By Len Bowers

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Nurses’ loyalty and trustworthiness were tested by patients, who fed them confidences to see whether or not they were maintained. A clear patient hierarchy was visible, with two pairs of patients competing for leadership, with symbolic displays of power and status being regular events. g. ). Through Richman’s eyes we gain insight into the realities of daily life for nurses and patients on a PD unit. Thus his account is rare and extremely valuable. Since the work of Peplau, who brought the neo-Freudianism of Harry Stack Sullivan into the nursing literature in the 1950s, psychiatric nursing textbooks have given a dominant emphasis to the importance of the nurse-patient relationship.

This inquiry was set up in response to yet another critical television documentary, alleging that patients’ complaints were not properly dealt with at Ashworth Hospital. It revealed an uncaring and a demeaning attitude to patients, resulting in their harassment and bullying; a low quality of life for patients, provoking difficult to manage behaviour; substandard nursing care; substandard medical care; and substandard management. The main nursing union at that time was the Prison Officers Association (POA), which chose to instruct its members not to cooperate Special hospital country 21 with the inquiry.

In common with this study, they found that patients were likely to be considered evil when crimes had been planned in advance and the victims were from vulnerable groups. In addition, because they included a wide range of examples in their vignettes, they discovered that PD patients were more likely to be considered evil than psychotic patients. Reading about crimes of horror In all three hospitals the case notes available on the wards contained clinical records, index offence histories and case conference reports.

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