Hot och våld inom psykiatrisk vård är ett omfattande arbetsmiljöproblem och sjuksköterskorna tillhör de mest utsatta yrkesgrupperna inom hälso- och sjukvården. Våldet kan vara verbalt, psykiskt eller fysiskt och påverkar sjuksköterskans hälsa och vårdens kvalité. Syftet med denna systematiska litteraturstudie var att belysa sjuksköterskors upplevelser av hot och våld i psykiatrisk vård, med fokus på riskfaktorer för våld, hur våldssituationer erfars och hanteras, samt vilka konsekvenser dessa händelser får för sjuksköterskan och vårdandet. Metoden utgick från en kvalitativ ansats och analysen genomfördes med tematisk innehållsanalys av 23 vårdvetenskapliga artiklar. Resultatet innefattar tre huvudteman: Risker och relationer i den vårdande miljön, Sjuksköterskans utsatthet och sårbarhet samt Återhämtning och behov av stöd. Vårdrelationen, samtalet och ett lågaffektivt bemötande ansågs vara viktiga faktorer för att förebygga och hantera utåtagerande beteende. Hot och våld medför både fysisk och psykisk påverkan som rädsla, stress, oro, sömnsvårigheter och utmattning. Kollegialt stöd, reflektion, handledning och erfarenhet upplevdes som stöd. Flera sjuksköterskor önskade utbildning, tydliga rutiner och bättre organisatoriskt stöd.

Threats and violence in psychiatric care are a widespread workplace problem, and nurses are among the most vulnerable professional groups in the healthcare sector. This violence can be verbal, psychological, or physical, and it affects nurses’ health and the quality of care. Threats and violence are normalized in psychiatric care, yet the science regarding their consequences is often overlooked, and they are viewed as part of daily work. The purpose of this systematic literature review was to examine nurses’ experiences of threats and violence in psychiatric care, with a focus on risk factors for violence, how violent situations are experienced and managed, and the consequences of these events for nurses and patient care. The method was based on a qualitative approach, and the analysis was conducted using thematic content analysis of 23 nursing science articles. The results encompass three main themes: Risks and relationships in the care environment, Nurses’ exposure and vulnerability, and Recovery and need for support. Eight subcategories were presented. The care relationship, conversation, and a low-affect approach were considered important factors in preventing and managing outward aggression. Threats and violence lead to both physical and psychological effects such as fear, stress, anxiety, sleep difficulties, and exhaustion. The nurse experienced feelings of guilt and inadequacy, which negatively affected their professionalism. Collegial support, reflection, supervision, and experience were perceived as supportive and provided a sense of security during recovery. Several nurses expressed a desire for training, clear procedures, and better organizational support in their efforts to prevent and manage threats and violence. To create a sustainable work environment in psychiatric care, the organization, management, and nurses need to collaborate to reduce the normalization of violence and strengthen the work environment, as well as to provide training and support for nurses in psychiatric care.