Multiple studies from various emergency department show that the rates of violence in the emergency department are higher than other wards in hospitals. These studies looked at violence and intimidation directed towards the emergency department staff in various forms. These included intimidating behaviour, verbal abuse, shouting, physical threats, attempts of physical assault to actually getting physically assaulted. The Emergency Nurses Association (an American organization) surveyed 3500 nurses, and found that 86% had experienced physical violence on the job in the last 3 years, and 72% stated they did not feel safe on the job. A Canadian study, that surveyed emergency department employees at St. Paul’s hospital, a downtown hospital in Vancouver had similar results. Of the 163 staff members that completed the survey, 97% stated they had experienced physical threats while working in the department, and 92% said they experienced verbal abuse and physical assault. Disturbingly, 68% of those surveyed believed that the frequency of violence at the emergency department was increasing over time.
The high rates of emergency department violence has multiple direct and indirect factors. The National Institute for Occupational Safety and Health (NIOSH) produced a list of risk factors for workplace violence in 1996. Almost 20 years later, these factors are still relevant, and many of them apply to the emergency department environment. A relevant factor on the list included working in a community based setting, since all emergency department wards in Canada are accessible to the public. Working over night or into the early morning is another applicable factor as the majority of hospitals are open 24 hours. Other relevant factors...
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...hospital has a zero tolerance for violence and the potential consequences are clear. This can be done through signs located in the ER waiting area, and in other areas of the ER. In addition, if a patient starts acting in an intimidating manner they should immediately be reminded of this zero tolerance policy towards violence. To minimize patient, family, and visitor stress and agitation which can potentially progress to violence, ER department staff should aim to communicate with them every half an hour. If despite these measures, a patient, visitor or family member becomes violent or verbally abusive, they should immediately be reported to well trained security or to the police if necessary. In addition, the patient’s name should be recorded for ER staff to view. This way if the patient visits the ER again the staff can be on high alert for violence from them.
Myers, et al., (2016) performed their study as through collaboration with a New York State wide study to explore nuurses’ experience with lateral violence. Myers, et al., (2016) offered both online and paper surveys for nurses comfort. The study revealed that lateral violence is seen throughout all roles of nurses from staa nurses to leadership roles. The results of this study led the organizations to perform educational programs and provide open forums to give staff the opportunity to talk about their experiences. Leadership has been made the point people to promote the eduacational programs and
Now a days, in the healthcare field the nurses are known to prevent, promote and improve the health and abilities of patients, families and communities. It is very heartbreaking to hear that in this honorable profession exists violence, bullying which is among not only nurses but also other healthcare professionals. According to the article, Reducing Violence Against Nurses: The Violence Prevention Community Meeting, violence is defined as any verbal or physical behavior resulting in, or intended to result in, physical or physiological injury, pain, or harm. In the healthcare field the term that is used when there is violence between coworkers is called horizontal violence. This is a term that is continued to be used but some hospitals have replaced it with the terms bullying or lateral violence. Horizontal violence is violence between nurses and it explains the behavior nurses have toward their coworkers and other healthcare professionals. This type of violence interferes with working together as a team and communicating between coworkers, which are things that are needed to promote and care for others.
Blair, P. L. (2013). Lateral violence in nursing. Journal of Emergency Nursing, 39, 75-78. doi:10.1016/j.jen.2011.12.006
According to the Bureau of Justice Statistics (BIS), workplace violence affects 1.7 million people each year. The Bureau of Labor Statistics’ Census of Fatal Occupational Injuries (CFOI) reported 11,613 workplace homicide victims between 1992 and 2006. Averaging just under 800 homicides per year, the largest number of homicides in one year occurred in 1994, while the lowest number occurred in 2006 (CDC).
McNamara, S. A. (2012). Incivility in nursing: unsafe nurse, unsafe patients. AORN Journal, 95(4), 535-540. doi:10.1016/j.aorn.2012.01.020
Several databases including Academic Search Premier, JSTOR, CINAHL, MEDLINE, and Cochrane were accessed using the key words “workplace violence,” “nurses,” student nurses,” horizontal violence,” “bullying,” “oppression,” and “intergroup conflict.” The purpose of the literature search was to determine the predominance of horizontal violence among new nurses and nursing students.
