Being burdened and balancing boundaries: a qualitative study of nurses' experiences caring for patients who self-harm.

Although nurses encounter self-harm patients in various settings, self-harm has seldom been addressed in psychiatric nursing research. The research question was: 'What are nurses' descriptions of experiences of caring for psychiatric patients who self-harm?' The data were comprised of text based on narrative interviews with six nurses employed in a psychiatric hospital in Sweden. By using qualitative content analysis, two themes and seven sub-themes were constructed. The theme 'Being burdened with feelings' involved the sub-themes: 'Fearing for the patient's life-threatening actions', 'Feeling overwhelmed by frustration' and 'Feeling abandoned by co-workers and management'. The theme 'Balancing professional boundaries' involved the sub-themes: 'Maintaining professional boundaries between self and patient', 'Managing personal feelings', 'Feeling confirmed by co-workers' and 'Imagining better ways of care'. Of significance are the nurses' feelings of fear, frustration and abandonment creating the sense of being burdened. This study points to the importance of releasing these burdens, not only for the sake of the nurses, but to improve the care of the patients. The importance of increased knowledge, support and supervision for professionals working with people who self-harm, not only in psychiatric care, needs to be addressed in research, education and development of practice.