected this narrative, its impact was evident in both their own responses to being assaulted, and the responses they received, particularly from their managers and the police. In order to protect themselves from the shame of being exposed as weak and a failure, they suppressed their emotional responses to being assaulted. The expectations on nurses to "crack on" was frequently reinforced by the responses they received from others both within and beyond their organisations. Conclusions: The normalisation of assaults on mental health nurses is understood with reference to the Fricker’s (2007) concept of epistemic injustice, influenced by mental health nursing’s history, associative stigma, and the narrative of nurses as ‘angels and heroes’. Recommendations for education, practice and further research are made, focussing on challenging the cultural, organisational, and systemic factors that serve to perpetuate the damaging normalisation of assaults on mental health nurses.

DOI (Digital Object Identifier)

Permanent link to this resource:

The fulltext files of this resource are currently embargoed.
Embargo end: 2024-06-03


Ayres, Helen


Supervisors: Kozlowska, Olga; Schutz, Sue

Oxford Brookes departments

Faculty of Health and Life Sciences
Oxford School of Nursing and Midwifery
Department of Nursing


Year: 2023

© Ayres, Helen
Published by Oxford Brookes University
All rights reserved. Copyright © and Moral Rights for this thesis are retained by the author and/or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

Related resources

This RADAR resource Cites Exploring mental health nurses’ experiences of assault by patients in inpatient settings.
This RADAR resource Cites Conducting research into assaults on mental health nursing during COVID-19: A reflection on a professional and ethical dilemma.


  • Owner: Helen Ayres
  • Collection: eTheses
  • Version: 1 (show all)
  • Status: Live
  • Views (since Sept 2022): 129