Experience of violence, coping and support for nurses working in acute psychiatric wards

Background: Acute psychiatric wards are stressful working environments because of the nature of the mental illness of patients admitted. These patients present with a variety of complex psychiatric problems and social control that require skilled and competent nurses to manage them. The shortage of nurses, especially with advanced psychiatric qualifications or necessary experience, may create challenges for nurses as they navigate this stressful working environment. Aim: The aim of this study was to explore and describe nurses' experience of patient violence, coping strategies and received support whilst working in acute wards in psychiatric hospitals. Setting: This study was conducted in six acute wards of the three psychiatric hospitals in Cape Town, South Africa. Methods: A qualitative, explorative, descriptive design was conducted using semi-structured interviews to obtain data from 14 nurses working in acute wards in three psychiatric hospitals in the Western Cape. Results: Five themes were generated using thematic analysis: violence perceived to be 'part of the job', contributing factors to patient violence, physical and psychological effects on nurses, adaptive and maladaptive coping strategies and perceived support from stakeholders. Conclusion: Participants normalised patient violent behaviour as being part of the job to minimise the physical and psychological effects of the traumatic experience. Adaptive and maladaptive coping strategies were used to cope with the traumatic experiences of being assaulted by patients. Recommendations allude to practising self-care and attendance of training in the management of aggressive patients for nurses, to enhance a variety of adaptive coping strategies.