Nurses’ Perspectives on Patient and Visitor Violence: A Qualitative Study

Abstract

The profession of nursing is at high risk for work-related threats and violence from patients and visitors. The purpose of this study was to investigate nurses" perspectives on patient and visitor violence. In this research study, a qualitative, phenomenological design was used. The study question was, "What are your lived experiences as a nurse with patient and visitor violence?" This study included what nurses have personally experienced and how they handled violent situations while performing their job. A total of 19 registered nurses were interviewed. Open-ended questions and follow-up probes evoked responses. Sequential interviews were conducted until all concepts were repeated multiple times without new themes emerging. Four common themes emerged were violence (punching, kicking, tackling, pinching, and spitting), long-term consequences of violence, need for education and training for violence, and the need for support from the organization. Taylor"s cognitive adaptation adjustments to threatening events theory helped guide the study.

A Literature Review: Violence and Aggression in Neuroscience Nursing

“…The balance between patient assessment, preventing deterioration, and staff safety is complicated, and avoidance of the patient by the nursing staff is a known balancing strategy 3,39 . Nurses may be more cautious or change the way they interact with patients after experiencing violence 4 . The provision of a safe working environment is fundamental to ensure quality patient care and positive patient outcomes and retention of staff 6,7,40–42 …”

“…4,5 Violence of any sort should not be tolerated and has a big impact not only on the patient but also on the nursing team, both psychologically and physically. 4 Incidents of violence can also impact staffing numbers through a lack of recruitment or retention. 6,7…”

“…The US Department of Justice carried out a survey in 2011 3 and found that the incidence of violence and aggression experienced by nurses was higher than the combined average for all other professions. Nursing is a high-risk profession for threats and violence from patients and patients' relatives, but incidents are underreported by up to 80% with nurses viewing violence and aggression as part of the job 4,5 . Violence of any sort should not be tolerated and has a big impact not only on the patient but also on the nursing team, both psychologically and physically 4 .…”

An International Study on Violence and Aggression in Neuroscience Nursing

“…A lack of support for staff experiencing violence and aggression has been identified, and support needs to be provided to ensure staff feel valued. 1,7 Follow-up support from colleagues was often mentioned, but more consistent support could be provided by the manager. It was surprising to see that only 10% of the respondents were offered counseling, and this should be considered for all staff who have experienced violence and aggression.…”

“…Nursing is a high-risk profession for threats and violence from patients and relatives, and can occur daily. 1,2 Neuroscience nursing is a challenging, high-risk speciality that involves dealing with agitation, violence, and aggression routinely among patients with complex conditions such as brain tumor, traumatic brain injuries, seizures, stroke, aneurysms, and Parkinson disease. 2,3 The reasons for agitation in this population are multifactorial and complex.…”