Workplace violence in nursing in Queensland,Australia: a self-reported study

This paper reports on workplace violence, self-reported as part of a survey among members of the Queensland Nurses' Union (QNU) in October 2001. The aim of the overall study was to ascertain how nurses perceived their work and their working conditions and to use the results of the study to inform strategic planning of the QNU. The participants of this study were drawn from a stratified random sample of 2800 QNU members employed in the public, the private acute and the aged care sectors. The total number of completed surveys analysed was 1436: 441 aged care, 497 public and 498 private acute sector surveys. The results suggest that the rate of workplace violence differs significantly across sectors. In the three months immediately prior to the survey, 50% of aged care sector nurses experienced some form of workplace violence compared to 47% of public sector nurses and 29% of acute private sector nurses. The major source of workplace violence was from patients. The second most common source of violence varied. Nurses in the public sector signified visitors and relatives while nurses in the aged care and acute private sectors indicated other nurses. The study found that inexperienced nurses are more likely to report workplace violence than experienced nurses. Additionally, the more experienced the nurse, the less likely they are to perceive workplace policies and procedures for workplace violence as effective. Additional findings include an apparent lack of policies and procedures for workplace violence in rural and remote areas, and an association between the designation of a nurse and the reported level of workplace 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.     

Adequacy of support for new graduates during their transition into the workplace: a Queensland, Australia study

In 2001, a study into issues of concern to assistant-in-nursing, registered and enrolled nurse members of the Queensland Nurses Union was undertaken. Approximately equal numbers of nurses from each of the aged care, acute private and acute public sectors were surveyed. Overall, 1477 nurses responded, representing a response rate of 53%. This article focuses on one aspect of the study-the perceived adequacy of support offered to new nursing graduates as they exit university and begin their transition into the workplace. In particular, responses from nurses are compared with professional level or current role designation, age, time spent in the workplace and health sector. Considerable divergence of opinion among the respondents, particularly across designation, age and years of experience, was found within the three sectors. For example, in the public and private employment sectors, older and more experienced nurses were more likely to perceive the support for new nurses as adequate compared to younger and less experienced nurses. Additionally, in the acute private sector, the more senior the nurse the more likely the perception that there was adequate preparation for new graduates entering the workforce.     

Workforce issues in nursing in Queensland: 2001 and 2004

Aims and objectives. The aim of the study was to identify the factors having an impact upon nursing work and to use the results to inform strategic planning of the Queensland Nurses Union. Background. In 2001 and 2004, a study was undertaken to gather data on the level of satisfaction of nurses with their working life. This paper reports the 2004 results on workload, skill mix, remuneration and morale. Where applicable, the results are compared with 2001 data. Methods. A questionnaire was mailed to 3000 Assistants‐in‐Nursing, Enrolled and Registered Nurses in October 2004. All participants were members of the Queensland Nurses Union. The results are reported in three sectors – public, private and aged care. A total of 1349 nurses responded to the survey, a response rate of 45%. Results. Nurses in the 2004 study believed: their workload was heavy; their skills and experience poorly rewarded; work stress was high; morale was perceived to be poor and, similar to 2001, deteriorating; the skill mix was often inadequate; and the majority of nurses were unable to complete their work in the time available. Nursing morale was found to be associated with autonomy, workplace equipment, workplace safety, teamwork, work stress, the physical demand of nursing work, workload, rewards for skills and experience, career prospects, status of nursing and remuneration. Conclusions. Overall the findings of the study are consistent with those determined by the 2001 survey. Relevance to clinical practice. The findings of this study indicate the importance of factors such as workplace autonomy, teamwork, the levels of workplace stress, workload and remuneration on nursing morale. The data also indicate that workplace safety and workplace morale are linked. These findings provide information for policy makers and nurse managers on areas that need to be addressed to retain nurses within aged care, acute hospital and community nursing.     

