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Question:

Discuss about the Nursing and Worplace Violence.

 

Answer:

Introduction

Healthcare as well as social service professionals frequently have to come across high risk of violence at their workplace. Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health (NIOSH) provides the definition of  workplace violence as threatening behaviour, physical assault or verbal abuse taking place in the workplace. In relation to employees of healthcare settings, workplace violence is the form of violence taking place during interaction and activities with the healthcare consumers. Assaults, to some extent, can also be suffered due to misconduct of fellow healthcare professionals.  The reports of the Bureau of Labor Statistics (BLS) in the year 2013 identified 27 out of 100 fatalities taking place in healthcare settings to be occurring as a result of violent acts and assaults. Between the year 2011 and 2013, the range of workplace assaults was between 23,540 and 25,630 annually. 70 to 74% of these reported assaults were found to be occurring in healthcare and social service settings (AnnMarie Papa et al., 2013).

Wyatt et al., (2016) stated that risk factors for workplace violence taking place in healthcare settings can be categorised into two classes; patient and setting related risk factors and organisational risk factors. The first category of risk factors include the following:

  • Transportation of patients
  • Working with individuals having a history of alcohol, drugs
  • Working with patients with mental instability
  • Poorly lit areas
  • Working alone in a particular facility
  • Lack of proper communication
  • Working with equipments that are at risk of causing harm
  • Working in a workplace with improper environmental design

The organisational risk factors include the following:

  • Absence of proper facility policies and adequate training to manage assaultive behaviours
  • High turnover of workers
  • Inadequate security personnel
  • Unrestricted movement of clients
  • Working under understaffed conditions
 

The American Nurses Association (ANA) has a revised position statement on incivility, bullying and workplace violence with effective in the year 2015. The ANA position statement states that nurses have the responsibility of creating an ethical environment and culture of kindness and civility, and treating the patients, colleagues, co-workers and others with respect and dignity. On a similar manner, nurses are to be given the same dignity and respect as others. Though the position statement is written particularly for registered nurses and employers, it is applicable for other healthcare professionals too (ANA-Incivility-Bullying-Violence: Position Statement, 2015).

As per the Occupational Safety and Health Act of 1970, employers are bound to abide by  the safety and health standards and regulations issued and enforced by Occupational Safety and Health Administration (OSHA). In addition, as per the Act’s General Duty Clause, Section 5(a)(1), employers are bound to create a workplace for the workers that is devoid of any hazards that may cause serious harm to the employees. As per the Section 11(c) (1) of the Act, no person should make a distinction between any employee. Section 11(c) of the Act forbids discrimination against an employee for brining into light any work-related fatal outcome, or illness. OSHA recommends that a well-constructed and implemented violence prevention program, along with training, administrative controls, and engineering controls can effectively bring a reduction in the incidences of violence at workplaces (Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, 2016).

As stated by Lanctôt and Guay (2014) nurses are to have a proper understanding of the organisational policies and procedures that relate to the workplace violence prevention. All healthcare organisations must have a strong workplace violence prevention program. The different components of the program are as follows:

  • Employee participation and management commitment
  • Analysis of worksite
  • Prevention and control of hazards
  • Training for health and safety maintenance
  • Program evaluation

Kaur and Kaur (2015) outlines the preventive measures that nurses can implement for protecting themselves against violence at work. The preventive measures can be divided into three classifications. The primary interventions involve education for identifying and reducing the possible vulnerabilities for preventing workplace violence. Nurses must learn how to prevent and adequately give a response to situations of crisis. They must also incorporate health and wellness measures for minimising workplace stressors. The secondary measures include reduction of the negative influence of the workplace violence. Using reporting systems and the administrative controls are the main measures. Tertiary prevention intends to reduce the results of workplace violence. Nurses must engage in the continued improvement of the workplace violence policies. Counselling programs are to be used after any instance of violence.

 

References

ANA-Incivility-Bullying-Violence: Position Statement. (2015). 1st ed.

AnnMarie Papa, D. N. P., Jeanne Venella, D. N. P., & CEN, C. (2013). Workplace violence in healthcare: Strategies for advocacy. Online journal of issues in nursing, 18(1), 101.

Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. (2016). 1st ed. [ebook] Available at: https://www.osha.gov/Publications/osha3148.pdf [Accessed 20 Dec. 2016].

Kaur, R., & Kaur, A. (2015). Prevalence of Violence towards Staff Nurses and their Knowledge and Utilization of Safety Resources. Asian Journal of Nursing Education and Research, 5(1), 124.

Lanctôt, N., & Guay, S. (2014). The aftermath of workplace violence among healthcare workers: A systematic literature review of the consequences. Aggression and violent behavior, 19(5), 492-501.

Wyatt, R., Anderson-Drevs, K., & Van Male, L. M. (2016). Workplace violence in health care: a critical issue with a promising solution. Jama, 316(10), 1037-1038.

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