Violence against healthcare at the place of work is becoming an alarming challenge in healthcare facilities in Canada. This is as a result of the existing forms of the violence which includes both verbal and physical violence. With the occurrence of violence in all domains of healthcare, the nurses are the most workers at risk, with the female gender being the most vulnerable with about 72% of them feel unsafe while at their workplace. Most of the nurses in Canada cases reported are of abuse of emotions, assaults alongside threats. In a research conducted in Ontario revealed that at least 67% of the registered practical nurses (RPNs) reported verbal attacks (Zagrodney & Saks, 2017). This study aims at raising awareness about the different types of verbal violence that occur between healthcare workers thus, bringing an insight by engaging our nursing peers through some strategies, leading to trust and a sense of empowerment. The technique was based on a cross-sectional correlation investigation done on a sample size of nurses working across Canada.
Types of violence
There are different types of violence affecting the nurses. Such violence includes other to other where the nurses are often the first line to be victimized. These violence acts are comprised of child and elder abuse and abuse by the spouse. The other type of violence is other to nurse where there is extensive violence towards healthcare professions. The offenders are patients, their families, and other workers in the health worker. Nurse to other people is another type of violence where the patients are abused and neglected as a form of violence by the nurses (Kelly & Quesnelle, 2016). The most challenging type of force which is associated with the undermining of the healthcare provision in Canada is the nurse to nurse violence. Horizontal aggression is typically witnessed where the nurse becomes a victim of violence by another nurse while in their practice at the healthcare. Horizontal violence, therefore, occurs among peers, in this case, it among the nurses (Quick, 2001). The behavior can be expressed to the victim either openly or in a manner that is subtle.
The instances of violence can be broadly categorized into physical, verbal and nonverbal. Such cases may include the physical violence where there may be physical dismissal and physical attacks by the healthcare parties. The verbal and nonverbal violence is the most common occurrence in most healthcare centers. Instances of verbal or non-verbal violence include; discrimination and intimidations at the workplace, reduced respect among the nurses and patients, throwing insults and rudeness towards each other, irrelevant facial expression which may portray disgust and neglect which may result to failure or denial to provide basic needs.
Possible Causes of Violence
There are some factors that are associated with the nurses' higher risk of violence at their respective workplaces. One of the main factors causing destruction is the inadequate levels of staffing and supervision (Dehghan-Chaloshtari & Ghodousi, 2017). This causes stress among the health workers as they feel that a lot of pressure is directed towards them through being overworked and may contribute to them being violent. Where there is a lot of a transit and work shift, primarily if the worker commutes to and from work especially at night, it may result to the nurse being violent as a result the fatigue. Similarly, Inadequate and poorly designed security system at the health facilities where there is an unregulated movement of the public in the hospital may be a cause for the healthcare provider. Extensively, in some healthcare facilities, there is a lack of a proper procedure for emergency handling where there are long waits in the department. This increases the stress among the patients and their caretakers who may tempt them to be violent to the health providers.
Consequences of Workplace Violence
Violence on the health centers has adverse effects on not only the workers' health but also the patients'. It is observed that there has been decreased general health, scores in vitality and mental health making the nurses feel threatened. Such violence among nurses increases the levels of psychological distress as a result of bullying and verbal harassment which affects the social and family of the nurses. The violence against nurses may have both direct and indirect adverse impacts to the organization, observers, and perpetrators (Violence against nurses, 1972). Force on the healthcare personnel may reduce the proficiency on nurses which would affect the patient negatively. Most of the research has shown that violent incidences of experience may cause severe distress psychologically, add the stress at work and reduce the efficiency at work. Violence I the hospitals have also caused job dissatisfaction resulting to intentions of change of career by some profession as a result of the loss of the psyche. Similarly, there has been generally low productivity in the organization. As a result, a lousy rapport is built among the service providers resulting to lack of faith for quality services by the patients.
Strategies of Risk Reduction
The best way to handle an incident of violence is being prepared for it. It is comprised of assessing of the healthcare facility, creating a plan of responding to the situation, training the staff and implementing the response (College of Registered Nurses of Manitoba, 2002). In the process of assessing the facility, there should be a view of the process that is real and significant. This includes a review of the current policies, community and historical data related to an approach of the violence cases. A response plan should be developed referring to other health cares in other countries that have been successful in mitigating violence. They should incorporate an effective system alongside workable up to date technology that factors all levels of staff. This encourages the implementation strategy. Additionally, the healthcare staff should be educated on how to handle such situations without acting violently and in a vengeance manner. In this case, in an occurrence of a violent targeted at the nurses, they can tame such situations in a professional a way. The most effective strategy is the implementation and practice of the response plan. Having trained the personnel and developed a response plan, practicing of the concepts developed to give an opportunity for the nurses to handle the patients and their families without collision.
What should be done by nurses?
The nurses by all mean not tolerate violence and harassment and support their colleagues who have been abused by undertaking collective actions within their places of work. They should report any cases of violence to the relevant bodies to facilitate data gathering and monitoring trends of abuse. The nurses should be guided by the code of Ethics for the Registered Nurses in all their roles of practicing their obligations (Workplace violence prevention for nurses, 2013). On the other hand, the employers should ensure that the programs aimed at promoting and maintaining a safe environment for the nurses.
The various researches indicate that there are high numbers of verbal violence against the health care workers, which results in undesirable impacts. There is a need for collaboration between the government in Canada, local and international agencies such as the World Health Organization and the International Labor Organization (World Health Organization, 2005).
College of Registered Nurses of Manitoba. (2002). Nursing practice expectation on professional boundaries for the therapeutic relationship. Winnipeg.
Dehghan-Chaloshtari, S., & Ghodousi, A. (2017). Factors and Characteristics of Workplace Violence Against Nurses. Journal of Interpersonal Violence, 088626051668317. doi:10.1177/0886260516683175
Kelly, P., & Quesnelle, H. (2016). Nursing leadership and management. Toronto, Ontario: Nelson Education.
Quick, G.(2001). Horizontal aggression among Manitoba general duty/staff registered nurses: A descriptive study. Master's Thesis, University of Manitoba.
Violence against nurses. (1972). Bmj, 4(5833), 129-130. doi:10.1136/bmj.4.5833.129
Workplace violence prevention for nurses. (2013). doi:10.26616/nioshpub2013155.
World Health Organization. (2005) framework guidelines for addressing workplace violence in the health sector.
Zagrodney, K., & Saks, M. (2017). Personal Support Workers in Canada: The New Precariat? Healthcare Policy | Politiques De Sante, 13(2), 31-39. doi:10.12927/hcpol.2017.25324
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