Paramedic student exposure to workplace violence during clinical placements – A cross-sectional study

Paramedic students are hesitant to formally report exposure to acts of workplace violence as they feel it may jeopardise their chance of getting a job. The objective of this study was to identify the type and number of workplace violence acts experienced by undergraduate paramedic students whilst on an ambulance clinical placement. This was a cross-sectional study using the Paramedic Workplace Violence Exposure Questionnaire to obtain student exposure to acts of workplace violence which occurred whilst on ambulance clinical placements. The survey response rate was 29.8%. The students’ average age was 24.1 years, median age of 23 years, range 18–47 years. There were 32.6% of students who were exposed to at least one act of workplace violence with 56% of these being females. Verbal abuse 18%, and intimidation 17% were the common acts of workplace violence students were exposed to. One female, a nursing/paramedic student, was exposed to sexual harassment on more than one occasion. The findings from this study suggest that paramedic students are exposed to similar rates of workplace violence as full time practising paramedics. Further research is required into workplace violence against students from all professions and what detrimental effect this may have on them.     

Pre-registration nursing students' perceptions and experiences of violence in a nursing education institution in South Africa

Violence is a growing problem worldwide in the field of health care and within the nursing profession. A study comprising a survey and focus groups with nursing students, and interviews with nurse educators was conducted to examine nursing students' perceptions and experiences of violence at a nursing education institution in the Western Cape, South Africa. A self-administered questionnaire was distributed to all nursing students. Two hundred and twenty three (n = 223) respondents completed the questionnaire. Focus groups were conducted with purposively sampled student participants and semi-structured interviews with nurse educators. The findings indicated that the nature of the violent incidents experienced by students on campus, especially in the residences, ranged from verbal abuse to violation of students' property and personal space, and could be attributed primarily to substance abuse. Violence among student nurses could negatively affect learning. In a profession in which nurses are exposed to violence in the workplace, it is important that violence in the learning environment is actively prevented and respect of individual rights, tolerance and co-operation are promoted.     

Workplace Violence in Healthcare Settings: Risk Factors and Protective Strategies

This article describes the risk factors and protective strategies associated with workplace violence perpetrated by patients and visitors against healthcare workers. Perpetrator risk factors for patients and visitors in healthcare settings include mental health disorders, drug or alcohol use, inability to deal with situational crises, possession of weapons, and being a victim of violence. Worker risk factors are gender, age, years of experience, hours worked, marital status, and previous workplace violence training. Setting and environmental risk factors for experiencing workplace violence include time of day and presence of security cameras. Protective strategies for combating the negative consequences of workplace violence include carrying a telephone, practicing self‐defense, instructing perpetrators to stop being violent, self‐ and social support, and limiting interactions with potential or known perpetrators of violence. Workplace violence is a serious and growing problem that affects all healthcare professionals. Strategies are needed to prevent workplace violence and manage the negative consequences experienced by healthcare workers following violent events.     

Midwifery student exposure to workplace violence in clinical settings: An exploratory study

Evidence indicates that nurses regularly experience bullying within the workplace which has the potential for health and social effects, as well as worker attrition. Literature suggests that nursing students are exposed to workplace violence during clinical placements including from health professionals and mentors, however little is known about midwifery students. This study sought to examine undergraduate midwifery students' experiences of workplace violence during clinical placements. A cross-sectional approach using a paper-based survey, the Paramedic Workplace Questionnaire, was used to solicit the information.Students were exposed to workplace violence with the main act being intimidation (30%), verbal abuse (17%), physical abuse (3%), and sexual harassment (3%). In more than three-quarters of the incidents the students had some level of apprehension or were frightened as a result of the violence. Students responded to the acts of violence with changes to emotions, self-confidence, and a desire to “give up”. This paper demonstrates ways in which midwifery students are vulnerable to potential workplace violence from various sources. Support mechanisms need to be developed to ensure this can be minimised.     

