Research Question
Workplace violence is a significant stressor for nurses working in Emergency Department settings worldwide(Gates, Gillespie &Succop 2011). It is estimated that a quarter of all health employees are likely to experience violent incidents, either verbal or physical, in their direct patient care during their career (World Health Organization 2016). Globally and within Australia, there is an increasing level of workplace patient-related violence toward health care workers in Emergency Departments(Sato et al. 2013).Notably, nurses have been identified as the most at risk health workers to be involved in aggressive situations with patients or relatives that result in physical injuries and psychological harm(Pich et al. 2011;Hahn et al. 2010).Violence is a significant occupational hazard, but is often under-reported by nurses. Violence influences nurses’retention, high turnover decisions and reduces nurses’ work productivity (Gillespie, Gates & Berry2013; Chapman et al. 2009). Studies show that nurses working in Emergency Departments (ED) experience physical assaults at the highest rate of all nurses (Crilly, Chaboyer, &Creedy 2004).In a US study, ‘ninety four percent of nurses experienced at least one post-traumatic stress disorder symptom after a violent event, with 17% having scores high enough to be considered probably for PTSD’ (Gates, Gillespie &Succop 2011, p. 59). But alarmingly, there is an under-reporting of workplace violence and aggression which has been attributed, in part, to the poor response by managers to deal with the problem (Wolf et al. 2014). In order to address patient-related violence, it is essential to understand the complexity of the problem. One aspect is to gain insight into the perceptions of nurses who have experienced violence in the ED setting.
Research Question: What are nurses’ experiences of patient-related violence whilst working in the Emergency Department setting?
The research question is highly significant in clinical practice because nurses’ experiences and coping strategies can provide insightsinto how they cope as they strive to provide person-centred care in a workplace withescalating levels of patient and relative-related violence (NMBA 2016). Whilst the issue of workplace aggression in the ED is complex and mulit-factorial, exploring this problem from the nurses’ perspectives is imperative. Findings could inform safe work practices, interventions to prevent patient aggression, and provide care to ED nurses after such events (Gates, Gillespie &Succop 2011).Findings could inform strategies that target audiences such as nurse managers and nurses could implementto improve safety in work environments and occupational health and safety for all. Findings could also be used by nurse educators to raise awareness and promote effective strategies in the nursing curriculum. The research question is therefore highly relevant to clinical practice and has wider implications for the profession and the provision of safe working environments for all nurses working in Emergency Department settings.
Select four (4) primary research articles (from the 8 articles provided) that provide relevant evidence to answer the research question. Write a 300 wordsummary of each primary research article using the three step formatlearned in Topic 2.
Paper 1: Nurses’ attitude towards the reporting of violence in the emergency department
The research paper revealed that the nurses are experiencing workplace violence in the emergency departments of the hospitals and it is increasing at an alarming rate. It has become a serious concern for the nurses working in the healthcare organizations. Nurses sometimes become the victims of violence which may affect their working life as well as result in mental misbalance to. The paper described that in order to identify the attitude of the nurses regarding workplace violence, a study was conducted in a large metropolitan emergency department of Melbourne, Australia according to Maguire et al. (2018 p. 170). All the emergency nurses who experienced such violence during their working hours were the participants of the study. There were 42 cubicles and 113 full-time nursing staffs in the hospital and all of them participated in the study. Some semi-structured interview questions were asked of all the participants regarding the violence they experienced from the patients and their families during their working hours and their responses were recorded for the further analysis as per Morken et al. (2015 p. 51). Therefore, from the analysis result, it was clear that although the participants accepted the violence as a part of their work they all have experienced physical violence and verbal abuse. Participants indicated that sometimes they received bad behavior from the patients also. The study revealed that they did not report anywhere for the verbal attacks from the patients who used abusive language to the nurses. It was found in the study that some of the nurses also excused the patients for their abusive behavior towards them. As a conclusion after the study, it can be said that nurses reported violence in their workplaces. Some of them were very much abusive also. But, most of the nurses accepted the violence as a common issue of the workplace. Nurses were highly selective about the incidence of violence they experienced whilst working in the emergencies.
