THE LIVED EXPERIENCE OF AGGRESSION AND VIOLENCE

The Lived Experience of Aggression

The Lived Experience of Aggression

Introduction

Aim

The aim of this study was to explore the lived experiences of individual mental health nurses in acute mental health wards to ascertain the main stressors and to gain an insight into the meaning that these experiences hold for them.

Rationale for The Study

In recent years a number of publications (Bowers et al, 2005; Sainsbury Centre for Mental Health, 2004; Department of Health, 2001) have raised concerns about standards of care and environments in acute mental health settings. While these publications document unacceptable levels of care and culture on acute wards, they also report on unacceptable levels of stress in nurses.

Acute mental health nursing poses many challenges against a backdrop of poorly resourced and structured environments. Studies (Richards et al, 2006; Bowers et al, 2005; Jenkins and Elliott, 2004; SCMH, 2004; DH, 2001) have shown that such challenges include:

•Inadequate staffing;

•Patients who are acutely disturbed posing risks of violence and self-harm;

•Bed shortages/occupancy rates;

•Workload.

While challenges may have some positive effects - such as bringing stimulation, excitement and enthusiasm to the workforce - the challenges described may become counterproductive, especially if they are seen as beyond nurses' control or threatening their well-being. In turn, they can become stressors and lead to stress.

Feelings of stress may predispose staff to other illnesses and have an adverse effect on people's lives (Richards et al, 2006; Norton, 2004; Caan et al, 2001). Recognising the impact that stress can have on individual staff members, their families, patients and the NHS, the DH (2000) advocated stress-reduction programmes and other work/life balance improvement strategies in the workplace.

One mechanism to tackle staff stress in acute mental health nurses may be to address the paucity of research in this area. While Edwards and Burnard (2003) detailed the variables and sources of stress, the real paucity lies in the meaning and the experience that it holds for individual nurses (Lambert and Lambert, 2001). This study used a qualitative paradigm to capture the experience and meaning that stress has for acute mental health nurses.

Literature Review

Occupational stress in nursing has been the focus of much research over the last 20 years. However, studies on stress in mental health nursing have been slower to emerge. Of the studies to date (for example, Jenkins and Elliott, 2004; Kilfedder et al, 2001), many have been quantitative in nature and sought to ascertain the levels of stress or the variables that accounted most for stress. Findings indicate that lack of adequate staffing levels (Jenkins and Elliott, 2004); levels of support at work and from family and friends; and emotional exhaustion, depersonalisation and lack of personal accomplishment (Kilfedder et al, 2001) are frequently cited as either stressors or indicators of stress in mental health settings.

Although many pressures faced by nurses in different specialties may be similar, generalising findings to a whole profession may be difficult due to different variables such as specialty and emotional demands of the job. Supporting this, McVicar (2003) stated that: 'Commonality of sources of ...