Workplace violence against nurses – Prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study

Purpose/objectivesTo determine the prevalence of workplace violence and explore the role of hospital organizational characteristics and health promotion efforts in reducing hospital violence among nurses in Taiwan.DesignCross-sectional survey.SettingOne hundred hospitals across Taiwan.SampleThe final sample in our study comprised responses from 26,979 nurses.MethodsThe data were obtained from a nationwide hospital survey, Physical and Mental Health and Safety Needs in Full-Time Health Care Staff, which was developed and conducted by the Bureau of Health Promotion, Taiwan, in 2011.Main research variablesThe main dependent variable was whether nurses had experienced violence within the past year. Physical violence, threatened or intimidated personal safety, verbal violence or sexual harassment were all included.FindingsOf the 26,979 nurses, 13,392 nurses (49.6%) had experienced at least one episode of any type of violence in the past year; 5150 nurses (19.1%) had been exposed to physical violence, and 12,491 nurses (46.3%) had been exposed to non-physical violence. The prevalence of having experienced any violence varied widely and ranged from the highest (55.5%) in an emergency room or intensive care unit to the lowest (28.3%) among those aged 55–65 years. After adjusting for other characteristics, younger nurses were significantly more likely to be exposed to any violent threat. Nurses working in public hospitals had a significantly higher risk of workplace violence than those working in private hospitals. Significant variations were also observed among work units. Although nurses working in a certified health promoting hospital (HPH) did not have a lower risk of workplace violence, those working in an outstanding HPH had a significantly lower risk of workplace violence. A similar pattern was observed for non-physical violence.ConclusionsWorkplace violence is a major challenge to workplace safety for nurses in hospitals. This large scale nurse survey identified individual, work and hospital characteristics associated with workplace violence among hospital nurses. Preventive efforts in reducing hospital violence shall be targeted these high risk groups and settings.Implications for nursingThis nationwide nurse survey assisted us in more clearly understanding the scope of the hospital violence facing nurses and identifying critical risk factors. The findings not only identified the most common locations of violence in hospitals but also suggested that extensive investments and efforts by hospitals in health promotion are crucial.     

门诊护士工作场所暴力调查与分析

目的了解门诊护士遭受医院工作场所暴力情况及其心理健康状态。方法采用自设调查问卷和症状自评量表对106名门诊护士遭受工作场所暴力及其心理健康状况进行调查。结果76．42％的门诊护士在过去一年中遭受过工作场所暴力;门诊护士的心理健康状况在各方面症状评分均高于常模（P〈0．01）;遭受工作场所暴力的门诊护士心理状况更差（P〈0．01）。结论门诊护士遭受工作场所暴力的问题较为严重,应加强法律法规、应对工作场所暴力的培训及心理疏导,以有效防范医院工作场所暴力的发生,维护门诊护士的身心健康。     

护理人员遭受工作场所暴力情况的调查与分析

目的探讨在医院中护理人员遭受工作场所暴力的流行特征及危险因素。方法根据WHO关于医院工作场所暴力的定义,采用自行设计问卷,调查我市两所三级甲等医院中护理人员在2004年4月~2005年4月遭受工作场所暴力的情况。结果420名被调查者中,1年内有234名遭受过工作场所暴力,发生率为55.71%,其中以心理暴力为主(40.24%)。媒体导向(48.29%)、肇事者酗酒(38.89%)、患者病情无好转或自认为无好转(35.47%),是发生医院工作场所暴力的主要原因。结论护理人员中医院工作场所暴力的发生率较高,需针对医院特点开展工作场所暴力防范与应对教育,提高护士应对各种医院工作场所暴力的能力和整体素质。     

