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.
Potter, J. E., White, K., Hopkins, K., Amastae, J., & Grossman, D. (2010). Clinic Versus Over-
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)
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
The trauma related to negative behavior can afflict the healthcare environment on many levels, from creating a hostile work environment in which job performance is affected, by increasing job turnover and causing nurses to leave the profession altogether. The Joint Commission states that in the United States 65.6 million workers have experienced or witnessed bullying, psychological harassment affects 38 percent of healthcare workers, and 44 percent of nurses are impacted by this behavior (The Joint Commission, 2016). Inclusively, this behavior can influence the way nurses care for their patients, staffing levels, and the healthcare organization’s
Wood, W. M., Karvonen, M., Test, D. W., Browder, D., & Algozzine, B. (2004). Promoting
...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.
...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).
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
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.
“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.
In order to recognize the behavioral patterns to prevent violence, one must understand the definition of workplace violence. According to the American Nurses Association, the definition of workplace violence means any sort of verbal abuse, threatening behavior, or a physical assault occurring in the workplace (“Workplace Violence” 2013). Some of the behaviors that might be observed indicating an act of violence is about to occur are: intimidating, harassing, bullying, inappropriate or aggressive behavior, increased agitation (i.e. snappy comments), inability to be still, noncompliance with simple requests, statements of desperation, references to committing suicide, direct or indirect threats. If these signs are noticed in a patient or family member, the nurse should intervene immediately. It is important to remember that other nurses are also capable of violence and looking for their behavioral warning signs are equal...
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.
Eisenstark, Lam, McDermott, Quanbeck, Scott and Sokolov (2007) reported that twenty five percent of mental health nurses working in public sector hospitals take the major risk in violent attacks from patients resulting a series injury: the prevalence rate being as high as three times that of any vocational group (Del Bel,2003).this number implies that nurses physical as well as emotional health is being compromised largely each day (Lanza, 1992). Another study done from five mental health inpatient units over a period of seven months, indicated that seventy-eight percent of violent incidences came from nurses (Jones, Owen, Tarantello, and Tennant,1998).Nurses are not the only ones being challenged by violence. A study done by Albert Banerjee et.al (2008) in long term care facilities, a shocking number of personal support workers have been a victim of workplace violence. Almost half (43%) of support workers reported they experience violence in everyday work activities. 16.8% of registered nurses and one quarter (24.6%) of licensed practical nurses, registered practical nurses, and registered nursing assistants experience violence on a daily basis. In 2000, social service workers incidence injuries also rose by 9.3 from work related assaults and injuries. As significant as this numbers could be, the numbers could go higher if those underreported cases are reflected that’s comes with the employees belief, “reporting won’t change
Couch, D., Liamputtong, P., & Pitts, M. (2012). What are the real and perceived risks and
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.