“Understand why this patient self-harms - who
you have in front of you (i5).”
A caring attitude was expressed; the participants reflected
on how the patient is doing and worried when a patient
was out on leave or had been discharged. Patients can be
ambivalent to whether they live or die, so the harm they cause
themselves can fluctuate between self-harm and attempted
suicide. The participants described that the patient’s selfharm
can be mild, moderate, or severe in degree and can lead
to death: also that there was a delicate line between life and
death. Patients can miscalculate the severity of their self-harm
and harm themselves more than intended. The participants
experienced that they continuously strive to understand each
patient and that patients can change their self-harm patterns,
with the end result that the participants were not always able
to recognize patients’ new patterns and/or methods:
“But there is, to be sure, a seriousness in it...at the
same time that it can, to be sure, change. Some
do not need to be so serious and suddenly it is
something else then (i5).”
Not appearing to be judgmental or guild inducing in
the nurse-patient relationship occupied the participants. In
the fact that the participants experienced that patients often
feel ashamed of their self-harm, the participants sought to
circumvent patients’ low self-esteem and instead promote
trust and a dialogue:
“How well you know the patient and they feel safe
with you - then we can, in a way, put some more
words into it - I think (i8).”
4.1.2. Bearing Hope for Recovery. The participants stated that
it is important to be attentive to patients’ experiences, see
the individual, and believe in the patient’s capabilities and
rational sides. They sought to be a friendly and respectful
presence and convey hope and also maintained the belief
that patients can improve. The participants sought to carry
the projections they feel in the relationship,to persevere
and withstand the relationship and bear hope regarding the
patient’s recovery when the patient him/herself is unable to
envision such occurring: