Experiences of psychiatric nurses working with aggressive patients

Abstract

The aggression of some psychiatric patients is recognised as a major problem in healthcare circles, both locally and internationally. It creates a significant risk for psychiatric nurses as these nurses spend more time with their patients than nurses from other nursing disciplines. Nurses are more likely to be involved in preventing and managing aggressive behaviour and are more at risk of being victims of patients' aggressive acts. Little research has been conducted to understand how nurses think when they have to manage aggressive patients. In an attempt to address this problem, the objectives of this study were to explore and describe the experiences of psychiatric nurses working with aggressive patients, and to propose guidelines that will assist psychiatric nurses in managing aggressive patients more effectively. A qualitative design was employed to conduct the study. Individual interviews were used as the method of data collection. Data saturation was reached after eleven individual interviews. The researcher and co–coder reached consensus during a meeting organised for this purpose. The findings suggest that the majority of the participants experience working with aggressive patients predominantly negatively, and only a few of them still hold positive attitudes. The most prominent themes were that participants felt incompetent in managing aggressive patients, and they also highlighted that they find themselves working in an unsafe environment where they have been assaulted by patients on numerous occasions. Based on these findings the researcher proposed guidelines to assist psychiatric nurses in managing aggressive patients more effectively. The researcher also compiled recommendations for nursing practice, nursing education, and nursing research with regard to the management of aggressive patients.