Feeling Safe and Taking on Responsibilities: Newly Graduated Nurses' Perceptions and Evaluations of Their Transition Into a Forensic Mental Health Inpatient Setting

Understanding the experiences of transition for newly qualified mental health nurses and their potential to stay in the role: A qualitative exploration

AIM

To understand the experiences of transition from the perspective of newly qualified mental health nurses and the impact this may have on their potential to remain in the role.

BACKGROUND

During the transitional period following registration newly qualified nurses experience feelings of being overwhelmed and shock. Internationally there is limited research on factors influencing transitional experiences in the field of mental health.

DESIGN

A qualitative exploration was conducted using thematic content analysis to analyse the data gathered from semi-structured interviews METHOD: 18 Newly qualified mental health nurses from two NHS Mental Health trusts were interviewed, all within 18 months of registration. Data were analysed and themes generated addressing the research aim.

RESULTS/FINDINGS

Five themes were co-created using this inductive technique: 'Transition to new role', 'Support for new role', 'Professional identity', 'Role development' and 'Working environment'. These themes are representative headings with the sub-themes making up the contributory content. Themes highlighted issues concerning newly qualified nurses and the transition which included aspects of anxiety and feeling overwhelmed initially. This highlighted the feelings associated with transition and progression through the process of liminality. Supervision was identified in the context of formal support, the presence of which is conducive to a positive transition. Imposter syndrome and experiencing reality shock were common aspects of role development and acknowledging the sense of responsibility gained once registered. Safety was highlighted as many experienced their first role on in-patient environments which was busy and potentially hostile.

CONCLUSION

The transition of newly qualified nurses in mental health services can prove to be a difficult experience, therefore it requires acknowledgment and careful consideration. Understanding the liminal process may allow staff to appreciate the effect of the transition and to understand that the NQN will face overwhelming and unfamiliar responsibilities. Despite the demands to boost the workforce in mental health services there is a need to understand how best to integrate NQN's into their role during this transition. Caution must be used if we are not to lose more NQN's, as despite concerns there are still NQN's looking to mental health nursing as their future and chosen career.

The experience of nurses moving into forensic mental health employment: A qualitative study

While forensic mental health has seen considerable growth over the last two decades, little is known about the experience of registered nurses working in these environments. This study used a qualitative descriptive approach and interviewed 11 registered nurses to explore the interpersonal experiences of transition into a forensic mental health hospital. The data revealed three themes. 'Observing what's safe' examined nurses' ability to maintain safety in the context of inconsistent practices among colleagues. 'Navigating cliques and divisions' focused on nurses' sense of belonging and adapting to professional and personal groups. Finally, 'gaining management support' reflected nurses' experiences of engagement with management. This study provides new insight into nurses' experience of adapting to employment in forensic mental health settings and highlights the importance of positive support strategies for workplace transition.

Trauma-Informed Approaches to Medicolegal Death Investigation: A Forensic Nursing Perspective

Forensic nurses engaged in medicolegal death investigations experience trauma-induced responses in responding to, investigating, and documenting sudden unexpected deaths. The trauma of these repeated experiences often results in diminished performance, job dissatisfaction, and burnout. The principles of trauma-informed care are not new but have not been incorporated into death investigation practices. When coupled with medicolegal death investigation procedures, application of these principles can help to alleviate distress for forensic nurses, colleagues, and decedents of concerned families. This case series illustrates how the principles of trauma-informed care can be implemented to enhance communication, deescalate emotional or threatening situations, and prevent retraumatization in the context of medicolegal death investigations.

Conflict management: A qualitative study of mental health staff's perceptions of factors that may influence conflicts with forensic mental health inpatients

Internationally, clinical services are under pressure to reduce their use of restrictive practices. The aim was to explore how mental health nurses and nursing assistants perceive conflict and their use of restrictive practices with mental health inpatients in forensic mental health care. A total of 24 semi-structured interviews with forensic mental health staff were conducted and analysed using thematic analysis. The findings propose a dynamic model that explains how tolerance of potential conflict situations changes depending on individual staff members' perceptions of patients and colleagues, and their relationships.