职场正念在护士工作绩效与职场暴力经历中的中介作用

目的评估护理职场暴力经历、工作绩效现状,分析职场正念在护士工作绩效与职场暴力经历中的中介效应。方法采用便利抽样法,于2016年3—5月采用医疗职场暴力问卷、工作绩效量表和职场正念量表对我国8个省份776名护士遭遇的职场暴力、工作绩效以及职场正念进行调查,采用相关性分析以及中介效应分析方法评价三者关系以及职场正念的中介作用。结果共收集776份问卷,有效问卷696份。696名护士医疗职场暴力问卷得分为(1.21±0.78)分,职场正念量表得分为(4.74±0.63)分,工作绩效量表得分为(3.77±0.96)分。Pearson相关分析显示,护士工作绩效与职场正念呈正相关(r=0.235,P<0.01);护理职场暴力与工作绩效(r=-0.098,P<0.05)、职场正念与职场暴力(r=-0.217,P<0.01)呈负相关。职场暴力对工作绩效的总效应为(β=-0.1306,P<0.01),职场正念在两者关系之间扮演中介角色,中介效应为-0.0675。结论在职场中经历的患者及家属暴力会破坏护士的职业沉浸度、警觉以及组织接纳水平,从而制约了护理工作绩效发挥,故增加护士在预防暴力方面的培训以及应对暴力的干预具有重要意义。     

医务场所暴力与实习护生专业态度的相关分析

目的探讨实习护生专业态度与经历（包括目睹与遭受）医务场所暴力之间的关系。方法对某校实习结束后返校的657名护生进行有关经历医务场所暴力情况和专业态度情况的问卷调查。结果53.88%的护生亲眼目睹过医务场所暴力,19.94%的护生遭受过暴力;在护生目睹及遭受的暴力事件中,心理暴力分别占78.89%和88.82%;专业自我概念及灵活性的影响因素为学历、志愿选择、是否遭受暴力;技能及沟通交流的影响因素为志愿选择、是否遭受暴力;领导的影响因素为志愿选择;满意度的影响因素为学历、志愿选择、是否目睹暴力。结论目睹暴力和遭受暴力都会影响护生的专业态度,应采取措施减少医务场所暴力的发生,同时加强教育培训,增强护生暴力应对能力。     

Violence in hospitals and burnout among nursing staff

BackgroundNursing staff, especially in violence-prone emergency departments (ED), are at high risk of burnout. Frequently experienced violence is expected to have a strong impact on the nursing staff's burnout. This study aimed to examine the differences in the level of burnout between nursing staff who work in the ED and nursing staff who work in other inpatient departments, and its relationship with violence in various hospitals in Israel.MethodA cross-sectional study that utilized a three-part questionnaire: demographic data, degree of burnout, and frequency occurrence of violence events against nurses.Results150 nurses in EDs (N = 75) and inpatient departments (N = 75) were sampled. Significant differences were found between the two groups: Nurses in EDs experienced a higher degree of burnout than nurses in other hospital departments, and the degree of burnout was found to have a positive relationship with exposure to both verbal and physical workplace violence.ConclusionsNursing staff in EDs could develop a high degree of burnout, and exposure to workplace violence could exacerbate it. The physical and emotional safety of the staff is an important aspect in preventing burnout, and creating a secure work environment.     

护理工作场所暴力现况及相关影响因素研究

目的分析护理工作场所暴力的现况和影响因素。方法用分层抽样法对2家综合医院和3家社区卫生服务中心312名护理人员进行工作场所暴力调查,用多因素Logistic回归分析护理工作场所暴力的影响因素。结果 5家医疗机构护理工作场所暴力发生率为43.27%;单因素分析显示,单位类型、所在部门及科室、有无培训、单位应对等是暴力发生的影响因素;Logistic回归分析显示单位类型、所在部门、单位应对是影响暴力发生率的主要因素。结论护理工作场所暴力的发生率较高,管理层应采取措施,有效防范暴力事件的发生。     

