The problem of violence and aggression in health care services has received great attention over the last few years. Many health care workers have to be able to handle behavioral emergencies. It is important not only to be able to react or avoid such situations. The primary problem refers to the need to understand the causes of such behavior. Nowadays, the number of people who have become victims of violent behavior has increased. This problem cannot be left without particular attention. In the following paper, the precipitating factors of the problem will be evaluated as well as the culpability of institutions, staff, and legal liability. Besides, the intervention based on the nine-stage model will be described as well.
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According to Ford, Byrt, and Dooher (2010), most patients of social and health services are not violent. Nevertheless, the media always report incidents. Nurses suffer from aggressive behavior in most cases. Over the last three decades, the level of incidences increased drastically. Aggressive behavior has always been regarded as normal in mental health settings. Nevertheless, violence is spread in other settings nowadays. The authors state that patient has always been central to the health care environment. There is a need to pay attention to the safety of health care workers now.
Researchers have been trying to define the precipitating factors of violence many times. Risk factors of violence in institutions are complex cannot be identified easily. James and Gilliland (2012) consider that gender-based stereotypes, substance abuse, and mental illnesses should be considered as precipitating factors.
Institutional and staff culpability should be regarded as two large groups of precipitating factors. The lack of proper policies and training is the first fault of institutions. The improper organization of the working process (such as working during visiting hours, mealtime, being alone with the patient) is also a problem of the organization. Security measures are often not efficient in health care settings. Poor lighting, lack of adequate alarm systems also belong to institutional culpability. These factors may lead to negative consequences (Occupational Safety and Health Administration, 2015).
Staff members may also be guilty of violence to some extent. In many cases, violence is the reaction to provocative behavior. Many workers do not think about the proper approach to treatment. Some patients are afraid of treatment. Experience is also significant. Investigations show that trainees and inexperienced workers become victims of violence most often (James & Gilliland, 2012).
Legal liability is rather a controversial issue. The problem is that even when the nurse reports about incidence, it is unlikely that he or she will be understood. Most lawsuits prove that nurses should be even blamed for not being able to provide a proper diagnosis or control the violent patient. According to Stokowski (2010), this problem is connected with the lack of adequate legal support for nurses and other health care professionals.
Piercy’s nine-stage model can be used for intervention. The first stage is education. It is necessary to educate staff on how to recognize a threat of violent behavior. The second stage is avoidance of conflict. Appeasement, being the third stage, is significant when nurses try to calm the patient down. The fourth phase, deflection, should be used for the direction of attention to something positive. Time-out and show of force are the next two phases (James & Gilliland, 2012). They are transitional as far as they presuppose the change of behavior and taking control of the patient. Seclusion, restraints, and sedation are the last three stages that aim at the monitoring of further behavior.
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Ford, K., Byrt, R., & Dooher, J. (2010). Preventing and Reducing Aggression and Violence in Health and Social Care. Cumbria, CA: M&K Update Ltd.
James, R., & Gilliland, B. (2012). Crisis Intervention Strategies. Boston, MA: Cengage Learning.
Occupational Safety and Health Administration. (2015). Guidelines for Preventing Workplace Violence for Health Care and Social Workers. Web.
Stokowski, L. (2010). Violence: Not in My Job Description. Web.