Unwillingness to be violated: carers' experiences of caring for a person acting in a disturbing manner. An interview study

Carers working in psychiatric care are sometimes exposed to insane, unpredi ctable and violent actions. In rare cases a patient appears to be resistant to all forms of pharmacological treatment. Fifteen carers (four registered nurses, 11 enrolled nurses) on a psychiatri c ward in Sweden were interviewed about their experiences when caring for a person who acted in a disturbing manner. Narrative interviews were conduct ed and interpreted using a method inspired by Ricoeur. Four themes were formulated which describe the carers' uncertainty about th e future, their inability to interpret the patient's disturbing behaviour a nd their own overall feeling of meaninglessness. The carers were of the opinion that the patient had the power and ruled the ward, which led to them feeling they were subjugated victims. The intervie ws also revealed the carers' recognition of forbidden feelings and actions and unknown negative sides. These results were interpreted and reflected on in the light of an ethical framework in order to achieve a deeper understanding of the text. This paper shows that an ethical perspective is important when searching fo r the meaning of caring for patients acting in a disturbing manner. The stu dy raises the question,'Is it possible to establish good when evil has domi nion?'.