Purpose: We aimed to deepen our understanding of the concept of compassion in caring for patients with mental illness in forensic psychiatric inpatient care settings.
Methods: Qualitative analysis was used to illuminate themes from interviews conducted with 13 nurses in a prior study. The audiotaped interviews, which had been transcribed verbatim, were analyzed following a hermeneutic approach with a secondary supplementary approach.
Results: Being compassionate in forensic psychiatry is described as an emotional journey as its varied over time. Compassion is developed from nurses being able to recognize and interpret suffering and need for support which depended on if suffering was seen as obvious, hidden or perceived as frightening. Recognizing and interpreting expressions of suffering was followed by actions, as nurses also responded to patients suffering, either by complying with the patient, feeling forced to persuade the patient or sometimes adapting oneself to the patient and the situation at hand. It was clear that the nurses invested a lot of time and energy in providing the best possible care for the patients. Meaning over time nurses becoming either persistent or resigned, even feeling a sense of shame as a reaction to one´s own vulnerability. As the encounters and their contact with the patients touched the nurses on an interpersonal and intrapersonal level.
Conclusion: Caring for patients with mental illness in forensic psychiatric in- patient care means being confronted sometimes by incomprehensible expressions of suffering. Being able to understand these expressions facilitates compassion and enables nurses to give adequate responses and simplify care. Overall, compassion was seen as a changeable asset, but also an obstacle when absent; sensitivity to one’s own vulnerability is necessary to overcome that obstacle.