Impacts of Workplace Violence in Nursing

Impacts of wee-weeplace Violence in nurseIntroduction (1/2 page)In this field of honor, I will explore the concept of the Workplace Violence with three pursuit issues of sense of impotence, reflect satisfaction and psychological and physiological cause on the victims well- creation. An example of the clinical situation detailing an environment, facts and events principal to the development of the clinical situation will be provided, followed by the in brief watchword of relevance of this motion to myself both clinic tot on the wholeyy and person-to-personly. The evidence from alert literature will be incorporated into the detailed identification, discussion and synopsis of all(prenominal) of the three issues. A special section with a discussion on how my further practice as a registered moderate influenced by the lessons learned from these events will follow. Conclusive remarks with some key elements in the paper will be elaborated at the end.Description of the Clin ical seat (1 page)While on the occupancy(p) as a newly recruited registered nurse (RN) in the short stay unit at our local hospital I was providing c atomic number 18 for a 25 years old woman. She was 13 weeks pregnant and a missed abortion. The enduring of was in the process of passing products of conception, experiencing a severe pain, constantly screaming and demanding me to provide her with much stronger pain medication. I allow explained that I reserve already administered painkillers, as prescribed, and it would take clock for them to kick in. Yet, patient was non listening and continuously demanded to see the doc. later numerous unsuccessful contracts, I contacted the physician, explained the situation and was at a time yelled at, now being labeled as unworthy, not knowing anything, unable to do my air with many other degrading and abase remarks at each phone call. Shocked, I contacted my supervisor and asked for an advice, besides got the reply that these th ings happen have to the received RN life, calm down and try to contact him over again. I did it again and got exactly same treatment. I have documented and reported these incidents on the same day. I learned that, apparently, the yelling, and name-calling was an put onable grade of behavior from this physician directed at all new RNs and I was told to accept the facts of life that, hierarchically, nurses are at the bottom of the feeder (Christie Johnes, 2009) and should not go against the physicians, advise them or even ask for help. This news rightfully threw me off. The following day I called in sick. I felt activatedly injuryed, billetless, unprotected and could not convince myself for making a right determination by choosing RN as my profession in Canada. I have never encountered these kind of physician-nurse relationships before.Discussion of Relevance of Clinical Situation/ depicted object Both Personally and Professionally (1/2page)The situation of the take ru nplace force-out speaks to me like a shot as it affects not only my personal wellbeing, but also impacts the step of care I provide. Unsafe break awayplace environment allowing for re-occurring forcefulness outbreaks in any figure of speech ultimately leads to deteriorating outcomes in emotional and mental wellness of the nurse, personal well-being and patient safety.As a nurse and a human being, I have a full right to work in a safe piece of work environment, protected from any form of physical and emotional abuse from either my clients (patients, visitors) or my co-workers and supervisors. The fact that mend continuously treated me as having less knowledge and his ongoing demeaning remarks as well as forcing me by staff nurse to accept such(prenominal) oppressing behaviour I consider as acts flat violence. (Johnson, 2009). (2) critique of literature(1/2 page)I have reviewed the available literature on the topic and nominate.list here statistical information of the preval ence of the flat violence, resulting powerlessness, nurse dissatisfaction, do on the physical and mental state of nurses.The frequency with which hospital violence occurs is kinda shocking. The Emergency Nurses Association (ENA, 2010) has conducted a study that demonstrate that 8%13% of emergency de casement nurses are victims of violence every(prenominal) week. According to the U.S. Bureau of Labor Statistics, 46% of all violent acts in the workplace that necessitated time off were against RNs. (1) -Identification, Discussion and Analysis of 3 Issues of the fancy Within the Clinical Situation (6-9)Issue 1 Powerlessness (2 pages)Hincherberger (2009) determine that one of the symptoms of the dynamics surrounding oppression that creates a sense of powerlessness in its victims is a swimming violence. In order for the plain violence to occur a formalized working relationship, where individuals are mutually working to achieve a certain goal, must be present. (Ventura-Madangeng Wilson, 2009,p.40). Evidently, in my situation, we had a formalized working relationship between physician and myself as a nurse, working together to achieve a common goal of percentage our patient to overcome severe pain followed by the procedure. An understanding how to agglomerate with nurses experiences of powerlessness at heart the workplace resulting from the acts of horizontal violence is essential for nurse practice and ultimately effective delivery of patient care (Coursey, Dieckmann, capital of Texas Rodriguez, 2013). While horizontal or lateral violence is generally be as any type of un cute abuse or uncongeniality within the workplace it is considered as an act of pugnacity among wellnesscare professionals (Becker Visovsky, 2012). Experiencing an aggression makes a nurse feel powerless. Some of the characteristic circumstances atomic number 82 to the experience of the powerlessness involve evidence of the exercising physician go over or dominance in incidents involving fundamental human situations triggering strong emotions in all involved (Coursey et all, 2013). Pain and miserable condition exhibited by my patient has stimulated strong emotions and desire to provide better patient care. some other