Factors affecting high secure forensic mental health nursing workforce sustainability: perspectives from frontline nurses and stakeholders

Introduction
There has been no previous study of stakeholders’ views on recruitment and retention concerns in high secure forensic settings.
Aim
To identify factors affecting recruitment and retention in high secure hospitals, from the perspectives of stakeholders with experience in forensic mental health nursing.
Method
Framework analysis of data from fifteen interviews and three focus groups with frontline nurses, nurse leaders, recruitment leads and union representatives from three high secure hospitals in England.
Results
Six themes emerged from the data: (i) the unique nature of high secure nursing; (ii) the impact of short staffing; (iii) wider factors affecting the high secure nursing workforce; (iv) the location; (v) staff being on different terms and conditions of work; (vi) recruitment strategies.
Discussion
Multiple factors are likely to simultaneously affect high secure hospital recruitment and retention. Findings on the unique nature of high secure work reflect previous qualitative research. The themes of location, working terms and condition and recruitment strategies have not been previously identified in forensic nursing research.
Implications for practice
Employers should ensure that employment terms and conditions are equitable and consistent. Furthermore, hospital managers should address the effect that movement of staff between wards may have on morale and therapeutic relationships.