A Research Study On The Minds ' Perspectives Through Interviews And Perceptions

Safety is an important factor and is a high priority in healthcare. Kelly, Fenwick, Brekke, and Novaco (2015) shared that workplace violence impairs the staff perceptions of safety. However, both patients and staff are affected by workplace violence in many ways, from physical to emotional aspects. There are many reasons why violence occurs, that will be explained later in this paper. The purpose of this paper is to explain the reason and importance of the chosen phenomenon of interest. Moreover, primary and opposing philosophic viewpoints will be discussed, as well as ways of recognizing and utilizing them in nursing. The ways of knowing patterns in nursing and the utilization of these patterns will be explained, pertaining to nursing care.

One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).

Horizontal violence is a hidden pattern of individual behavior in controlling other individual that risk health and safety (Hinchberger, 2009). According to Roche, Duffield and Catling-Paull, violence can be describe as emotional abuse, threat, or actual violence in any health care setting. Although the definition varies according to situations and practice settings, there is agreement that workplace violence has a negative impact on the health and wellbeing of nurses and the delivery of quality nursing care (Hinchberger, 2009). Violence mostly occur in any health care setting, However, it mostly occur in emergency department, waiting room, psychiatric ward and geriatric unit on which people involved psychological situations.

As health care workers we are under a legal obligation to protect an individual from any kind of abuse, whether it is physical, financial, emotional, sexual or psychological .Legislation, policies and procedures exist to promote a safer working environment and reduce the potential for risks occurring. They are tailored for the needs of each setting, known and understood by employers and employees and reviewed on a regular basis.

A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.

Literature that investigates the rates of lateral violence has confirmed that LV has been and currently still is prevalent in the nursing profession. A survey taken during the Upstate AHEC Lateral Violence Among Nurses Project by Jacobs and Kyzer (2010) revealed that 93 percent of nurses have witnessed lateral violence among coworkers, while 85 percent have been a victim of lateral violence. As can be seen by these percentages, lateral violence in nursing is very real and affects many of those who are identified as a nurse. Although these statistics are informative, it is critical to remember that they do not capture all incidents of LV in the nursing profession. Since these statistics come from reported incidents of lateral violence in nursing, there may be additional incidents that were not reported. Therefore, the rates of

It is evident that the majority of all healthcare workers do not see help for traumatic situations. It is my belief that there is a stigma attached to seeking help. There are very few people that are capable of understanding another coworker that has just been rattled by a very upsetting situation.

The Bureau of Labor Statistics (2000) shows that 48% of all non-fatal work related assaults and acts of violence have occurred in health care and social service settings. Violence against mental health and health care workers has the potential to cause major physical injuries and psychological trauma. In return this poses serious consequences on employers such as increased turnover, medical and psychological care, increased absenteeism, decreased morale, job dissatisfaction, legal issues, and worker burn-out. Agencies and clinicians are encouraged to evaluate and identify the risks that are potential barriers in their agencies. Safety plans need to be implemented and strategized along with re-evaluations on a continuous basis (Taylor, H. 2013).

Horizontal violence is characterized by the presence of series of undermining incidents overtime, as opposed to one isolated conflict in the workplace (Jackson, Flirtko, & Edenborough, 2007). I believe that being a nurse is one of the most rewarding careers. At the same time it is very challenging work physically and emotionally. When faced with horizontal violence in a workplace; it makes it very difficult for the nurses to provide a focused patient care especially working under mostly male physicians and being looked down upon at times. Cherished nursing characteristics, such as sensitivity and caring are viewed as less important or even negative when compared to those of medical practitioners, who often are seen as the central culture in health care (Woelfle & McCaffrey).

Besides using governmental data and statistics to compile information regarding workplace violence in health care settings, voluntary surveys are taken (Stokowski, 2010). These surveys and reports of violence are usually unreliable due to the nurse’s lack of ability to remember the incident, fear of affecting patient satisfaction scores, uneducated on the reporting policy, or concern for questioned competency (Stokowski, 2010). It is said that seventy percent of physical abuse towards nurses are unreported and many nurses never seek treatment (Stokowski, 2010). The hesitancy to report is sensible when incidents reported reviewed are often questioned by the nurse’s actions and solutions are addressed to prevent another occurrence (Stokowski, 2010). These approaches administered by health care facilities imply that the nurse is at fault. Sadly, nurses are often reprimanded or fired defending themselves against violence (Stokowski, 2010).

The goal of this research was to quantitatively describe the occurrence of healthcare worker directed violence, describe how the violence is dealt with, and describe the consequences to the healthcare worker. This research was performed at a general hospital in Sweden using a cross-sectional survey that was dispersed to many types of healthcare workers ranging from physician to physical therapist to nursing assistant and midwife. The Survey of Violence Experience by Staff (SOVES-G-R) was given to 4,845 workers that had patient contact and 2,495 surveys were returned. Three categories are looked at using the SOVES-G-R including: individual characteristics, interactions, and organizational work environment. Results of these surveys showed that violence was seen by workers in all areas of patient care, often when medical or therapeutic interventions were taking place. The interventions used by the healthcare workers were also documented and found to be very inconsistent throughout the hospital, showing that the lack of education on avoidance of violence and de-escalation of violent patients was a problem that needs to be addressed throughout the healthcare

However, what some don’t know is that assaults on first responders are happening across the nation and many go unreported. Violence against EMS experts takes many forms. Most acts of brutality are not less than deadly. Statistics shows that the risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers a year; the national average is about 1.8 per 10,000 workers. The National Association of Emergency Medical Technicians (NAEMT) found 4/5 medics have experienced some form of injury as a result of the job. The U.S. Department of Labor reported that about 52 percent of EMTs operating in the field have been assaulted.

Consequently, employees have suffered injuries from assaults by patients. Dresser states, “Gilmore said the center has seen an increase in assaults recently. She said employees have suffered scratches, bruises, bites, knee injuries and concussions.” Understaffing is causing this increase in injuries suffered during assaults. Therefore, mental health facilities should hire more staff.

Trauma exposure and a stressful work environment, not only have a deleterious impact on the physical and mental health of nurses and other healthcare workers, but on productivity and patient care outcomes as well (Gates, Gillespie, & Succop, 2011). Increasing access to affordable, comprehensive, evidence based advanced psychiatric nursing practice will improve the health outcomes of nurses and other healthcare worker as well as the patients they serve.

Indeed, Fudge (2006) describes this as vertical violence, which means that the act of violence is between senior and junior colleagues. Horizontal violence is across peer groups and similar levels of staff. The most common aggressors or bullies are nurse-managers and supervisors (Leiper, 2005). Certainly, education is very influential in terms of the respect seen among health care professionals, because it has been an ongoing issue as to understanding the hierarchy in the health care profession. The bridge between education and collaboration is still suffering today and it is an issue to address.