In 3 articles, survivors of healthcare worker directed violence admitted to knowingly spending less time with their patients after the attack.(8, 12, 16) Quality of care is also reduced as survivors admit to being fearful of their patients as well as being reluctant to care for specific patients or any patients at all.(8, 17, 19, 25) After an incident of workplace violence, survivors stated that they have decreased communication with their patients, patient families, and coworkers.(12, 27) Survivors also admitted to having reduced interest in being a part of patient care, as well as being in their current position.(8, 12, 14, 19) One article found that physiotherapists often reduced their expectations for their patients after experiencing an incidence of workplace violence from a patient.(8) Survivors also found that they had reduced empathy and gave reduced emotional support to patients and their families after returning to work.(15) After an attack by a patient, survivors admitted to lacking concentration that led to missed medication administration, increased falls, and increased errors in administration of care.(10, 15, 17, 27) Discussion The purpose of this review was to discover and asses the effects of healthcare worker directed violence on healthcare providers as well as the effect on patient care. There is sufficient evidence to say that workplace violence perpetrated by patients has a negative effect on the healthcare worker as well as the quality of care they are
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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.
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 negative phenomenon that is increasing significantly in the hospital setting. It is defined as bullying, verbal and physical aggression that occurs to employees in the workforce. Horizontal violence has harmful effects on nurses as it lowers their self- esteem, and makes them feel as if they have no power in their career. This phenomenon also negatively impacts patient centered care and safety as nurses are more vulnerable to making medication errors and careless mistakes. Horizontal violence can be decreased in the hospital setting if interventions are implemented by members of the health care team. Education is key to decrease the occurrence of horizontal violence as it enables health care workers to
The purpose of this integration paper is to educate about lateral violence in the professional setting, more specifically within the nursing profession. Lateral violence is defined as “profound and pervasive source of occupational stress with physical and psychological and organizational consequences.” (Cervalolo, D). Types of lateral violence include rude comments, verbal attacks, condescending language, sexual misconduct, lack of collaboration, professionally attacking a person integrity and reputation, blaming others for your own mistakes in front of others and family members of the patient, withholding important information and other non-professional behaviors.
Tony York, the chief operating officer for Healthcare Security Services in Denver, Colorado, which monitors security at hospitals throughout the nation, says there has been an “explosion of patient-generated violence” in the past several years – both from patients themselves and, often, the people accompanying them to the hospital. “Those are things that have driven this industry immensely,” York
Workplace violence has existed throughout history. However, historical documentation of workplace violence is vague and sometimes non-existent. Documented workplace violence is believed to have existed during the Roman Empire, the Renaissance Era, and it continues today. It seems unfortunate, but as long as a “society” exists, workplace violence will more than likely exist. Therefore, employers must understand: the history of workplace violence, the effects it has on the organization, the reasons why it occurs, the warning signs, and ways to prevent it from occurring. Most importantly, it is the responsibility of the Manager, to not only understand workplace violence, but to ensure that all employees
The lateral violence comes in many forms and in many ways, such as abuse in the workplace that occur between colleagues, it can be verbal or nonverbal aggression, intimidation, bullying, harassment, discrimination, stereotyping, gossiping, criticism, and other related mistreatment behavior at work. Institutional lateral violence also happens between manager and subordinate where they can use their higher position to perpetrate assault to their subordinate such as acts of lasciviousness, shouting, anger outburst, forced overtime request, giving work beyond the job description, work overload, over blaming or insulting a staff and more. All these happen occasionally because of the lack of respect in the workplace and it comes without notice, especially in healthcare practices where the nature of work is tough and decision making must be made immediately.
According to Purpora and Blegen, approximately 60% of actual errors in patient care result from poor and ineffective communication (para. 3). Horizontal violence causes a decrease in effective communication between caregivers which places the patient’s safety in jeopardy. Horizontal violence decreases staff morale which leaves room for error in the workplace (Longo & Smith, 2011).
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.
This is relevant for me as it is for everyone in the healthcare industry. We all want to work in an environment that is free from violence especially in an environment that is already full of stress. It is good to know that there are governmental sanctions for those that violate harassment or violence regulations in the workplace. We still need management to be accountable with those under their direction, disciplining and counseling problem employees as necessary. Because of this threat that constantly hangs over our heads we as nurses should develop a process or plan
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).
Nurses continually strive to bring holistic, efficient, and safe care to their patients. However, if the safety and well-being of the nurses are threatened or compromised, it is difficult for nurses to work effectively and efficiently. Therefore, the position of the American Nurses Association (ANA) advocate that every nursing professional have the right to work in a healthy work environment free of abusive behavior such as bullying, hostility, lateral abuse and violence, sexual harassment, intimidation, abuse of authority and position and reprisal for speaking out against abuses (American Nurses Association, 2012).
Workplace violence is a serious and growing issue in society. Employers need to develop intervention strategies to decrease reduce violence in the workplace. Also, employers and employees need to be aware of the signs when people exhibit behaviors that can lead to workplace violence. As a society, the issue needs to be acknowledged of the reality and work together for creating a solution. Lastly, employers and employees must not live in fear of addressing concerns if they see the potential for workplace violence or report when they witness or experience workplace violence.