患者对护士遭受工作场所暴力相关因素认知的调查研究

目的了解患者对护士遭受工作场所暴力相关因素的认知,为建立预防护士遭受工作场所暴力的应对策略提供参考依据。方法 2016年3月,采用便利抽样法选择重庆市2所三级甲等综合性医院门急诊和住院部的475例患者为研究对象,采用《医院工作场所暴力相关因素调查表》对其进行问卷调查。结果患者对护士遭受工作场所暴力的相关因素认同程度依次为护理服务因素、社会环境因素、医院管理因素和患者自身因素;其中认可程度前10位的条目中8项与护理服务相关,1项与患者自身因素相关,1项与社会因素相关;多重线性回归分析结果显示,患者的性别、职业、婚姻和学历对评分结果均有影响(均P0.05),年龄、常住地、收入、付费方式和就诊科室对评分结果均无影响(均P0.05)。结论患者对暴力相关因素中护理服务维度的认同度高,提示医院管理者及护士自身都应加强对护士专业能力及沟通能力的培训,同时应充分评估患者社会及支持系统情况,提供个性化的专业服务和指导,从而减少工作场所暴力的发生。     

护士工作场所暴力的原因与对策

护士工作场所暴力作为一种职业危害因素严重危害了护士的身心健康,降低了护士工作积极性,影响了护理质量。本文阐述了护士工作场所暴力的原因、对护士和护理专业的影响,并提出了相应的对策。     

Violence against caregivers in nursing homes. Expected, tolerated, and accepted.

Violence against caregivers is not a new phenomenon. Caregivers have experienced verbal and physical assaults from nursing home residents for many years. However, because much of the violence has been associated with demented or mentally ill residents, the word aggression was used in lieu of violence. This study found that the caregivers and nursing directors considered the assaults to be violence. The study suggests that such violence occurs frequently and is of concern to caregivers and nursing directors. The study also suggests that nursing homes may not have policies or procedures in place for preventing, monitoring, and controlling violence in their workplaces. In 1996, OSHA published violence prevention guidelines for health are facilities. These guidelines support OSHA's mandate that employees are entitled to a safe and healthy workplace (OSHA, 1996b). Although it is not possible to prevent all violence against caregivers in this unique setting, nursing home directors and administrators have a legal and moral responsibility to develop an action plan to minimize the violence and plan interventions for its effects. Violence against caregivers in nursing homes no longer can be thought of as expected, tolerated, and accepted. Quality of care and employee well-being depend on it.     

Pediatric emergency nurses’ workplace violence experiences: A qualitative study

IntroductionWorkplace violence is a crucial problem experienced by health workers who serve at the emergency service. The identification of emergency nurses’ workplace experiences is of importance to the prevention of violence and the development of solutions.PurposeThis study was performed to identify the workplace violence experiences of the nurses working for the pediatric emergency units.MethodA total of 20 nurses who experienced violence at the emergency service participated in the study that was conducted as qualitative research. The data were collected with the semi-structured interview form and were evaluated by using thematic analysis.ResultsFive themes, namely, “the characteristics of violence”, “the causes of violence”, “the approach during/after the violence”, “the consequences of the violence for the person”, and the “consequences of the violence for the profession”, were identified. Nurses stated that they often experienced verbal violence due to patient relatives’ unmet expectations, the failure of patient relatives to understand treatments and practices, and the heavy workload, they endeavored to eliminate violence by trying to communicate with perpetrators of the violence, calling the security staff, and reporting the violence to their managers, and they were individually and professionally affected by the violence.ConclusionNurses are negatively affected by workplace violence. Pediatric emergency nurses should be supported with training programs and policies to be developed for the prevention and solution of violence.     

Workplace violence in Queensland, Australia: the results of a comparative study

This paper presents the results on workplace violence from a larger study undertaken in 2004. Comparison is made with the results of a similar study undertaken in 2001. The study involved the random sampling of 3,000 nurses from the Queensland Nurses' Union's membership in the public (acute hospital and community nursing), private (acute hospital and domiciliary nursing) and aged care (both public and private aged care facilities) sectors. The self-reported results suggest an increase in workplace violence in all three sectors. Although there are differences in the sources of workplace violence across the sectors, the major causes of workplace violence are: clients/patients, visitors/relatives, other nurses, nursing management and medical practitioners. Associations were also found between workplace violence and gender, the designation of the nurse, hours of employment, the age of the nurse, morale and perceptions of workplace safety. Although the majority of nurses reported that policies were in place for the management of workplace violence, these policies were not always adequate.