Well-Being and Safety Among Inpatient Psychiatric Staff: The Impact of Conflict, Assault, and Stress Reactivity

Abstract

Psychiatric staff are faced with multiple forms of hostility, aggression, and assault at work, collectively referred to as workplace violence, which typically is activated by patients but can also come from coworkers and supervisors. Whether workplace violence adversely affects staff well-being may be related not only to its presence, but also to an individual’s stress reactivity. At a large public psychiatric hospital, an online survey was completed by 323 clinical care staff, of whom 69.5% had experienced physical assault in the previous 12 months. Staff well-being (depression, anger, and physical health) and staff safety concerns were adversely affected by conflicts with other staff members and by individual reactivity to social conflict and to assault. To improve staff well-being, in addition to safety protocols, interventions should target staff relationships, personal health maintenance practices, and individual coping skills for dealing with adverse workplace experiences.

Predictors of depressive symptoms among psychiatric nurses who suffered from workplace violence

“…The relationship between severity/type of violence and depressive symptoms were not significant in our study. The finding was similar to the previous study that explored the relationship between patient conflict/assault frequency and psychiatric nurses’ depression and showed no statistical significance (Kelly et al., ). It implied that most of the assaulted nurses (76%), whether the severity or types of violence, have suffered from depressive symptoms.…”

“…It is commonly seen in psychiatric wards that patients’ hostility, arguing, aggression and assault are induced by their unstable mental status or conditions those are not consistent with their expectations. These violent events in psychiatric wards make nurses to be in uncertain situations with potential stressor and these led them to stay in an alert state with subsequently a higher risk of developing depressive symptoms (Kelly, Fenwick, Brekke, & Novaco, ).…”

On PAR: A feasibility study of the Promoting Adult Resilience programme with mental health nurses

“…Exposure to high workplace physical and verbal assault has also been correlated with poor cardiovascular and respiratory health (Kelly et al . ). Further, negative workplace experiences such as these impact on job satisfaction (Baum & Kagan ) and are linked with lower retention of nurses in the workforce (Lamont et al .…”

“…Nearly all (98–100%) mental health nurses have been reported to experience verbal aggression (Kelly et al . ; McKinnon & Cross ), and 70% report being exposed to physical assault (Kelly et al . ).…”

“…In acute mental health services, managing high patient acuity and unpredictable situations are common challenges (Tonso et al 2016). Nearly all (98-100%) mental health nurses have been reported to experience verbal aggression (Kelly et al 2016;McKinnon & Cross 2008), and 70% report being exposed to physical assault (Kelly et al 2016).…”