Aged care nursing in Queensland - the nurses' view

Aims and objectives. Through comparison of two studies undertaken three years apart the opinions of nurses working in aged care facilities in Queensland were determined. Results will support policy planning for the Queensland Nurses Union. Background. An ageing population in Australia is placing increased demands on residential aged care facilities. In Queensland, the national situation is exacerbated by an influx of retirees from other states and territories. The ongoing problem of shortages of nurses in the workforce may be addressed by gaining further insight into the nurses’ own views of their conditions and experiences. Methods. One thousand nurses working in public and privately owned residential aged care facilities were surveyed by postal questionnaire in 2004. Results were compared with data collected in an identical study in 2001. Results. Respondents offered their opinions on working hours and conditions, professional development and experiences in nursing. The predominately female aged care nursing workforce is ageing. Reported workplace violence has increased substantially since 2001. Some improvements are reported in staff numbers, skill mix and workplace policies. Nurses expressed very serious concerns about pay, workload, stress, physical and emotional demands and staff morale. Conclusion. Working conditions for nurses in the residential aged care sector in Queensland must be addressed to retain the current nurses and to encourage new nurses to replace those that retire. Relevance to clinical practice. The findings of this study provide information not only for the Queensland Nurses Union but also policy makers and nurse managers both nationally and internationally on areas that need to be addressed to maintain the required workforce within the aged care sector.     

Violence Against Female Student Nurses in the Workplace

Violence, harassment, and bullying in the workplace are not new phenomena. However, the growing epidemic of violence in the health sector workplace is raising great concern among workers, employers, and governmental agencies across Australia, Canada, the United Kingdom, and the United States. National and international literature reveals that the prevalence of violence experienced by graduate and undergraduate female nursing students in the college and workplace settings are largely unknown. Moreover, the prevalence of violence is now recognized as a major health priority by the World Health Organization, the International Council of Nurses, and Public Services International. Even so, the number of nursing personnel affected by this problem continues to rise. A modified self-report online survey was used to ascertain the level of violence experienced by nursing students in their clinical placements. One hundred percent of those surveyed had experienced some type of workplace violence and the perpetrators were most often other staff members followed closely by patients. The American Association of Colleges of Nursing Position Statement recommends that all faculty prepare nurses to recognize and prevent all forms of violence in the workplace. This research seeks to develop practical approaches to better understand and prevent this global public health issue.     

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.     

Tenure, mobility and retention of nurses in Queensland, Australia: 2001 and 2004

AIM: Data were collected on tenure, mobility and retention of the nursing workforce in Queensland to aid strategic planning by the Queensland Nurses Union (QNU). BACKGROUND: Shortages of nurses negatively affect the health outcomes of patients. Population rise is increasing the demand for nurses in Queensland. The supply of nurses is affected by recruitment of new and returning nurses, retention of the existing workforce and mobility within institutions. METHODS: A self-reporting, postal survey was undertaken by the QNU members from the major employment sectors of aged care, public acute and community health and private acute and community health. RESULTS: Only 60% of nurses had been with their current employer more than 5 years. In contrast 90% had been in nursing for 5 years or more and most (80%) expected to remain in nursing for at least another 5 years. Breaks from nursing were common and part-time positions in the private and aged care sectors offered flexibility. CONCLUSION: The study demonstrated a mobile nursing workforce in Queensland although data on tenure and future time in nursing suggested that retention in the industry was high. Concern is expressed for replacement of an ageing nursing population.     

Psychological consequences of bullying for hospital and aged care nurses

RODWELL J. & DEMIR D. (2012) Psychological consequences of bullying for hospital and aged care nurses. International Nursing Review Aim: This study examines the psychological consequences of workplace bullying by negative affectivity (NA) and demographics for hospital and aged care nurses. Introduction/Background: Nurses are particularly vulnerable to workplace bullying, with suggestions that oppressed group behaviours may play a role. Bullying is a potent stressor that can negatively impact psychological well‐being, which, with NA and demographics, may be important in understanding the consequences of nurse bullying. Such factors are yet to be examined together across different nursing contexts. Methods: A cross‐sectional survey was conducted across hospital and aged care nurses working within a medium to large Australian healthcare organization in October 2009. The sample comprised 233 (29.1%) hospital and 208 (43.8%) aged care nurses. Analyses of covariance were used to evaluate the data. Results: For hospital nurses, psychological distress was noted as an impact of bullying, while depression was the impact for aged care nurses. Full‐time aged care nurses reporting bullying had higher psychological distress scores, compared with part‐time workers in the same area. NA was a significant covariate across both outcomes in both contexts. Discussion/Conclusion: This study demonstrates that bullying has detrimental consequences for the mental health of nurses in both hospital and aged care contexts. The results support the suggestion that nurses are an oppressed group at high risk of bullying, confirm the intrinsic nature of NA to the bullying process, and highlight the importance of employment type for aged care nurses. Given the shortage of nurses, managers need to give higher priority to addressing workplace bullying and implementing zero tolerance policies.     

