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‘Safe Enough in Here?’: Patients’ Expectations and Experiences of Feeling Safe in an Acute Psychiatric Inpatient Ward

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    Rights statement: © Stenhouse, R. (2013). ‘Safe Enough in Here?’: Patients’ Expectations and Experiences of Feeling Safe in an Acute Psychiatric Inpatient Ward. Journal of Clinical Nursing. 10.1111/jocn.12111

    Accepted author manuscript, 505 KB, PDF document

Original languageEnglish
JournalJournal of Clinical Nursing
Early online date22 Jul 2013
Publication statusPublished - 22 Jul 2013


Aims and objectives. To understand the experience of being a patient on an acute psychiatric inpatient ward.
Background. Acute psychiatric inpatient care is an integral part of the mental health system. A key driver for admission to
acute wards is risk. Previous research indicates that people do not always feel safe when in an acute ward. Understanding
the patient experience of safety can influence nursing practice, as well as policy and service development.
Design. A qualitative approach was used. Patient experience was conceptualised as represented through narrative as data.
Sociolinguistic theories linking narrative structure with meaning informed the development of the analytic framework.
Methods. Thirteen patients with a variety of diagnoses were recruited from an acute ward. Unstructured interviews were
carried out in participants’ homes two and six weeks postdischarge. Holistic analysis of each individual’s data set was
undertaken. Themes running across these holistic analyses were then identified and developed.
Results. Participant narratives were focused around themes of help, safety and power. This study presents findings relating
to the experience of safety. Participants expected to be safe from themselves and from others. Initially, they experienced a
sense of safety from the outside world. Lack of knowledge of their fellow patients made them feel vulnerable. Participants
expected the nurses to keep them safe, and felt safer when there were male nurses present.
Conclusions. Participants talk about safety in terms of psychological and physical safety. A key issue was the perception of
threat from other patients, highlighting the need to consider patient safety as more than physical safety.
Relevance to practice. Nurses need to be sensitive to the possibility that patients feel unsafe in the absence of obvious threat.
Institutional structures that challenge patients’ sense of safety must be examined.

    Research areas

  • acute psychiatric inpatient care, narrative, nurse–patient relationship, patient experience, patient safety

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