Workplace Violence in Nursing

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Introduction

In the position paper “Violence in the Workplace” by Washington State Nurses Association, workplace violence is said to be a significant concern. The paper demonstrates that there have been improvements on the definition of workplace violence. In the mid 1990s, the National Institute for Occupational Safety and Health and the Occupational Safety Health Administration defined workplace violence as “violent acts directed towards person at work or on duty” (1). This definition was later improved to include “physical assaults and threats of assaults directed towards persons at work or on duty” (1). It considered terrorism as an example of workplace violence. However, the Federal Bureau of Investigation in collaboration with the American Association of Occupation Health Nurses came up with a broader definition of workplace violence that considers physical, property impact, and psychological perspectives. They defined it to be “any action that may threaten the safety of an employee, impact the employee’s physical or psychological well-being or cause damage to company property” (1). I agree that workplace violence is a big problem in the healthcare sector and there is need to advocate for policies, laws, research, and position statements that would promote safe workplaces.

It seems that the healthcare sector is among the top four workplaces that are most affected by violence. The most vulnerable people are the nurse’s aides, nurses and the elderly. Those working in the emergency departments are also vulnerable to violence. For example, nurses who handle accident victims come in contact with the body fluids the victims. These fluids are capable of transmitting diseases like HIV/AIDs if they are not handled safely. If a nurse has an opening on the body and comes into contact with infected blood, there exists a risk of contracting such diseases. In addition, nurses are vulnerable to accidental pricks from used needles that expose their bodies to various health hazards. I was moved by the fact that WSNA condemns any form of abuse and harassment in all professional association and working environment. It is time that we work as one nation and look after one another. The days of racism and sexism should be long gone. Everyone should, therefore, be able to get services from a public institution regardless of his color, gender, religion, health status or disability.

I see that lateral violence is also common in hospitals. This involves nurse to nurse aggression which hinders the delivery of services. I feel that when nurses are not in good terms with one another, they will not be able to cooperate when attending patients. The patients are, therefore, left at risk of poor services. A frustrated nurse is likely to bully patients instead of being ethical in her work. I think that it is important to ensure that nurses are satisfied with their work for them to provide better services. If a nurse has any problems, she should not be allowed to attend the patients before the problem is solved. The author seems to call for reforms in the healthcare sector to ensure that every nurse works in a safe environment. For instance, the WSNA endorses the development of a workplace that is safe and nondiscriminatory, offers equal opportunities and is open to cooperation.

 However, some patients are threats to the nurses. For instance, mentally unstable patients can be rowdy to the nurses who have to tie them up before attending them. Such scenarios put the lives of the nurses in danger. WSNA affirms that the causes of workplace violence are diverse and multifaceted. For example, it states that the increasing risks in ED environments are a sign of drug and alcohol abuse by visitors and patients, poor coping skills for the patients and visitors, the presence of weapons, and a rapid increase in patients suffering from psychosis or dementia. In addition, there is concern that the workplace violence is a reflection of the violence being witnessed in the communities. If people are not raised in a way that they can respect their neighbors, this bad behavior is likely to be reflected in the hospitals because these are the same people that are treated at the community hospitals.

Most incidences of violence go unreported. In my opinion, most nurses encounter violence activities but they do not report the cases because no disciplinary measures are taken. If the hospital administration followed up all the reported cases, people would be willing to report because they would be assured of the problem solution. However, since reporting would not make any difference, they prefer not to report. In addition, patients whose rights have been violated may not know where to report because of their poor state of mind. Furthermore, reporting any form of bullying by a nurse to another nurse might not bare any fruits because the nurses might protect their friends’ interests. No nurse would want to see his or her colleague suspended from duty and, therefore, they would play down the incident instead of reporting it to the authorities.

