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. The impact of aggression and violence in mental health units is substantial. Effects that have been documented include physical injury, emotional and psychological harm, compromised patient care, and financial expense to the organization. In a review of literature, physical injury to inpatient mental health staff is high and poses a strong threat to staff and other patients (Foster, Bowers, & Nijman, 2006). Although the rates of victimization that occur between patients are low, it is an increasing concern. In these acts of aggression, both verbal and physical violence can occur. Aggression Management To manage the aggression both for patient and staff victims, Eileen Morrison and Colleen Love (2003) evaluated four aggression management programs using predetermined criteria for their effectiveness in training behavioral health staff. Morrison and Love’... ... middle of paper ... ... in psychiatric inpatient units. Australian and New Zealand Journal of Psychiatry 34, 967-974. Bowers, L., Allan, T., Simpson, A., Nijman, H., & Warren, J. (2007). Adverse Incidents, Patient Flow and Nursing Workforce Variables on Acute Psychiatric Wards: The Tompkins Acute Ward Study. International Journal of Social Psychiatry 53(75), 75-84. Foster, C., Bowers, L., & Nijman, H. (2007). Aggressive behavior on acute psychiatric wards: prevalence, severity, and management. Journal of Advanced Nursing 58(2), 140-149. Ilkiw-Lavalle, O., & Grenyer, B. (2003). Differences between Patient and Staff Perceptions of Aggression in Mental Health Units. Psychiatric Services 54(3), 389-393. Morrison, E., & Love, C. (2003). An Evaluation of Four Programs for the Management of Aggression in Psychiatric Settings. Archives of Psychiatric Nursing 37(4), 146-155.
Lateral Violence in Nursing Lateral violence is an act of aggression that occurs among nurses (Becher & Visovsky, 2012), many nurses are exposed to incidents of lateral violence two or more times weekly (Ceravolo, Schwartz, Foltz-Ramos, & Castner, 2012) (American Association of Nurse Anesthetists, 2014). Lateral violence which is also called bullying, incivility, disruptive behaviors and horizontal violence may be covert or overt acts of verbal or nonverbal aggressions (American Nurses Association, 2011). Lateral violence may be verbal, physical or psychological in nature (Blair, 2013). Victims of lateral violence may have profound psychological effects including fatigue, insomnia, stress, depression, shame, guilt, isolations, substance abuse,
As a healthcare professional, everyone that we encounter with is perceived differently and each patient is treated differently depending on what is needed. Horizontal violence, on the other hand, is considered to be subjective, meaning that the effects differ person to person. The effects of the person may grow if they are not addressed. One of the traits that all nurses, I believe, must have is to be able to work as a team. This trait regrettably can offset due to verbal abuse and other intimidating behaviors that can cause health professionals to refuse to share information needed to provide the best patient care. Communication between colleagues is needed because if does not exist this will again affect the patients care and their own safety.
Potter, J. E., White, K., Hopkins, K., Amastae, J., & Grossman, D. (2010). Clinic Versus Over-
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.
In the early 1980s aggression and violence in the workplace have been a source of a lot of public discussion. (Piquero pg.383) The issues have risen again recently and have mostly been present in management and business fields. Workplace aggression often includes “behavior by an individual or individuals within or outside organizations that is intended to physically or psychologically harms a worker or workers and occurs in a work related”. (Schat& Kelloway Pg. 191) A national survey Conducted by the National Centers for Victims of Crime shows several statistics regarding workplace homicide by type show that is the year of (see fig. 1), violent crimes against victims working or an duty( see fig. 2) and nonfatal workplace violence committed by strangers(see fig. 3
Mental health nurses are exposed, due a lack of community support, low staffing levels, stigma and client pressures including the risk of violence, The increasing number of mental health patient compare to the decreasing number of beds and capable staff, means that mental health nurses are spending less time per patient and potentially providing a minimum quality of care level , Moreover, mental health nurses are dealing with caring for patients in inappropriate settings, with a reduced level of ,all factors leading to an increase in stress and burnout (Barling, 2001, p. 252; MHCA, 2005, p. 3)
Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
Wood, W. M., Karvonen, M., Test, D. W., Browder, D., & Algozzine, B. (2004). Promoting
Research shows horizontal violence to be prevalent in the field of registered nursing. Although a comprehensive quantity of incidences within the profession is undetermined, the literature is in agreement such phenomenon exists and the effects of which require further scholarly observation and evaluation.
...ink that I will ever work in the field, I think these skills are beneficial within the field of psychology. In working with patients in the future, I will remember to explore all areas of their lives and do my best to not stereotype a person with mental illness. Lastly, I will use the information on warning behaviors to assess whether or not one of my patients intends on hurting others with mass violence or violence in general. I think this is the most important thing that I could take away from this experience due to the fact that research has shown that third-parties are often aware of such warning behaviors but never voice their concerns to the police. Going forward, I will definitely voice my concerns through the proper channels should I ever encounter someone that seems intent on committing any act of violence (i.e. school related, domestic, or otherwise).
...ic violence, as we can see from the previous read information, results in injury. It is a very serious issue for the people within a violent home setting and with today’s legal system domestic violence cases are being taken extremely serious. It is important that we as nurses, if we feel someone is in a violent home setting, to identify these patients and assess as needed. By nurses identifying and assessing victims of violent acts we can help these people and contribute to decreasing the number of violent acts that occur. If a nurse or anyone knows or suspects that someone is being abused, we need to let that victim know there are alternative solutions, choices they can make, and that there is hope to solve the problem at hand. We should also let this victim know that without help, this problem may only get worse and could progress in frequency and severity.
The staff knew the patient well, knew that she had a history of being violent, knowing the patient positively affects patient outcomes (Zolnierek, 2013). The Quality and Safety Education for Nurses Project has established nursing evidenced-based practice competencies which include: patient-centered care, teamwork, safety, informatics, quality improvement, and evidence-based practice. Some barriers to evidence-based practice include fixed tradition, with an inability to adapt; time constraints, inadequate education, resistance from nurses and doctors (Melnyk et al., 2014). In looking at the evidence that informed my nursing practice: this doctor was not trusting my judgment, even though I have been a nurse for 28 years, almost as many years as this doctor has been alive. She was resistant to teamwork, she placed staff at risk, and did not do what was best for the patient; Further, 30%-76% of psychiatric staff is assaulted by a patient at least once in
“Understanding the Relationship between Mental Disorder and Violence: The Need for a Criminological Perspective.” Law and Human Behavior 30(6):685-706. Silver, Eric and Brent Teasdale. 2005. “Mental Disorder and Violence: An Examination of Stressful Life Events and Impaired Social Support.” Social Problems 52(1):62-78.
Glied, S., & Frank, R. G. (2014). Mental Illness and Violence: Lessons From the Evidence.
Couch, D., Liamputtong, P., & Pitts, M. (2012). What are the real and perceived risks and