Violence in Nursing Working place

Kvas &Seljak (2014) carried out research on unreported workplace violence (WPV) in nursing. The study was carried out to explore the violence experienced by nurses in Slovenia. There are many acts of violence in the nursing workplace, but a majority of them go unreported making it difficult to determine the degree of occurrence.  The reasons why most of these cases go unreported are; fear of losing one’s job, the belief that no action will be taken if reported and it has become a routine occupational hazard. Different types of violence occur in the nursing workplace, they are; psychological (relate to the mind), sexual (physical or verbal), economic (property or material damage), and physical (bodily harm). The ILO (2009) postulates that it the reported or registered acts of WPV are lower compared to the actual number; this makes it difficult to determine the exact prevalence of the violence. Some of the effects of WPV are decreased commitment to work, increased absenteeism, low-quality teamwork and declining levels of quality healthcare. 

Specific Aims

  The main goals of the study were three. The first goal was to determine the different groups affected by WPV in Slovenia and compare it with other research. The second goal was to determine the actions taken after reporting WPV and why in some cases actions are not taken. The third goal is to define how the current circumstances could be improved. 

Methods

  Three level stratified sampling was carried out in the following order: gender, job experience, and leadership position. The research survey was employed as the research method while questionnaire was used to collect data. The questionnaire was sent to 3756 nurses and only 692 responded. The survey questionnaire had multiple choice questions based on three areas: the actions of nurses after WPV, the reason for inaction after WPV and proposal for improving the situation. The response was coded into categories. The responses were analyzed using SPSS 19.0 and the differences between the groups established using chi-square and t-tests. A Significance level of 0.5 was used. 

Results

  The most utilized action in the event of a WPV was discussing it with a co-worker/colleague (41.5%) followed by discussing it with a superior (27.3%). Formal written reports after violence were 8.5% of the total responses. The nurses who did not discuss the situation with anybody averaged 13% of the total respondents while those who notified the professional were 9.4%. The main reason for not taking any action after a WPV event was because nothing would change if they report (61.7%). 21.7% could not report because of the fear of losing their job. 11.5% who did not report the violence feared the person who initiated the violence. 1.5% belief that they caused the violence themselves so they could not report the incident. 5.1% gave other reasons for not reporting WPV. The highest form of violence was psychological followed by economic violence. The physical abuse followed economic violence and least prevalent form of WPV was sexual abuse. The difference between WPV between men and female was not statistically significant, and most of the economic violence came from top level management. The most widely supported action to improve the situation was training in communication skills and conflict resolution at 28.8%. 28.7% proposed implementations backed by external stakeholders such as the NGOs. 24.8% proposed internal improvements such as reporting mechanism. 17.7% suggested improvement of awareness of WPV issues.

Discussion

 In comparison with other research, psychological violence is the most dominant form of WPV followed by economic violence. Statistics on physical and sexual prevalence differ between different researchers. The data set on male and female groups was not statistically significant, but other researchers indicate that men are more likely to report WPV cases. Young nurses are more exposed to WPV issues than the old ones especially those entering the profession. Most of WPV issues are present in the emergency department. Research differ on the education level WPV prevalence as others state that those with higher education are at risk while others were stating is the ones with lower education level at risk. 

 The formal written report of WPV incidences was small in Slovenia compared to other places and was mostly used by those affected by physical violence. Victims of physical violence are the most likely group to discuss this issue with their seniors at work. If victims cannot discuss WPV issues with their leaders at the workplace, they should report these incidences to professional unions: victims of economic violence are the most likely to use this avenue.  Victims of Psychological violence mostly discuss it with their colleagues, and this is the most used channel across all groups. There is a concerning group that keeps silence and does not report WPV incidences to anyone. Many of the victims believe that no change would be taken if they reported the incidence that is why they fail to report; this may be due to conflict of interest especially if the violence is instigated by the management or a senior member. Most of the proposals to improve the situation were both internal and external. Creating awareness and training on WPV and strengthening mechanisms were the primary focus. 

 

Conclusion

 Many cases of workplace violence go unreported because many nurses believe that nothing would change if they report the cases and the fear of losing their jobs. The most prevalent form of WPV is psychological violence, and the most of the victims talk about it with their colleagues as the main action. There are different vulnerable groups in WPV cases such as the young nurses and those with the low level of education. Internal and external measures should be undertaken to remedy the situation such as training on communication and conflict resolution, creating awareness on WPV issues and strengthening of reporting institutions and systems.

 

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