defining attribute of horizontal violence is the use, misuse and abuse of power in an attempt to disempower the individual, to elicit favourable solvent and that is used within formal relationships to achieve goals and objectives done an interpersonal process (Ventura-Madangeng Wilson, 2009, p.40). Doctors have traditionally dominated those groups scorn in the hierarchy, most notably nursing (Dykema, 1985). change magnitude of nursing care and disregard for nursing decisions are often manifested through power plays (Dwyer, 2011). Newly recruited nurses, myself not exception, frequently see themselves as having short(p) or no power period in the role. Physicians continuous degrading statements about my practice character and methods in an attempt to force me to act independently or convince the patient understandably demonstrated physicians power control and push for dominance. succeeding supervisors comments about the general acceptance of the existing creaky hierarchical relationship created frustration, unwanted feelings of being out of control, understanding of non-existent collegial support, pressured, isolated, hopeless, demoralized and invalidated. A detailed psychoanalysis of the impact of powerlessness arising from incidents involving horizontal violence has helped to identify its numerous effects. Being constantly subjected to the effects of horizontal violence nurses, in general, feel oppressed (King-Johnes, 2011). The oppression of nurses is perpetuated by both the hierarchical structure of health care organization they work in, and by nurses internalized oppression. The superior impact is on the nurse as victim, professional practice, and the implications for patient care. Zerabvel Wright (2012) believed that being exposed to harmful effects of horizontal violence make nurses less empathetic to the wounds of others. And what is more(prenominal) alarming is that coping with feelings of powerlessness members of the oppressed group contributed to displacing all aggressiveness and negative emotions onto each other rather than onto actual culprits or members of the dominant group (King-Johnes, 2011).Issue 2 effects on physical and psychological well being (2 pages)Boykova (2011) indicated that based on hospital power hierarchies, nurses as a group, are always subject to various types of oppressions. She also, suggested that nursing continues being perceive inferior to the checkup profession. Oppressors are always clearly identified, but are not frequently reprimanded. miscellaneous researchers have identified members of medical team and nursing management as a valid oppressor of other nurses in an attempt to absorb lower status nurses into existing hospital power hierarchi es (Roberts, Demarco, Griffin, 2009). Being repeatedly told that all new nurses with this doctor have gone through similar events and verificatory indication that these events were not to be taken personally, but to be legitimate as is created an unwanted psychological effect of viewing myself as a weak and unable to provide good care nurse.Hutchinson, Vickers, Wilkes Jackson (2010) found that horizontal violence exercised by the members of medical team and management scum bag ultimately affect nurse wellbeing. Effects of exposure to horizontal violence include psychological and physiological impacts on victims well-being often results in health and mental problems.Many psychological unintended consequences occurring sometime after an event affect the victim with such outcomes as change magnitude fatigue, frequent mood swings, negative changes in personal life and values and frequent ranting to partner. Faced with organizational vindication to support me, I emotionally reacte d manifesting not one but some(prenominal) symptoms at once including sadness, frustration, irritability, hurt, anger and most importantly stress.An analysis of several(prenominal) studies substantiate that approximately 80% of health care employees experienced at least one adverse symptom in response to work-related violence, while 25% of victims of nonphysical violence experienced five or more troublesome symptoms (Kitaneh Hamdan, 2012 Findorff, McGovern, Sinclair, 2005 APNA, 2008).Additionally, Thomas and Burke (2009) examining narratives of nurses experiencing horizontal violence stated that the greatest impact of horizontal violence is stress. Stress-related health and workplace problems include increased blood pressure, avoidance of professional relationships, depression, anxiety, lowered work performance, toxic work environment, and an emotionally oppressive environment (Broome, 2008).Physical and psychological maladies deriving form exposure to stress include weight loss /gain, hypertension, cardiac problems, gastro-intestinal disorders, headache, insomnia, continuing fatigue, anxiety, depression, substance abuse, and feelings of isolation, insecurity, low self-esteem, post traumatic stress disorder, and suicidal and murderous thoughts (Bigony et al. 2009). One of the emotions shared by the bullied and bystanders is idolize. Fear is a very real and powerful emotion that can result in negative consequences. movie to horizontal violence can result in anxiety, weight changes and provocation of previously controlled conditions such as hypertension or irritable intestine syndrome (Faminu, 2011). Randall (2001) studied the effects of bullying in adulthood and states that stooges of bullying whitethorn develop autonomic reactions (e.g., feeling out of breath, blood pressure changes) heftiness manifestations (e.g., rumpache, neck pain), cognitive reactions (e.g., inability to concentrate, irritability, sensitivity) up to and including post-traumatic stress disorder.Intimidation and fear of retaliation prevents reporting of bullying behavior by both the target and the witnesses allowing the negative behavior to continue (Lally, 2009). The greatest danger of fear in healthcare is the fear of participation that can result in medical errors if those intimidated by aggressive behavior fail to speak up (Langlois, 2009). Adult targets often do not have the capability of profitably handling a bullying situation. Their attempts to manage