Violence and Abuse in Health Care Settings: An Increasing Challenge

Abstract

This commentary provides a partial review of the consequences of violence bullying and incivility for nursing staff. These factors are widespread and increasing. Each of these factors has been shown to have negative effects on nurse job satisfaction, job performance, quit intentions and psychological and physical health. Most victims are uncertain of the best ways to respond to these experiences. Sources of each include patients, families of patients, physicians, supervisors and co-workers. Interventions that have proven to be successful in reducing workplace violence, bullying and incivility in nursing settings are described. Common factors include developing policies and procedures to recognize and indicate when one is experiencing these, informing those at senior levels, investigating the incidents and providing follow-up care and support. Staff training to recognize potential threats and ways to best respond to them is vital but not always offered to staff. I have undertaken research on the work experiences of nursing staff over the past 25 years. My first project, with the Ontario Nurse’s Association, studied the effects of hospital restructuring and budget constraints on the quality of work life, satisfaction and performance of nursing staff. Other research projects in the US and Turkey examined workplace factors such as hospital culture associated with work engagement, satisfaction and psychological well-being of nursing staff. This commentary takes a different tack. I am now editing a book for Gower titled “Violence and abuse in and around organizations.” In identifying potential chapters I came across studies of workplace incivility and violence in health care settings suggesting these are increasing documents increasing levels of violence towards nurses from patients and visitors in all countries. As I am writing this, nursing staff worldwide are experiencing violence, abuse and incivility. Warplanes from Russia, the US and Syria are dropping bombs on hospitals in Aleppo, accidentally or deliberately, killing nurses, patients and families of patients. A sample of this material forms the basis of this commentary. It will consider violence, bullying and incivility in health care settings focusing on the experiences of nursing staff.