Issues and Trends in Nursing
Miss Cookie
POWERPOINT-2.pptxIMPACT OF WORKPLACE HARRASSMENT & VIOLENCE IN NURSING
MARLA PITALUGA
WHAT is harassment & violence?
An act in which a person is
Mistreated
Threatened
Intimidated
Attacked
Violence against nurses in the workplace is a serious global issue that has gained prominence recently. Approximately 25% of RN have been physically attacked by a patient or family member, and more than 50% have been subjected to bullying or verbal abuse. Nurses, who are largely responsible for delivering lifesaving care to patients, are attacked at a substantially greater rate than other healthcare workers, and workplace violence is projected to cause 17.2% of nurses to leave their jobs each year (Al-Qadi, 2021).
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Why is violence under reported?
Dissatisfied with how previous violence cases were handled
Accept that violence is part of the job
Discouraged from reporting
Insufficient time
Believe harm was provoked
Capability to protect oneself
Violence cases are often under reported. This is due to many reasons, starting with nurses being dissatisfied with how previous violence cases were handled, or if they know someone who reported violence and the perpetrator suffered no repercussions. Another reason is that they may feel that dealing with violence is a part of the job and they end up accepting it, which is unfair. Sometimes, they are sadly even discouraged from reporting the cases from other people which doesn’t help. Other times they feel they can handle the abuse if they were not physically hit and they feel they are able to defend themselves. It is sad, but these are some of the many reasons why violence is under reported (Al-Qadi, 2021).
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Why does it happen?
Lack of proactive laws
Lack of resources
Lack of communication skills
Scarcity of personnel
Previous research has found that nurses attribute workplace violence to a lack of proactive laws, inadequate management of violent occurrences, a lack of resources, such as insufficient equipment, medical mistakes and a bad atmosphere. Workplace violence can also be caused by a lack of adequate communication skills, lack of expertise, lack of quality treatment and a scarcity of nursing personnel. Nursing workforce shortages are a serious problem which has affected many countries (Al-Qadi, 2021).
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Prevalence of abuse
Verbal abuse
Swearing, screaming, cursing
Physical abuse
Being pushed or struck
The most prevalent kind of abuse aimed towards nurses in healthcare settings is verbal abuse. It is 3x as likely than physical violence to occur. According to Al-Qadi (2021), 82% of nurses identified verbal abuse as the most prevalent sort of abuse, while 63.9% of nurses had experience some form of verbal abuse from patients. Swearing, screaming, and cursing have been recognized as the most prevalent kind of verbal abuse, as well as the most aggressive sort of verbal violence. According to data obtained from 349 nurses, 79.5% had been subjected to verbal abuse, while 28.6% had been subjected to physical assault. Physical violence frequently coexists with verbal abuse, suggesting that the latter may serve as a predictor of future physical abuse. The most prevalent kind of physical abuse has been found as ”being pushed or struck” while the use of deadly weapons has been demonstrated to occur primarily at night.
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WHO ARE THE BULLIES?
IT CAN BE:
OTHER NURSES
DOCTORS/PHYSICIANS
PATIENTS
FAMILY MEMBERS
While it is true that senior nurses “eat their young”, bullying behavior is not limited to age, gender, or experience level. Younger nurses may be critical of their senior colleagues’ looks or physical limitations while older nurses may use their younger colleagues’ lack of experience. Male nurses can bully female nurses and RNs can abuse LPNs. Certain specialties and units have been known to band together against nurses in other departments. Other nurses are the most common bully of nurses. Sometimes, even patients and their family members can abuse other nurses by being racist, yelling at them, or even physically harming them. Sometimes, nurses tolerate it because they understand the patient and family is under a lot of overwhelming stress (Edmonson & Zelonka, 2019)
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Impact on nursing
Reduced efficiency
Increased stress
Sleep disorders
Negative impact on patient care
Nurse burnout
Negatively impacts the quality of life of a nurse
Workplace violence may seriously take a toll on a nurse’s mental health. It may lead to a stressed nurse which in turn may reduce efficiency. These increased stress levels may cause the nurse to lose sleep and acquire chronic sleep disorders. If a nurse is tired and not getting enough sleep, this may also negatively impact patient care. Nurses may end up being dissatisfied with their jobs and become burned out (Teymourzadeh, 2014). I would try not to let it affect me as a nurse by working on my communication skills, being as patient as possible, and learning how to de-escalate a situation. I would also report it as it is unacceptable behavior.