Assaults in the healthcare setting are recognized as a growing problem. In considering the violence and aggression in mental health units, the larger issue of violence and aggression in mainstream culture must not be ignored. It has been observed that physical attack in a mental health unit setting appear to be happening more frequently while the attacks include patient-to patient and patient-to-staff aggressive behavior. Most commonly, reporting of aggressive behavior toward healthcare staff is noted; however, it cannot be completely explained by patient characteristics or staff member behaviors (Foster, Bowers, & Nijman, 2006). To improve patient control of aggression and violence, an organization must better define the management and reporting of this behavior, identify appropriate management programs and training, and evaluate the frequency and precipitants.
Kleim et al. (2015) referenced other studies indicating burnout and stress in medical professionals having a positive correlation with work volume, patient load, number of night shifts, number of consecutive work days as well as females and alcohol consumption having a positive correlation with PTSD presence. The prevalence of physical violence upon ED nurses has been studied and indicates twenty-five percent of ED nurses reporting physical violence occurring more than twenty times in the past three years (Lavoie et al., 2016). Further research in this area is likely to indicate a positive correlation between the two per the above statistic and results of high PTSD. Lavoie et al. (2016) further highlighted the impact on attendance with nurses missing an average of 14.5 work days per year for health-related reasons with 11.6% being attributed to psychological health. These studies in comparison to those referenced in my research are crucial indicators for the need to address PTSD and treat those involved, as well as the need for further research to compile more accurate
Arnetz, J. E., Hamblin, L., Ager, J., Aranyos, D., Essenmacher, L., Upfal, M. J., & Luborsky, M. (2015). Using database reports to reduce workplace violence: Perceptions of hospital stakeholders. Work, 51(1), 51-59.
Workplace violence is a frustrating issue confronting businesses today. While more data on the reason for violence and how to handle it is getting known, there is frequently no sensible basis for this sort of behavior and, in spite of all that we know or do, fierce circumstances happen. No superintendent is resistant from working environment brutality and no manager can completely anticipate it.Workplace violence can cause many issues for a business, from extra expense, to how to deal with the problem, and prevent it from happening in the future.
Therefore, this position statement is relevant because these abuses can be seen in day-to-day healthcare environment. The effects of violence in nursing can be harmful to the proper function within a workplace. It can be damaging to the nursing profession and patient care. According to (Johnston et al., 2010, p.36), workplace violence is “spreading like a ‘superbug.’” Studies have shown, that lateral violence, nurse-on-nurse, has been one of the highest incidence of violence within the workplace. Also, statistics have shown that lateral violence has one of the most emotional impacts on an individual. This will be further discussed below. For these reasons, it is important for healthcare workers to validate the detrimental effects violence can have in the workplace, and be prepared to combat and prevent workplace violence.
Everyday risks present themselves in various workplaces through a variety of situations. Risk managers have been set in place to establish rules and guidelines by which employees are to follow. Any risk manager would agree that programs are set into place to reduce exposure risks, and provide a safe working environment. The elimination of undesirable outcomes in an emergency setting is critical and should not be taken lightly. Medical facility holds the key to important protocols and needs to work closely with risk management in order to instill cooperation.
On Wednesday, December 28, 2016, approximately at 2:36PM, I responded to the ER, Room 15, in reference to an intoxicated patient that was being very disorderly with medical staff and officers. Upon arrival, I made contact with a patient that was identified as Burke W. Duncan, medical staff and officers. I observed officers standing in the hallway in front of this patient room. A nurse by the name of Allison Cockerham was caring for this patient and this subject became beligerent and started using all kinds of profanity and vulgar language towards her. This subject was so agigated that he started using profanity towards the doctors, nurse and officers on scene.
The 9-1-1 emergency dispatcher, dispatches a call to the local fire department. “55 year- old male, chest pains, has been having chest pains for the last couple hours.” The department responds to the call, as they would any call. This is the 4th time this week they have been called out to the same old man, with the same complaints. These patients are known as the “frequent flyer’s”, they received this nick-name from constantly calling EMS personal, when deemed not appropriate. Some of these patients call everyday, and every fire station has that several individuals who gives them a purpose daily. This is a problem in the Emergency Medical Service field and seems to be growing out of control.
Research indicates the relationship between horizontal violence and the burn out rate of registered nurses to be epistemologically significant due to a determined prevalence of nonphysical violence in the health care setting and the potential nature, severity and ubiquitous state of its prospective consequences. This systematic review will examine the aforementioned phenomenon in further detail with a focus on specific implications, if any, on the burn out rate of registered nurses.