Nursing workloads: the results of a study of Queensland Nurses

This paper reports the findings of a survey undertaken in Queensland, Australia in October 2001. The participants were registered and enrolled nurses and assistants in nursing who were members of the industrial body - the Queensland Nursing Union (QNU), and who were in paid employment in nursing in Queensland. Participants were selected by random sampling from each of the three major employment groups - the aged care, public and private acute sectors. Of the 2800 invited participants, 1477 responded resulting in an overall response rate of 53%. The findings indicate that over 50% of nurses in the aged-care sector, 32% of nurses in the public and 30% of nurses in the private acute sector experience difficulties in meeting patient needs because of insufficient staffing levels. The nurses in this study also believed that there was poor skills-mix, mostly caused by lack of funding, too few experienced staff or too many inexperienced staff. Many nurses in this study expressed their anger and frustration about their inability to complete their work to their professional satisfaction in the paid time available. Further, many nurses also expressed the view that because of this inability they were planning to leave the nursing profession. These findings are consistent with other research into the nursing workforce both within Australia and internationally.     

Emergency nurses' experience with violence: does it affect nursing care of battered women?

OBJECTIVE: To determine what effect nurses' experience of interpersonal violence had on proposed nursing care of battered women ED patients. METHODS: One hundred ninety-five emergency nurses completed surveys on their personal experiences with violence involving patients or intimate partners and on their proposed nursing care of battered women given 2 vignettes. RESULTS: Seventy percent of participants experienced violence perpetrated by a patient; 40% of the nurses reported violence perpetrated by their intimate partners; and 19% had used force on their partners. Prior assault of a nurse by a patient or partner did not affect the proposed nursing care that would be provided by that nurse to battered women ed patients. Female nurses who committed violence against their intimate partners proposed less nursing care than did those who did not commit violence against their intimate partners for the vignette describing a woman who had received minor injuries. CONCLUSIONS: This study documents the vulnerability of nurses to assault by patients and intimate partners. This vulnerability does not affect their proposed nursing care of battered women. An exception is nurses who themselves commit violence against intimate partners. Findings point to the need to increase safety for nurses in the workplace and provide employee assistance to help nurses confront violence at home.     

Construct validity and reliability of the Practice Environment Scale of the Nursing Work Index for Queensland nurses

Parker D, Tuckett A, Eley R, Hegney D. International Journal of Nursing Practice 2010; 16 : 352–358
Construct validity and reliability of the Practice Environment Scale of the Nursing Work Index for Queensland nurses This article reports on construct validity and reliability of 30 items of the Practice Environment Scale of the Nursing Work Index (PES‐NWI). Australia, like other countries, is experiencing a shortage of nurses; a multifactor approach to retention of nurses is required. One significant factor that has received increasing attention in the last decade, particularly in the USA, is the nursing practice environment. The reliability of the 30 items of the PES‐NWI was assessed by Cronbach's alpha and factor analysis was performed using principal component analysis. The PES‐NWI was completed by nurses working in the aged‐care, private and public sectors in Queensland, Australia. A total of 3000 surveys were distributed to a random sample of members of the Queensland Nurses Union. Of these, 1192 surveys were returned, a response rate of 40%. The PES‐NWI was shown to be reliable demonstrating internal consistency with a Cronbach's alpha of the total scale of 0.948. The 30 items loaded onto five factors explaining 57.7% of the variance. The items across the factors differed slightly from those reported by the original author of the PES‐NWI. This study indicates that the PES‐NWI has construct validity and reliability in the Australian setting for nurses.     

