responding to patients suffering The nurses' narratives exposed the process of making sense of and gaining meaning from encountering patients in forensic psychiatry. Despite facing different types of encounters, the complexity of care was always present and the nurses must carefully control their responses to the various expressions of suffering. Complying with the patient In some encounters, the nurse responded immediately to expressions of suffering with compassion, in a way that felt obvious and natural. Providing care for patients who explicitly requested help felt right and left the nurses with feelings of having done a good job. “When they come by themselves and want help, it goes without saying that you are there for them, it sorts of becomes a proof that you have done the right thing when they themselves want help.” In encounters with patients, the nurses expressed that adherence made it simpler to maintain control of the situation and to give care, which awoke feelings of enthusiasm. Taking advantage of these meetings seemed to be valuable and strengthened nurses in future encounters. “It's much easier to help them when they want to receive the help I can give them…it also makes it easier to motivate myself and stay committed”. Persuading the patient In situations when patients hid their suffering or opposed help and did not realize it would be for their own good, the nurses spent a lot of energy on trying to persuade and influence the patients to adapt to the care. The nurses found it tedious having to treat and guide patients who were consistently reluctant. Although the nurses' responses were grounded in concern for the patients, these experiences influenced how the nurses engaged with them in the long run. “It's hard when they just disappear from you and don't want to receive the help we can give. You want what's best for them, you want them to move forward. Because it's about what you have to cope with yourself, too. It's tedious to have to nag the patient.” Adapting oneself to the patient When nurses found themselves in a situation, in front of an unpredictable patient, they had to first adapt to the situation, not letting fear, anger or frustration take overhand. Despite being worried the nurses did not show this to the patients. Instead, they tried to show a façade of calm and comfort. “Sometimes it happens that you are at the front of a situation and have to confront someone. That is extremely intimidating. Then it's hard. Then it's so…I do not want to communicate to the patient that I am afraid. I want to hide it, while this feeling is stirring up inside me. I don't have so many tricks other taking a deep breath, far down in the belly... Try to keep control of my voice.” Making the effort of gaining control of the situation was not only an act of what's best for themselves, not making a decision based only on the effect, but also on what was best for the patients, an act of what was best for the other, an act of compassion. However, if the nurses were unable to maintain control of themselves and they let their emotions take over, they rapidly took a step back in order to be able to give a more adequate response to the patient's expression of suffering. This allowed them to regulate and adapt to the situation, thus gaining control of both themselves and the situation. “ I notice that he often turns to me, it's me he wants to talk to; you have to think about the patient's situation. I always try to think that they are ill, that's why they are here. At the same time, it's a protection for me not to take everything that happens personally when they choose to take out their bad feeling on their surroundings…if my feelings take over I will most certainly not be able to handle the situation, then I must take a step back” Third theme: reacting to their own vulnerability Becoming persistent It was clear that the nurses invested a lot of time and energy in providing the best possible care for the patients. When they received positive feedback from the patient and succeeded in gaining contact and mutual respect, this meant both self-respect and renewed commitment. This investment could be seen as the nurses' attempts to alleviate their own frustration and suffering in times when patients did not cooperate. Sometimes it was just the passing of time that led to a changed situation. “It took time, we had to take many walks and car rides, but eventually he started to trust me, we got to know each other, all the hard work paid off. We developed a special bond, I got to know the person behind his illness and crime… I got a whole different understanding of him as a person. I really wanted what's best for him.” Caring in a forensic setting meant being confronted with non-comprehensible expressions. Having time on your side helped the nurse to respond to the patient's plea. Feelings of hopelessness decrease and the nurse could more easily unravel the patient's suffering as well as her own. “It's not as hopeless as you might think, sometimes the patients who are the most ill are the ones you develop most compassion for over time; you just have to get to know them, but it takes time”. Becoming resigned The opposite of becoming persistent was also a topic in the interviews with the nurses. Being in an environment where they are not seeing any results during long periods of time, awoke feelings of discouragement and