Utilizing compassion and collaboration to reduce violence in healthcare settings

Beth A Lown,Gary S Setnik

doi:10.1186/s13584-018-0234-z

Abstract

Violence in healthcare settings is a global problem and violent acts are more likely to occur in emergency departments (EDs). Significant barriers to reporting workplace violence persist among healthcare workers. This, and lack of shared definitions and metrics, increase the difficulty of assessing its prevalence, understanding its causes, and comparing the impact of interventions to reduce its frequency. While risk factors for violence in EDs have been articulated, less is known about how the perspectives of patients and accompanying persons, and their interactions with ED staff may contribute to violence.We discuss the nature and social context of ED violence and some approaches used to address this problem in the U.S. We argue that perpetrators of violence as well as healthcare staff who experience ED violence suffer when it occurs. While securing safety is paramount, compassionate practices to address this suffering and the social context from which it emerges should be developed and provided for all involved. Collaboration among stakeholders, including patients and family members, may lead to effective approaches to address this problem.

Highlights

Violence in healthcare settings is a global problem and violent acts are more likely to occur in emergency departments (EDs)
The implicit challenge posed in the article by Landau et al is this: Is it possible to effectively diagnose and treat and sustain our empathy and compassion towards patients and accompanying persons who threaten or commit violent acts in healthcare settings, while ensuring the psychological and physical safety of the workforce that serves them? In the study by Landau, et al, the authors approach this question by trying to understand the emotions and perspectives of patients and accompanying persons in emergency departments (EDs) - itself an act of cognitive empathy [1]
We agree with the authors that violence by patients and accompanying persons emerges from the frustration, anger and dissatisfaction they experience in their interactions with ED staff

Summary

Conclusions

Landau and colleagues offer important new insights into patients’ and accompanying persons’ negative feelings from which violence emerges. Their data suggests the solutions they propose: addressing care quality, quality of ED experience, improving interpersonal interactions and inclusion. A factorial analysis of the Negative Feelings Scale might add detail to this roadmap. If two factors are identified (e.g. feelings about received treatment and feelings about staff attitudes), the roadmap may split into pathways to improve perceptions of quality of treatment, and pathways to improve interactions and communication. We cannot lose sight of the need to support staff for whom episodic violence adds to the daily stress of working in an ED. We can create pathways to preserve our collective safety, health, wellbeing and compassion

Availability of data and materials No data generated

Findings

32. International Association for Healthcare Security and Safety