Iranian pre‐hospital emergency care nurses' strategies to manage workplace violence: A descriptive qualitative study

Abstract

Aim:To explore the experiences of Iranian nurses working in pre-hospital emergency care services and the strategies used to manage of workplace violence.Background: Pre-hospital emergency nurses are subject to workplace violence; however, little research addresses their experiences, particularly related to their strategies in dealing with workplace violence. Methods:A descriptive qualitative study that involved nineteen male nurses who were working in pre-hospital services collected data using semi-structured interviews and analysed it using qualitative content analysis.Results: Data analysis yielded four descriptive categories including no reaction to violence (tolerance and acceptance as common workplace conflicts), situational management (patient and scene management), confrontation (direct and indirect) and escaping the scene. Patient management was the dominant strategy used and had the best outcomes related to both patient and personnel safety. Conclusion:This study showed that pre-hospital nurses use different strategies to manage violence and patient management was a common and useful strategy for managing workplace violence. However, the pre-hospital nurses have little training, insufficient support and are poorly prepared to manage workplace violence. Implications for Nursing Management:The development of context-based guidelines, continuing education, better-equipped ambulances that include medical and defence equipment, as well as better coordination of the police force in ambulance operations, can help to reduce workplace violence. K E Y W O R D S emergency medical technician, nurse strategies, pre-hospital emergency care, workplace violence | 1191 DADASHZADEH Et Al. How to cite this article: Dadashzadeh A, Rahmani A, Hassankhani H, Boyle M, Mohammadi E, Campbell S. Iranian pre-hospital emergency care nurses' strategies to manage workplace violence: A descriptive qualitative study. J Nurs

I do not even tell my partner: Nurses’ perceptions of verbal and physical violence against nurses working in a regional hospital

“…Nurses in this study stated that it was difficult for them to tolerate and cope with intentional violence, while they tend to tolerate unintentional violence from patients suffering from delirium or dementia. This finding, consistent with other studies (Dadashzadeh et al, 2019;Hogarth, Beattie, & Morphet, 2016), found that tolerance of WPV was related to the nurses' ability to understand unintentional violence related to the severity of the patient's conditions in comparison with intentional violence. Some participants in this study experienced horizontal violence from doctors, nurses and other staff: "I mean most of it [is] patient violence but you can get verbal violence from doctors all the time" (ICU1).…”

Strategies used by emergency care professionals to handle interpersonal difficulties with patients: a qualitative study

“…Strategies implemented by hospital staff in the face of violence and, more generally, of interpersonal difficulties are multiple. 35 They may involve communication strategies (with the use of rational explanation, seduction and empathy) and confrontational or flight-related behaviours. While the management of deviant behaviours can involve collective intervention, the strategies used to deal with difficult interactions are essentially individual.…”

“…44 The strategy of escape or flight has barely been dealt with in the existing literature so far. 35 There are sociological mechanisms at work behind these strategies. The caregiver-patient relationship in the ED has changed significantly and there is 'a growing intolerance among patients regarding the status of being hospitalised, and the dependence and even submission that this status implies'.…”

Workplace violence and influencing factors among paramedic pre hospital paramedic personnel (city and road) in Iran: a quality content analysis

“…However, in the second type of violence, the source of violence is the people working in medical departments or emergency wards who show violence against victims or their relatives [ 4 , 10 ]. It is worth noting that when violence is committed by employees, no disciplinary action is usually taken, because such a violence is attributed to staffs’ anger or troubles caused by issues in their workplace [ 4 , 11 ]. Nonetheless, being upset and angry cannot justify committing violence and aggression in the workplace, because it can have detrimental consequences for the organization [ 12 ].…”