S.TRUEMAN PhD THESIS 2016

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to the nurses and/or witnesses, the mental health nurse educator would provide individualised and group support, counselling and de-briefing, as required. The researcher remembers one incident in which a nurse was working in a single station primary healthcare centre on a remote island. There were no resident police, and nurses stationed on nearby islands, still some distance away, did not travel at night-time due to safety concerns. On a Saturday at around 6 pm, there was a frantic knock on the front door of the nurse’s accommodation. Upon opening the door, the nurse was confronted by a highly distressed, yelling and sobbing female covered in blood, who had sustained a number of serious injuries and wounds. The nurse immediately stopped her dinner preparations and assisted the female patient next door to the primary healthcare centre, which consisted of two treatment rooms. The nurse commenced attending to the patient’s serious head, limb and torso wounds, which required a variety of interventions. Approximately 90 minutes later, there was a loud banging on the locked front door of the primary healthcare centre, accompanied by a tirade of verbal abuse and shouting: it was the patient’s male partner. The male was a ‘known’ mental health patient and under the influence of alcohol and cannabis. The nurse observed through the ‘spy hole’ in the front door that he was carrying a machete knife. The patient became increasingly frightened. Despite extensive discussions and negotiations between the nurse and the partner through the locked door, he would not desist from his angry, threatening and violent ranting, which was directed at the patient. The remote general nurse then spent the night locked in with the patient. She was awake all night, caring for the fearful patient, who could not return home, despite it being evident in the early hours of the morning that the partner had succumbed to the effects of intoxication and wandered off. At daybreak, the remote general