Workplace violence is an occupational hazard that has become typical of most workplaces across the world. Anderson, FitzGerald & Luck (2010) define workplace violence as an array of behaviors that range from mild violence to murder. It occurs in a variety of forms depending on a number of factors. According to Hinchberger (2009), some occupations have a higher susceptibility to workplace violence in comparison to others.
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Evidence suggests that presently, workplace violence against nurses is a global menace (Anderson, FitzGerald & Luck, 2010). Hinchberger (2009) agrees with this argument when he notes that nurses are three times more likely to face workplace violence compared to workers in other occupations. At this rate, it is essential to understand this violence and everything that pertains to it, including its typology, prevalence, causes, and abatement efforts.
Classification of Workplace Violence
Anderson, FitzGerald & Luck (2010) note that the classification system used to categorize workplace violence was coined by the University of Iowa Injury Prevention Research Centre (UIIPRC). According to this system, a criminal, client, worker, family member, or close friend can perpetuate violence against a particular worker or all the people in a given workplace. It bases its classification of workplace violence on the perpetrator.
If workplace violence occurs due to criminal intent, it is known as Type I-criminal intent violence. In some cases, a client may become aggressive towards a worker. This category of workplace violence is Type II-customer/client violence.
Alternatively, a current or former worker may choose to bully, intimidate, or abuse a fellow worker. In such a case, the worker perpetrates Type III-worker-to-worker violence. Finally, a close friend or family member may show aggression towards an individual in the workplace. This behavior constitutes Type IV-personal relationship violence.
Prevalence of Violence against Nurses
Although nurses face all the four categories of violence at the workplace, existing evidence overwhelmingly shows that Type II violence is the most dominant category of workplace violence in nursing practice (Anderson, FitzGerald & Luck, 2010). In other words, patients are responsible for the highest number of cases of violence against nurses.
In a study conducted by Lepping, Lanka, Turner, Stanaway & Krishna (2013), 83% of health care workers in high-risk UK wards had been verbally abused, 55% had been threatened, and 68% had been physically assaulted in the preceding four weeks. The same study reports that the figures from the UK were lower compared to Germany and Switzerland because the UK has tougher measures aimed at protecting health care workers against workplace aggression than other European countries (Anderson, FitzGerald & Luck, 2010).
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Although this study covers all health care workers, it is important to point out that nurses form a large majority of this group (Anderson, FitzGerald & Luck, 2010). Hence, any aggression shown towards this group affects a larger number of nurses than all other healthcare workers.
Elsewhere, a comprehensive review of the literature was conducted on the prevalence of violence against nurses in emergency departments. The study established that nurses who serve in emergency departments faced a high risk of workplace violence.
Reportedly, the most outstanding articles among those reviewed in this study highlight the findings of two studies that were conducted in 1999. In one of them, 57% of the participating nurses had undergone physical assault in the preceding twelve months (Taylor & Rew, 2011). In the second study, 72% of the respondents had encountered physical abuse in the course of their career (Taylor & Rew, 2011).
Further, Lepping et al. (2013) report that a recent Australian study shows that over 70% of health care workers had experienced some form of aggression. Additionally, 32.3% of the workers had undergone physical assault. Many more studies have been conducted across the world. Most of them report similar results with only slight variations. Clearly, nurses and other health care workers are engaged in a high-risk occupation.
Causes of Violence against Nurses
The prevalence of workplace violence against nurses necessitates the need to explore the reasons behind this violence. Croft & Cash (2012) observe that the nursing profession is perceived as the least ranking element in the hospital hierarchy. Doctors, administrators, and patients come before nurses in the hospital setting (Croft & Cash, 2012). Although nurses do most of the work in a hospital, they feature as faceless and nameless entities.
This insubordination is one of the main causes of workplace incivility towards nurses. In addition, nurses have been an oppressed group since the inception of the nursing profession (Croft & Cash, 2012). Nurses always play second fiddle to other groups in a hospital.
This state of affairs gives patients, their relatives, and their friends the audacity to subject nurses to incivility. To cap it all, the nurses are predominantly women (Croft & Cash, 2012). Hence, since society looks down upon women, the same perception extends to the hospital setting.
Unfortunately, despite the workplace violence against nurses, nothing tangible has been set up to abate it. A very small number of countries across the world have laws that aim to protect nurses from this menace. Despite the spirited efforts made by representative bodies to agitate for the rights of nurses, violence against nurses remains largely underplayed by the concerned authorities. As such, workplace violence against nurses is liable to remain a protracted nightmare for the nursing profession.
Anderson, L., FitzGerald, M., & Luck, L. (2010). An integrative literature review of interventions to reduce violence against emergency department nurses. Journal of Clinical Nursing, 19(17/18), 2520-2530.
Croft, R. K., & Cash, P. A. (2012). Deconstructing contributing factors to bullying and lateral violence in nursing using a postcolonial feminist lens. Contemporary Nurse, 42(2), 226-242.
Hinchberger, P. A. (2009). Violence against female student nurses in the workplace. Nursing Forum, 44(1), 37-46.
Lepping, P., Lanka, S. V., Turner, J., Stanaway, S. E., & Krishna, M. (2013). Percentage prevalence of patient and visitor violence against staff in high-risk UK medical wards. Clinical Medicine, 13(6), 543-546.
Taylor, J. L., & Rew, L. (2011). A systematic review of the literature: Workplace violence in the emergency department. Journal of Clinical Nursing, 20(7/8), 1072-1085.