Nurse Violence Workplace Violence:

A Discussion Regarding the Healthcare Field

Workplace violence is defined as "violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty" by the National Institute for Occupational Safety and Health (NIOSH).

This same organization also recognizes the increase in workplace violence in the healthcare field in the past few years, and the necessity to implement policies that address these disturbing trends. Furthermore, the problem must be addressed, according to the U.S. Department of Labor, in the nursing field specifically, where cases climbed to 48% of all violence-related cases, as opposed to other fields, and where nurses, aides, orderlies and attendants suffered most injuries.

In order to explore workplace violence in more detail, this essay is divided into three categories: violence between nurses and physicians, violence among nurses, and violence between nurses and unlicensed personnel, and aims to provide statistics and ways to resolve conflict, to finally put an end to workplace violence in the healthcare field.

Conflict between Nurses and Physicians

The first topic to be addressed is conflict between nurses and physicians. There are few documented cases of actual violence as defined above between the two parties mentioned here, but there is plenty of verbal abuse, from both sides. One of the most important reasons as to why such conflict exists is because of the incredible stress placed upon these individuals who are, after all, dealing with saving people's lives. The most common form of conflict exhibited here is in highly contentious arguments dealing with the roles of the various individuals involved in a particular situation. For instance, nurses often believe that their role in helping individuals heal is much more extensive than that of doctors, who, after all, do not spend as many hours in a hospital as a nurse would and do not care for an individual so directly.

One manifestation of such verbal abuse is documented in a case where a nurse became enraged with a doctor who admitted a very difficult patient. The nurse reprimanded the doctor in front of the hospital staff, stating that the nurses' views were not taken into account when admitting the patient. Due to this, the patient was very hard to care for, from the nurses' point-of-view, and the doctor was blamed for essentially leaving the nurses to care for someone he had admitted. The patient in question was difficult to deal with, as this person was a crack cocaine addict. In defense, thus, the doctor stated he saw no other option. However, this defense proves a lack of consideration and respect towards the nurses. What the doctor should have done instead was to anticipate the problems that the patient would cause for the staff and discuss the situation with the nurses, so that all parties could agree on the same course of action. Such arguments, if well discussed, as described above, would be avoidable, and would foster better working relations between these two parties.

Better communication is key to avoiding conflict in the workplace between nurses and physicians. However, respect is also necessary in order for working relations to improve. Studies show that nurses deal with physicians "who are rude, unpleasant, dismissive, belittling, or intimidating" and report this kind of behavior quite often, especially in older physicians.

Thus, it is vital to check dismissive attitudes and lack of respect towards nurses, as this is a great source of conflict that can be easily mitigated. Furthermore, fostering respect, communication, collaboration, and empowerment are ways in which resolving conflict can become a reality. There are no 'cons' to the above-mentioned advise, as only positive things can come out of a positive working environment.

Violence among Nurses

Another area of concern in that which regards conflict in the workplace is violence among or between two or more nurses, respectively. Abuse between nurses is quite common, and can be defined as lateral violence and bullying. Statistics show that most nurses have experience some sort of abuse or bullying in their career. Bullying is defined as an "offensive abusive, intimidating, malicious or insulting behavior, or abuse of power conducted by an individual or group against others, which makes the recipient feel upset, threatened, humiliated, or vulnerable, which undermines their self-confidence and which may cause them to suffer stress."

Lateral violence is also defined as the physical, verbal or emotional abuse of an employee, and is thus very closely connected to bullying.

Due to the fact that these are common occurrences in nursing, and are known as the profession's "dirty...

A former nurse states,
"I've heard […] stories [of abuse] coast to coast, and I've experienced hostile treatment myself. In my first nursing job, some of the more senior nurses on the floor lied about work I had or hadn't done, refused to help me at times when I really needed it, and corrected my inevitable mistakes loudly and whenever possible, in public. By the time I left, I felt like I had a huge bull's-eye on my back, and once I became a target, it was difficult to be an effective nurse."

Just as in the section presented above, it is important to recognize such disruptive behavior and address it, especially as it is among nurses, who should help each other, not hinder each other, and who should feel as equals who can depend upon one another. There are, in fact, ways in which to resolve such conflicts. Of course, respect, once again, plays a big role and respect must be given to a nurse and a doctor, and vice versa, as well as to other staff members. Yet when the environment is so stressful, often times angry or disrespected nurses cannot control themselves and be the bigger person, and this is completely understandable. In other words, when the job is stressful on all sides it creates a cycle of uninhibited stress that cannot be easily combatted, especially in that which concerns floor nursing, where patients are unpredictable and phones ring incessantly. Despite aiming to combat nurse to nurse violence, in any of its forms, with good will and respect, this will never work as long as the cycle persists. Unfortunately, due to the nature of the job and to the people with whom one works, it is unlikely that the cycle and truly and completely break. Yet recognizing these problems and aiming, as little as possible, to combat and correct behavior does help, and nurses ought to focus more on this latter way in which to resolve conflict.

Violence between Nurses and Unlicensed Personnel

The last facet to be examined here is violence between nurses and unlicensed staff. Just as in the above sections, disruptive behavior between these two parties can stem from the same causes, and can be carried out by nurses or by other personnel against the former and the latter. In a study, for instance, it was reported that after observing hospital workers, including medical and nursing staff, as well as administrators and other staff members, "seventy-seven percent of the participants reported witnessing disruptive behaviors in physicians, and 65% of the participants identified disruptive behaviors in nurses."

In this particular case, furthermore, the same study observes that nurses can display unprofessional and violence or combative behavior more so than physicians, which also points to the greater amount of stress placed upon these individuals. Yet it is also mentioned that disruptive behavior was seen in unlicensed assistive personnel and the study finally concludes that all are at fault, due to the exact problems mentioned in the previous sections, in which the solutions are also found.

Conclusions

This paper has examined three types of violence or conflict in the workplace, that between doctors and nurses, that among nurses, and that involving unlicensed personnel. Despite the various natures of conflict arising from these various sources, the base causes are all similar, and clearly point out to a great amount of stress that is found in the healthcare field. However, one must not despair, for in the problem one can also find solutions. The medical field must thus ensure respect, communication, and minimize stress in all areas. It is only in this way that these above-discussed negative effects and be minimized.

Works Cited (in order of citation):

Occupational Safety and Health Administration. (2011). U.S. Department of Labor. Retrieved January 18, from .

Garelick, A. & Fagin, L. (2004). The doctor -- nurse relationship. Advances in Psychiatric Treatment (10). Pp. 277 -- 286.

Sirota, T. (2007). Nurse-physician relationships: Improving or not? . Lippincott Nursing Center. Retrieved January 19, from .

No Author. (2008). Lateral Violence and Bullying in the Workplace. Center for America Nurses. Retrieved January 19, from .

Brown, T. (2010). When the Nurse is a Bully. New York Times. Retrieved January 19, from .

Longo, J. (2010). Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment. Online Journal of Issues in Nursing. Retrieved January 19, from .

Occupational Safety and Health Administration. (2011). U.S. Department of Labor. Retrieved January 18, from .

Occupational Safety and…