A study of the movement of nurses and nursing skills between the NHS and the private sector in England and Wales

An investigation of 2165 qualified nurses joining eight NHS District Health Authorities (DHAs) and 72 private sector institutions was undertaken in order to measure the skills which move between these sectors and to estimate the likely impact on NHS nursing services of any future growth in the private sector. It was found that 42% (95% confidence interval: 36%, 48%) of the nurses joining private acute hospitals and 28% (95% CI: 21%, 37%) of those joining long-stay private nursing homes came directly from the NHS workforce. Fewer qualified nurses move from the private sector to the NHS. Private acute hospitals appear to attract recruits from a specific section of the NHS workforce: nurses under 30 years of age with specialist skills such as theatre nursing, renal nursing, intensive care and oncology.     

Negative workplace behavior and coping strategies among nurses: A cross‐sectional study

Negative workplace behavior affecting nurses is an internationally recognized problem. This study examines the types and extent of negative workplace behavior experienced by nurses in non‐metropolitan, regional acute care settings and their ways of coping when subject to that behavior. A cross‐sectional study was conducted involving 74 nurse participants in four regional hospitals in Australia. The structured questionnaire consisted of four parts: demographic questions, the Negative Acts Questionnaire – Revised, questions on exposure to bullying and/or incivility and policy awareness and use of pathways, and the Ways of Coping Questionnaire. Overall, 34% of participants were exposed to bullying and 49% to incivility over the previous month. The most common type of negative workplace behavior reported was “work‐related bullying,” which included exposure to excessive workloads, unrealistic deadlines, and information being withheld. Nurses reported the use of a variety of coping mechanisms, including problem‐focused coping strategies and seeking social support. The findings imply that negative workplace behaviors occur not only at individual nurses? level but also derive from the broader contexts of organizational management and systemic factors.     

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.     

Extrinsic and intrinsic work values: their impact on job satisfaction in nursing

AIMS: The aim of this study was to identify the intrinsic and extrinsic work values that were perceived by the members of the Queensland Nurses Union (QNU) in Queensland, Australia, to influence job satisfaction. BACKGROUND: The current shortage of nurses in Australia has been the focus of many recent studies and national inquiries. This shortage is experienced internationally in both developed and developing nations. Few studies, however, have examined the results of surveys from the model of intrinsic and extrinsic work values and their impact on job satisfaction. METHODS: Following a pilot study, a questionnaire was posted to 2800 assistants-in-nursing, enrolled and Registered Nurses in October 2001, who were members of the QNU. The sampling of nurses was undertaken from three sectors - public, private and aged care and therefore the results are reported separately for these three sectors. A total of 1477 nurses responded to the survey, equating to a total overall response rate of 53%. It should be noted that the study was limited to members of the QNU, and therefore does not represent nurses who are not members of the Union. RESULTS: The results show that intrinsic and extrinsic work values do impact upon job satisfaction and therefore intention to leave employment. The results also indicate that work stress was high and morale was low and decreasing. CONCLUSIONS: The findings of this study give some indication of what should be included in a nursing workforce planning strategy, the need for which in Australia is 'fundamental and urgent' (Senate Community Affairs References Committee 2002, p. xiii). The findings of this study also suggest that a 'one size fits all' solution across sectors will not work.     

The impact of regulatory perspectives and practices on professional innovation in nursing

Since at least the 1970s in Canada, there have been calls for health system reforms based on innovative roles and expanded scopes of practice for nurses. Professional regulatory organizations, through legislation, define the standards and parameters of professional nursing practice. Nursing regulators emphasize public protection over the advancement of nursing; regulatory processes and decisions tend to be conservative and risk‐averse. This study explored the impact that regulatory processes have on innovation in nursing roles. Nurses in a range of unique practice situations were interviewed, including nurses in non‐traditional roles and/or settings, those with cross‐jurisdictional career histories, and those working in interdisciplinary practices and educational settings. For these nurses, nursing practice was viewed through a traditional clinical lens, which did not fit for them. They experienced hassle, delay, and inconsistencies in regulatory practices. They felt mistreated and fearful of the regulator and lamented the ways in which ambitious, creative, capable nurses were stymied in attempting new applications for nursing knowledge. Nursing is constraining its own mandate to contribute to health care through stringent licensing processes. Healthcare reform provides an opportunity for nursing regulators to rethink their processes and provide the latitude for nurse‐driven change.