User:Cstoviak/sandbox

Bullying in Nursing
The nursing organisation workplace has been identified as one in which workplace bullying occurs quite frequently. It is thought that relational aggression (psychological aspects of bullying such as gossipping and intimidation) are relevant. Relational aggression has been studied amongst girls but not so much amongst adult women. According to a finding, 74% of the nurses, 100% of the anesthetists, and 80% of surgical technologists have experienced or witnessed uncivil behaviors like bullying by nursing faculty.Many health care workers have been getting so much violence from their own colleagues. There are many stressors that have been occurring in hospitals nowadays, it's been causing  relationships to have disruptive behavior. Health care workers have been receiving verbal abuse the most from their coworkers, this can range from accusing all the way to ignoring and withholding information. “Verbal abuse has been linked to serious psychological effects, including anxiety, depression, humiliation, stress, loss of confidence and self-esteem, and feelings of powerlessness”(Keller et al. 2018, para. 4). There are physical responses that are caused because of verbal abuse like headaches, sleep disturbances, increased blood pressure, gastrointestinal disturbance, and other illnesses. There is another data perspective from the American Journal of Nursing that says, “675 surveyed nurses, 86% reported witnessing disruptive behavior by a physician. More than one-fifth of the nurses and physicians surveyed said this occurs on a weekly basis. Disruptive behavior by nurses was reported by 72% of the surveyed nurses”(Johnson,  DeMass Martin, & Markle-Elder, 2007, para. 4). Many nurses have stated that they have been verbally abused by a physician that has been so angry that they may be hit. This type of behavior from physicians has ranged from verbal abuse to sexual and physical harassment.

Various bullying permutations are possible, such as:


 * doctor or management bullying a nurse
 * nurse bullying another nurse
 * nurse bullying a patient
 * patient bullying a nurse.
 * nurse bullying other healthcare providers

There was a study that was done that showed 25% of registered nurses reporting physical abuse by a patient or their family members while more than 50% of nurses have reported exposure to verbal abuse. As stated before, the statement goes into a more depth explanation of what nurses are dealing with in their everyday work lives. The main problem in the nursing world that is currently trying to be solved is the issue of nurse abuse. Taking care of patients during vulnerable times of their lives can lead to an increase in the risk of workplace violence. This gives us a reason as to why nurses are dealing with violence at work. Years ago this is not an issue that would have been brought up due to people not talking about it.

There was a lot of research done on healthcare workers and the abuse that they are dealing with at work. Across all of the studies in the different articles, studies were taken on how many nurses are dealing with abuse in their everyday lives. Some of the studies lead to the side effects that the nurses deal with due to workplace violence. All studies were done by professional researchers and the data found was based on nurses. Between the articles the researchers all agree that nurse abuse is an issue that needs to be dealt with, so there is no disagreement.

Bullying of nurses by managers
In 2003 the Community Practitioners' and Health Visitors' Association in the UK carried out a survey showing that half of the health visitors, school nurses and community nurses working in the National Health Service (NHS) have been bullied by their managers. One in three of the 563 people questioned said the bullying was so bad they had to take time off work. Constant criticism and humiliation were the most common complaints. Others said they were shouted at or marginalised.

Nurses deal with abuse from their leaders in the workplace as well as their patients. When bullying is allowed in the workplace it can lead to workplace burnout and complications between coworkers.

Dealing with abuse
Dealing with abuse can lead to professionals not wanting to come to work. Researchers have found out that 13% of missed workdays are because of workplace violence and how it could affect the quality of care that the patients are getting. Another major effect of the abuse is that the nurses are getting very burnt out. Burnout occurs by being mentally exhausted and detached with negative attitudes towards work.

Aggression in the healthcare industry
The rate of aggression within the healthcare industry varies by country, globally 24% of healthcare workers experience physical violence each year and 42% experience verbal or sexual abuse. This rate has been decreasing in North America and increasing in Australasia. In Europe, rates of verbal abuse have decreased and physical violence have remained stable over the past decade.

Aggression and violence negatively impact both the workplace and its employees. For the organisation, greater financial costs can be incurred due increased absences, early retirement and reduced quality of care. For the healthcare worker however, psychological damage such as post-traumatic stress can result, in addition to a decrease in job motivation. Aggression also harms patient care. Rude remarks from patients or their family members can distract healthcare professionals and cause them to make mistakes during a medical procedure.

A survey from the British National Audit Office (2003) stated that aggression and violence accounted for 40% of reported health and safety incidents amongst healthcare workers. Another survey looking into the abuse and violence experienced in 3078 general dental practices over a period of three years found that 80% of practice personnel had experienced self-reported verbal abuse, abuse or violence. It was reported that, over 12 months in Australian hospitals, 95% of staff had experienced verbal aggression. Moreover, in the UK over 50% of nurses had experienced aggression or violence over a 12-month period. In the United States, the annual rate of nonfatal, job-related violent crime against mental healthcare workers was 68.2 per 1,000 workers compared to 12.6 per 1,000 workers in all other occupations.

In the United States, the emergency department is one of the most high-risk places to work in a hospital. The emergency department is one of the most high-risk departments that makes sense. Most individuals in the emergency room are people who have just been injured and need to be rushed to the hospital. In that situation, it is very stressful and scary for most people, so it may lead to emotions that are not truly meant. In these departments, the nurses are not taken seriously with the aggression from patients that they are dealing with. For nurses to report their incidents they need to be treated seriously. With nurses working in these demanding environments, it could lead to mental health issues.

Evaluating the effectiveness of training
It remains that training is not universally or consistently offered to healthcare workers. Beale et al. found that the levels of training offered ranged from nothing to high-level restraint/self-defense training. A report by the National Audit Office (NAO) in 2003 found that, within mental health trusts, a reactionary approach tends to prioritise over prevention. Although criticised by many; restraint, seclusion and medication are used (Wright 1999, Gudjonsson et al. 2004). Breakaway techniques, restraint, rapid tranquilisation or isolation tend to be recommended when violence is instigated with a failure to prevent aggression. This correlates to the level of training offered, which dominates in these areas, however lacks in situation risk assessment and customer care –methods that are vital in a preventative approach to prevent escalation of the situation, causing for reactionary measures to be brought into play.

The study by Beale et al. therefore provides the following advice as to good practice:


 * Training should emphasise prevention, calming and negotiation skills as opposed to confrontation
 * Training should be offered in modules, ranging initially from basic customer care and handling difficult patients to full control and restraint of patients.
 * Material relating to the causes of aggression, how to reduce risks, anticipation of violence, resolving conflict and dealing with post-incident circumstances should be provided to staff.
 * Physical breakaway skills should be taught–however an understanding as to situations in which such skills should be practiced must be appreciated.
 * Staff should be taught to control their own feelings
 * An understanding of normal/abnormal post-trauma reactions should be reached
 * Staff should be familiar with local arrangements and policies

How to cope with abuse

 * Nurses should properly report their abuse to their supervisors
 * If it is not properly dealt with go to individuals who are higher-up
 * It is completely up to the individual who is dealing with the abuse to report it, no one else
 * Try to contribute to a more positive work environment
 * Nurses can go to informational meetings to deal with the abuse

The American Nursing Association provides sources to be used if nurses are dealing with abuse, however, it is up to the individuals to report the incidents. Some more resources to help deal with abuse are going to informational classes if the place in which you work offers them.

Due to the individual being the one experiencing the violence, researchers can not fully understand the extent of the abuse. Future researchers could make a survey asking nurses about where most of the abuse occurred and ways it would be easier for them to report the abuse.