Carriers of pain: Vulnerable meetings between staff and clients with a dual diagnosis

Abstract

Persons with complex problems challenge nursing. The interest of this study was to identify the tools staff have used to continue working with compassion, empathy and sensitivity amongst vulnerable clients with complex problems, mental ill health and substance use (so-called dual diagnosis). The data were collected in a focused ethnographic study at a low-threshold service for substance users, and were analysed using Leininger’s ethnographic and a phenomenological lifeworld method. The staff attitude was positive towards the clients, they approved of the client’s background. Vulnerability appeared as a common pain, which touched both the staff and clients, and needed to be negotiated. A staff tool was the capability of carrying the pain, not being overwhelmed by it. The implications for practice are to recognize openness, awareness, reflexivity and communion with other staff members, the need for balancing of personal and ethical roles with professional requirements.