Workplace Violence, Nurse Burnout, and Patient Safety

Introduction

The topic selected for this discussion relates to workplace violence among nursing professionals. This is an issue of great relevance in the nursing field, as instances of nurse exposure to violence — including verbal and written threats, verbal and physical harassment, and physical assault — have been well documented. Perpetrators of workplace violence may include colleagues and peers, patients, visitors, patient family members, support staff, and collaborators across diverse settings. Studies have indicated that nurse exposure to workplace violence can negatively affect the quality of care. For this reason, the topic warrants further exploration and serves as the focus of the study critiqued in this discussion.

Study Overview

The study under critique concerns workplace violence in nursing. Titled Relationships between Nurses' Experiences of Workplace Violence, Emotional Exhaustion and Patient Safety, it was authored by Sinhye Kim, Celeste Mayer, and Cheryl B. Jones. In essence, the study assesses the extent and nature of workplace violence in healthcare institutions and examines how nurse exposure to workplace violence relates to emotional exhaustion and perceptions of patient safety.

The authors found that the most frequently occurring form of workplace violence is verbal abuse, which largely originates from patients and their visiting friends and relatives. They also established that "emotional exhaustion mediates the relationship between verbal abuse from both patients and visitors and patient safety" (43). In other words, nurses who are less emotionally resilient are more likely to be affected by workplace violence and to hold compromised perceptions of patient safety. Consequently, the authors argue that there is a need to strengthen nurses' resilience. In their words, "interventions designed to strengthen nurses' resilience, such as mindfulness, empowerment and team support are needed to mitigate the potentially devastating effects of nurses' frequent exposure to verbal abuse and, to some extent, physical violence" (43).

Strengths of the Study

The study has several notable strengths. First, the authors employ a cross-sectional design, which is well suited to this type of research. Because the authors do not seek to manipulate variables but rather to capture data from a study population — in this case, hospital nursing staff at a specific medical institution — the cross-sectional approach is appropriate. The authors draw upon Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPS) data collected from that institution's staff. Importantly, they assess multiple variables simultaneously: workplace violence, emotional exhaustion, and patient safety. They are also interested in relationships among these variables at a specific moment in time. As Creswell (2014) notes, "unlike longitudinal studies, which look at a group of people over an extended period, cross-sectional studies are used to describe what is happening at the present moment" (186).

A second strength is the authors' use of a wide range of high-quality sources in their literature review. Most sources cited are current — published within the last five years — and are drawn from government databases and peer-reviewed journal articles. This enhances the overall quality and credibility of the study.

Third, the study demonstrates adherence to key principles of research ethics, particularly with regard to confidentiality. According to Flick (2020), confidentiality is a critical issue in research ethics and involves ensuring that personally identifiable information about participants is not disclosed to third parties. The present study takes concrete measures to anonymize such data. As the authors state, "all data were de-identified through the use of codes assigned for individual responses" (44). This is an important step given that the subject matter is sensitive and could expose participants to repercussions from hospital administration. By concealing participants' personally identifiable information, the authors promoted both willingness to participate and the genuineness of responses.

References

American Nurses Association. (2019). Reporting incidents of workplace violence. www.nursingworld.org/?495349/globalassets/docs/ana/ethics/endabuse-issue-brief-final.pdf

Corbin, J., & Strauss, A. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. Sage Publications.

Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. SAGE.

Flick, U. (2020). Introducing research methodology: Thinking your way through your research project. SAGE.

Williamson, K., Lank, P. M., Cheema, N., Hartman, N., & Lovell, E. O. (2018). Comparing the Maslach Burnout Inventory to other well-being instruments in emergency medicine residents. Journal of Graduate Medical Education, 10(5), 532–536.