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Nursing Ethics
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Justifying Coercion

Paula K Vuckovich

University of San Diego, CA, USA, pvuckov{at}calstatela.edu

Barbara M Artinian

Azusa Pacific University, CA, and California State University, Northridge, CA, USA

A grounded theory study of psychiatric nurses’ experiences of administering medication to involuntary psychiatric patients revealed a basic social process of justifying coercion. Although the 17 nurses interviewed all reported success at avoiding the use of coercion, each had an individual approach to using the nurse-patient relationship to do this. However, all the nurses used the same process to reconcile themselves to using coercion when it became necessary. This has three stages: assessment of need; negotiation; and justifying and taking coercive action. Two critical junctures - decision to engage and impasse - determine the progression from one stage to the next. The process of justifying coercion allows a nurse to engage in behavior generally disapproved of while retaining a self-image of a ‘good’ nurse.

Key Words: coercion • ethics • involuntary hospitalization • mental illness • psychiatric nursing • psychotropic medication

Nursing Ethics, Vol. 12, No. 4, 370-380 (2005)
DOI: 10.1191/0969733005ne802oa


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