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.
Permanent link to this resource: https://doi.org/10.24384/zarx-9k49
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Supervisors: Kozlowska, Olga; Schutz, Sue
Faculty of Health and Life SciencesOxford School of Nursing and MidwiferyDepartment of Nursing
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