Selecting Primary Research Articles
Paper 2: Workplace violence against emergency nurses in Taiwan: A phenomenographic study
In this paper the author stated that different types of workplace violence may occur such as threatening, physical assault, verbal abuse, harassing and rude behavior also. In an American study, it has been found that 50% nurses of emergency department become the victim of workplace violence in a single week as per Pouryaghoub et al. (2017 p. 16). This violence may occur when a nurse is treating a patient in the emergency department and the family members of the patient may become aggressive on the procedures of the hospitals and as a consequence, nurses become the worst sufferers. It is becoming increasingly and the report says that nurses sometimes beaten, spat on or punched by the family members of the patients. Violence in the emergency department not only creates a problem for the staffs and nurses but also becomes the reason for the safety issues of the patients admitted there. The riskiest place for the workplace violence for nurses is the emergency department and it has been found from many researched that almost 90% of nurses have experienced such violence which resulted in physical injuries too according to (Hamdan, 2015). A qualitative study was organized in Taiwan to understand and the personal and professional responses of the nurses regarding their experience in workplace violence. In the study, the phenomenographic approach was taken in which many questions were asked of the participating nurses individually and their responses of experience were recorded for the further analysis. The nurses who participated in the study were above the age of 20. From the result it was analyzed that some nurses reported, workplace violence in the emergency department can sometimes be a direct threat to their life also and even it is an ongoing nightmare for them (Arnetz et al. 2015 p. 340). Nurses never get support to report such violence and they accept that as a part of their work. Hospitals of Taiwan are looking to put serious attention for the safety of their workers.
Paper 3: Nothing Changes, Nobody Cares: Understanding The Experience Of Emergency Nurses Physically Or Verbally Assaulted While Providing Care
In the paper, it is mentioned that workplace violence is termed as violent crime and in some recent studies it has been found that more than 70% nurses of emergency departments experience workplace violence like threatening, physical as well as verbal assaults and others (Egerton-Warburton et al. 2016 p. 155). This paper also mentioned that in order to understand the experience of the nurses who work in the emergency department and received verbal and physical assault, a study was organized with the use of a qualitative descriptive exploratory design. 46 English-speaking nurses from Emergency Nurse Association were the participants of this survey and they sent emails elaborating their experience of violence in their workplace. The participants were asked to narrate their worst experiences in the mails. All the narratives were reviewed by the principal investigators. Most of the nurses explored that they work in such an environment where nobody cares about their safety (Hogarth et al. 2016 p. 80). Some of the nurses said that they found themselves fearful before coming into their workplaces because they were reluctant to come into any violent situation. Many nurses find it difficult to work alone as people often behave badly or loudly. Even they also experience the reaction of post-traumatic patients which makes them cry too (Wei et al. 2016 p. 65) Sometimes institutes also leave the nurse in vulnerable positions so they experience much unacceptable behavior from psychiatric patients. The nurses not only receive verbal abuse but also physical assaults which may result in physical injuries too. From the qualitative study, it became quite clear that nurses experience severe workplace violence and they fear to work sometimes. Violence in the emergency department is quite common and it affects the mental stability of the nurses as well as other healthcare professionals (Hsieh et al. 2016 p. 25). The nurses are seeking the intervention of higher authorities in order to reduce the workplace violence so that they can work safely and efficiently to cure the patients which will benefit both the parties.
Paper 1: Nurses’ attitude towards the reporting of violence in the emergency department
Paper 4: Patient-related violence at triage : a qualitative descriptive study
According to the author of the paper, many issues may arise in the workplace and one of them is workplace violence which is increasing in the emergency departments of the hospitals globally and due to this the most sufferers are the nurses. This common feature of emergency department has become a significant professional issue worldwide. In order to describe the experiences of triage nurses with patient-related violence, a study was organized. Therefore, to conduct the study, a qualitative descriptive design was selected. Data was collected after the completion of semi-structured interviews which were conducted on the nurses of the emergency department of a public hospital situated in New South Wales, Australia. The experiences of a single moth were recorded in the study (Speroni et al. 2014 p. 220). There were six participants from the age between 29 to 53 years and it included two male and four female participants. In the interview, data were recorded in an audio tape for the further analysis by the researchers using qualitative content analysis (ALBashtawy et al. 2015 p. 75). Moreover, the result revealed that all the nurses experienced physical abuses that include slap, kick and hit by the patients. One of them shared that a patient used his fist to protest and punched on the safety glass of the nurse. Even, another participant stated that once a knife was thrown by an agitated patient and taking out needles and other small objects as a weapon is quite common in physical violence in the hospitals. One of the participants shared that threaten from the family members of the patients is also common and it makes them really afraid (Jiao et al. 2015). Patients often shout and use abusive words to the nurses which make them emotionally broken sometimes. So, from the study, it was absolutely clear that the nurses always experience different kinds of physical as well as verbal assaults in their workplace which make them a bit nervous sometimes to work efficiently.
