Abstract

This study explored the subjective experience of nurses working with female inpatients
engaging in frequent and severe self-injury. Instances of self-injury
within female secure inpatient hospitals include scratching of the skin, selfligation
and removal of body parts. Six nurses working at a high secure hospital
in England were interviewed using interpretative phenomenological analysis
methodology. From the data, two super-ordinate themes were established;
‘Experiencing of affect’ and ‘containing processes’. ‘Experiencing of affect’
involved the sub themes: ‘fear of patient death, ‘state of perturbation’ and
‘culmination of stress’. The theme ‘containing processes’ involved sub-themes:
‘Habituation’ (toward the self-injury), ‘enjoyment of the job’, ‘establishing
boundaries’ and ‘peer support’. It was hypothesised that these latter themes
provided some containment for nurses’ distress or protection from the negative
impacts of working with self-injury. These findings differ somewhat from existing
literature on professionals working with self-injury. The theoretical and clinical
implications of these findings for nursing practice when working with self-injury
are considered.