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RELEVANCE
”Nurses Eat Their Young”
The term “Nurses Eat Their Young” is a global idiom that has been used for more than thirty years, and despite the fact that we are aware of the issue, it is still a big issue (Gillespie et al., 2017). Despite the fact that we condemn bullying from early on, bullying still occurs on a regular basis. Sadly, even in healthcare settings across the globe. Horizontal aggression are major issues in healthcare settings which have had an impact on the patient care quality (Escribano et al., 2019). This may all lead to stress on the nurse which then may have a detrimental influence on their mental health and impact their job abilities and productivity (Gillespie et al., 2017). It is important that more attention is brought to this subject so that nurses can work on their communication and interprofessional relationship skills in the hopes that bullying and horizontal aggression be diminished.
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HOW THE TOPIC IS INTEGRATED IN CLINICAL PRACTICE
Professional socialization
Communication skills
Interprofessional relationship skills
Discussion groups
Enforcing rules & not tolerating bullying
Harassment and violence can be prevented. The topic could be integrated in clinical practice in many different ways. The nursing manager may enhance professional socialization by teaching and mentoring employees about the need for healthy socialization and importance of communication. She/he may do this by arranging discussion groups and holding meetings to educate on the principles which must be stressed in order to create a healthy work environment for everyone (Zarshenas et al., 2014). She/he may also collaborate with administration of the hospital to make sure that there is a 0 tolerance policy for bullying as well as severe consequences for it. Younger nurses may also be encouraged to speak up and report any bullying. All of these actions may be done in order to prevent or at the very least minimize bullying in clinical practice.
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Plan to lobby legislators
Contact a lawmaker at least 6x a year
Letter, email, office visit
Educate the lawmaker
Be flexible
Power in numbers
Reach out often
Don’t waste time
First, I will take 30 minutes to reach out to a politician via letter, email, office visit or other means, 6 times a year. Then, I will educate the lawmaker how important this subject truly is. I will show the legislator all of the facts and the consequences harassment and bullying can be in nursing practice. I will also be flexible, sometimes I will have to compromise and determine what is reasonable and most important right now and what I can work on later. I will need to be patient as sometimes these adjustments may take months. There is power in numbers, I will remind my legislator how many people agree with me on the topic. I will need to be reaching out often as these legislators have other things to do. Lastly, I will make sure not to waste anybody’s time. I will get straight to the point and show the important facts and ask for what needs to be done.
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References
Al-Qadi M. M. (2021). Workplace violence in nursing: A concept analysis. Journal of occupational health, 63(1), e12226. https://doi.org/10.1002/1348-9585.12226
Escribano, R. B., Beneit, J., & Luis Garcia, J. (2019). Violence in the workplace: some critical issues looking at the health sector. Heliyon, 5(3), e01283. https://doi.org/10.1016/j.heliyon.2019.e01283
Edmonson, C., & Zelonka, C. (2019). Our Own Worst Enemies: The Nurse Bullying Epidemic. Nursing administration quarterly, 43(3), 274–279. https://doi.org/10.1097/NAQ.0000000000000353
Teymourzadeh, E., Rashidian, A., Arab, M., Akbari-Sari, A., & Hakimzadeh, S. M. (2014). Nurses exposure to workplace violence in a large teaching hospital in Iran. International journal of health policy and management, 3(6), 301–305. https://doi.org/10.15171/ijhpm.2014.98
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References CONTINUED
Gillespie, G. L., Grubb, P. L., Brown, K., Boesch, M. C., & Ulrich, D. (2017). "nurses eat their young": A novel bullying educational program for student nurses. Journal of nursing education and practice. Retrieved October 6, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544026/.
Zarshenas, L., Sharif, F., Molazem, Z., Khayyer, M., Zare, N., & Ebadi, A. (2014, July). Professional socialization in nursing: A qualitative content analysis. Iranian journal of nursing and midwifery research. Retrieved October 6, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145501/.
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