Nurses should take the initiative to demand for a better working environment because they are the most affected. It is their territory and they should not wait for any external force to fight for their safety. They should, therefore, take the lead in creating a better working environment. Changes should be started by them. For example, they have a responsibility to demand a violence-free environment. If the nurses are not safe, they are unlikely to provide high quality services to the patients because they will be cautious of their health. Thus, it is necessary that nurses are assured of a safe and respectful working environment to improve the quality of service delivery. Some of the examples of an unsafe working environment include huge workload and inadequate support staff. In my opinion, more supporting nurses must be employed in order to avoid extra workload of the staff. Just like any worker, a nurse needs to rest. However, since people fall sick every day, the nurses are always attending to many patients. Employment of more nurses would ensure that the nurse gives maximum time to a patient rather than rushing up to attend another patient. Consequently, nurses should advocate for policies that support harassment free, abuse free and safe working environments through a comprehensive security program.

One of the ways to implement security programs is by establishing an identification process of all the patients upon admission in the hospital. I feel that noting down patients with violence history would enable the nurses to know the kind of patients they are dealing with. However, I did not like the fact that the author seems to focus more on the violence upon the nurses and forgets the patients. WSNA’s endorsements are mostly focused on how to create a safe environment for the nurses forgetting that the patients are also exposed to violence either from other patients or from nurses. Therefore, there is a need to identify violent nurses so that they could be guided and trained on how to deal with the patients.

I do not think that the healthcare professionals do not understand the importance of safety at the workplace. I believe this is one of the topics they tackle in training. The problem, therefore, is all about the will to implement the safety mechanisms. I do not agree with the idea that there is a need to promote education on healthcare safety as such educational base already exists. It would be much better if strict measures were taken against nurses or patients who pose a threat for the industry. For instance, nurse to nurse aggression is unprofessional and should not be tolerated. Everyone joining the profession should be aware of the fact that personal problems must have no interference with the delivery of services. I, therefore, support the idea that there should be safe and confidential ways to report any form of violence. However, there is a need to conduct comprehensive investigations on the claims before any action is taken.

Nonetheless, sometimes the problem does not lie with the nurses but the management. The author has made me understand that nurses are not always involved in the decision making processes, yet they are expected to implement the decision. For instance, nurses are required to work overtime without being asked about their attitude to it. The labor laws clarify that any form of overtime work should be compensated. It should, therefore, be upon the nurses to decide on whether they want to work for an extra cent or not. Forcing them into mandatory overtime affects service delivery because they work against their will. The nurses should be involved in determining the staffing needs.

I feel that the recommendations made by WSNA are genuine and very important in eliminating workplace violence. One of the best ways of improving the health sector is through research. The medical industry is characterized by numerous research activities. Thus, it is necessary that resources are invested in research programs to find better ways of making workplaces safer. All the stakeholders should be involved in the process by giving their views on how to improve the sector. However, I do not believe that the definition of workplace violence has a huge impact in solving the problem. The most important thing is to make workplaces safer.

WSNA recommends creating a culture of safety not only in the healthcare sector but in the entire community. To a great extent, the behavior of individuals depends on how they were brought up. It is necessary to collaborate with community agencies to eliminate violence in the community. This will improve the safety in the healthcare sector. I believe that there is a code of conduct for every workplace. Instilling good behavior in the community will, therefore, prepare the population to respect and abide by the rules in the health facilities. All the visitors should also be notified of the code of conduct so that when they come to the facility, they obey the rules. I think there should be a procedure for all the visitors to report their complaints. Encouraging communication would help to solve issues as soon as they arise so that they would not escalade into bigger problems. I think, collaborating with other professional labor organizations is a good idea because the nurses will be trained on how to handle confrontations and how to maintain safety at workplace. Additionally, they will be able to voice their concerns without any fear of intimidation or victimization.

Conclusion

Workplace violence is a huge concern that needs to be addressed as soon as possible. The best definition of workplace violence considers the physical, psychological impact and impact on property. Nurses in the emergency department are most vulnerable to violence and, therefore, require proper protection mechanisms. Additionally, the violence in the community might be the cause of workplace violence. There is a need to collaborate with community agencies to fight violence in the community so as to eliminate violence at workplaces. However, the safety mechanisms should not only concentrate on the nurses but the patients too. I concur with the recommendations by WSNA for security programs to prevent violence at the local, state and national levels. These programs should be implemented in research, legislation, education, and work environments.

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