Being in conflict: Physicians' experience with using coercion in psychiatric care

Abstract

Swedish physicians (five specialists and five assistant physicians) in acute psychiatric care narrated their experiences with using coercion. The commonest action using coercion related to in all the interviews was forced injection. The assistant physicians also described persuasion as an action using coercion. A content analysis showed four characteristic themes from the physicians' narratives: being in conflict with the patient, being under pressure and avoiding conflict, being in conflict with ethical demands, and needing reflection and support. The physicians expressed being in conflict with the patient and being under pressure and avoiding conflict with nursing staff, colleagues, and legal demands. For most of these physicians this resulted in a conflict with the ethical demands of giving good care. Ways to relieve pressure and conflict when using coercion with psychiatric patients included connecting with the patient, agreeing and reflecting with nursing staff and colleagues, and gaining more support from colleagues.