Discussion
Compare andcontrastthe findings of four (4) primary research articles using the approach learned in Topic 3. Ensure the analysis explains how the findings answer the research question. Identify any existing gaps in knowledge or practice. Discussion may be supported by additional relevant literature.
From the analysis of the research paper, it has become quite clear that nurses face extreme violence in their workplace (Waschgler et al. 2013 p. 1420). In the first paper, the research team went to a hospital in Melbourne, Australia in order to record the responses of nurses regarding their experience of physical assaults and other violence in their workplace. All the participants indicated that they not only get bad behaviors from the patients but also from their families. But, most of the nurses also accepted such behaviors and they did not report it anywhere. Again, in the second research which was held in the Taiwan hospital, 90% of the nurses reported that they experienced violence in the emergency department of the hospitals. Even they have received many threats from the family members of the patients which made them really afraid. The nurses were sometimes beaten, spat on and hit by the patients which resulted in some serious injuries also. So, they all share their personal experience and stated that working in the hospital sometimes seemed to be a nightmare for them. Even they do not always get support from the hospitals to report against such violence. In the third research paper, a study was organized with the nurses of the Emergency Nurse Association and 46 nurses participated in the survey (Pouryaghoub et al. 2017 p. 20). 70% of the nurses stated that they have experienced physical and verbal assaults in their workplace. The nurses shared their experience via mail and one of them shared that due to abusive behavior by the patients in the workplace sometimes their willingness of coming in the hospitals gets destroyed. Even work becomes the nightmare to them. Some of the behaviors from the psychiatric and post-traumatic patients even make them cry also. So, this paper also revealed that nurses experience severe violence in their workplace. In the fourth research paper, the author mentioned that violence in the emergency department is quite common and in order to have an idea about their experience a study was organized in a hospital of New South Wales of Australia. In the interviews which were conducted with six participants revealed that all of them experienced physical harassment (Angland et al. 2014 p. 135). Patients slapped, kicked and even punched on them. Sometimes this led to serious injuries. The nurses were habituated with the shouting and the abusive language of the patients. So, all the researches were successful in establishing the fact that nurses experience various kinds of violence in the emergency departments of the hospitals. Not only they receive verbally abusive language but also some physical assaults and threats from the patients as well as from their families. The main research question was to find the experiences of nurses regarding workplace violence and all the research papers and study results prove the fact that nurses experience various dangerous situations whilst working and most of the violence occurs in the emergency departments of the hospitals. Even some additional research papers also revealed that in many cases nurses fear to stay alone in their workplaces as they get afraid of violence while taking care of different kinds of patients (Blando et al. 2015). Although in all the research papers the experience of the nurses has been recorded properly it also has some gaps in the research process. The interviews were conducted with the nurses only. It was necessary to record the experience of other staffs and their opinion on the workplace violence in the emergency department of the hospitals. If it could have taken then the research would get a huge amount of result from different perspectives which would produce a more accurate data (Phillips, 2016). So, the findings from the research perfectly answered the research question.
Paper 2: Workplace violence against emergency nurses in Taiwan: A phenomenographic study
Conclusion
Summarise the major points in a non-repetitive manner, discuss future directions for research.
The above paper discusses the professional issue regarding workplace violence which affects the nurses in doing their work effectively. The paper analyses many research articles for the scenario package and establishes the fact that nurses face various physical as well as verbal assaults from the patients and their families too. It is appropriate in answering the research question also as the analysis of various research articles provides some example of real life experience regarding violence of the nurses in their workplace and mostly in the emergency department. Although, there was a little gap in the analysis as other than nurses none involved in the interview round to express their opinion. If it would happen then the result could produce a larger data. But, as a conclusion it can be said that all the research papers proved the fact perfectly that nurses experience several troubles as workplace violence.
References
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