the situation frequently step forward the conflict, particularly if the bully has greater authority. The negative behavioral effects on the target progress from anxiety to loss of motivation and to outbursts of emotion. Loss of emotional control can result in the target displaying aggression and escalating the conflict and bullying behavior (Lee Brotheridge, 2006).Must ADD some line of how all of the above linked back to my clinical situationIssue 3 decreased job satisfaction/motivation (1.5page)Wor k-related violence in the health care system is a complex and dangerous occupational opportunity and impacts the job satisfaction and motivation as well as the quality of the care provided (Arnetz Arnetz, 2001 Needham et al., 2005).Research identified multiple situations in which nurses felt unheard, obscure and disrespected by their medical blighters that ultimately led to nurses re-examination of their stand on patient-organization loyalty. (Aytac Dursun 2012 Rodwell Demir 2012). As in my clinical situation, this manifested in moral distress and dilemma, as I felt my loyalty should be primarily to the patient.It is obvious, that the greatest negative effects of workplace violence are felt by the victim (Kvas, 2011). Budin et al. (2013) confirmed that it not only affects the victims health, satisfaction with work and life, confidence, but also causes emotional exhaustion and burnout. Being subjected to this situation I was depressed, skittish and basically encountered a work -related stress (Aytac Dursun 2012 Rodwell Demir 2012).(kvas)Many psychological unintended consequences arising from experiencing acts of non-physical horizontal violence have a strong impact on the victims with such outcomes as decreased job satisfaction, performance and absenteeism (Merecz, Drabek Moscicka, 2009 Schat Frone, 2011). The following day I felt tired, upset, unhappy and did not come to work reporting being sick. I believed that my knowledge and my skills deserved better recognition either from physician on call or from the nurse manager. When I finally went back to work I noticed my decreased job performance curiously in the daily routine activities.Gerberich et al. (2004) observed that workers exposed to nonphysical violence had high rates of quitting or job transfer. Continuous exposure to the immodest remarks and unwillingness of management to deal with situation as it arose I immediately comeed to research other departments at our hospital where I could tran sfer to work with physicians known to be more respectful of nurses skills.An analysis of the issue clearly sheds a light to the fact that perceptions of violence affects job satisfaction and motivation. (Roche). Generally, nurses experiencing horizontal violence felt less happy at work, had greater work stress, lower morale, less respect for staff compared to unexposed nurses and perceived less supervisory support. The number of violent exposures is inversely correlated with feelings of job safety and satisfaction (Ienacco et al, 2013).Violence is not a constituent part of the profession and nurses deserve to work in a safe working environment. To achieve this goal, all members of the nursing profession must, jointly with other stakeholders (doctors, patients, relatives), actively contribute to changes.(kvas).Discussion of How My Future Practice May be Influenced (1-1.5 pages)Nurses must acknowledge the existence of horizontal violence, break short horizontal violence, and take e armark actions to mitigate it (Vessey et al., 2010). A policy of zero tolerance for any variant of horizontal violence in the workplace is the goal (Center for American Nurses, 2008).Nursing staff must take a role in combating horizontal violence. Nurses must know the policies that govern professional conduct in the workplace (Maxfield et al., 2005), and feel empowered to take actions against HV. Strategies for empowerment consist of confronting and teambuilding (Kupperschmidt, 2006), mentorship programs (Latham, Hogan, Ringl, 2008), and cognitive report (Stagg et al., 2011). Maxfield and colleagues (2005) found only 5%- 15% of nurses would confront a colleague concerning unprofessional behaviors. Only 10% of nurses felt comfortable enough to confront a coworker displaying HV (Wilson et al., 2011).Based on the impact horizontal violence had on the me as a nurse, especially effects of psychological and physical on well being, sense of powerlessness and dramatic reduction in job sa tisfaction I learned important lessons from it.First lesson was that I wanted to continue working as a nurse I have to stop thinking of myself as a member of the oppressed group, start being proactive, disallow any attempts on diminishing my efforts or stop any occurences of any demaning remarks directed at me from any member of medical team being so physician, supervisor or colleage.Second lessond I should save a healthy view of self, so as not to personalize attacks of HV (Kerfoot, 2007). avoid unnecessary emotional turmoil, learn to be emphatic (Exhibiting assertive behavior at the time of the event is considered an acceptable response to HV behaviors. If possible, actions that constitute bullying should be confronted during or immediately following the incident. conference must remain both empathic and factual (Randle et al., 2007).) in situations of horizontal violence. Journaling, another strategy to address HV, can serve dual purposes. First, tutelage a detailed journal w ill help the victim maintain a timeline of events (Cleary et al., 2009). Second, journaling may provide an emotional outlet for the psychological distress associated with HV. Good documentation requires a list of witnesses to the accounts and all notes, texts, or emails from the perpetrator also be kept as part of the journal (Cleary et al., 2009 Edwards OConnell, 2007). lowest lesson, that influenced my further practice was job satisfactionSummary/Conclusion (1/2 page)Text hereKitaneh, M., Hamdan, M., (2012) Workplace violence against physicians and nurses in Palestinian universe hospitals a cross-sectional study, BMC Health Services Research 2012, 12469 retrieved from http//www.biomedcentral.com/1472-6963/12/469