Verified Document

Cares For Nurses" By Cecil Deans 2004  Term Paper

¶ … Cares for Nurses" by Cecil Deans (2004) When people become healthcare practitioners today, perhaps one of the furthest things from their minds is the increasingly violent nature of their potential workplaces. In his article, "Who Cares for Nurses" (2004), though, Cecil Deans makes the point that North American healthcare settings are very violent places to work and many institutions are not providing their practitioners with sufficient protections, and some are simply looking the other way -- all at the expense of the mental and physical well-being of their nursing staff. In their essay, "Challenges Facing Nurses' Associations and Unions: A Global Perspective" (2003), Clark and Clark note that, "Nurses, as the most highly trained caregivers with regular patient contact, are at the heart of any health care system. Widespread anecdotal evidence suggests that the problems in health care have had a particularly negative effect on the workplace experience of nurses" (29). According to Gribbin (2002), "Hospitals can be scary places for patients, but for doctors, nurses and others who work there they can be downright dangerous" (28). Likewise, Hanrahan (1997) points out that: "Nurses get abused all the time. We don't call it that. It's just part of the job" (43). This aspect of being compelled to accept violence in healthcare settings is a common theme in the literature.

The study by Deans points out that violence in the healthcare industry has been widely reported as a serious problem with registered nurses frequently being on the receiving end of physical, verbal and sexual abuse: "Some authors have reported aggression is so prevalent nurses accept it as part of their job" (32). For nurses, the anger that naturally results from being subjected to a hazardous working environment is frequently directed at colleagues and supervisors, with demands for immediate remedies for potentially hazardous work conditions and improvement on existing policies (Clements, Fay-Hillier & Sacks, 2001).

Rationale for Relevance to Nursing/Clinical Practice.

According to Antai-Otong (2001), "Workplace violence is at epidemic levels and grips our society. Workplace murder is the leading cause of death in working women (35% of all female workplace deaths) and the second leading cause of death in working men" (125). Furthermore, the U.S. Bureau of Labor Statistics figures for 1995 showed that 1,071 workers were murdered in the workplace in 1994; the incidence of workplace murders is just one aspect of workplace violence though. "There is growing recognition that all employees face some exposure to violence, by virtue of association with co-workers and client populations. Some data show an estimated 2 million people in the United States are assaulted each year by co-workers and 6.3 million are threatened by co-workers" (Antai-Otong 2001:125). Certainly, violence and assault can take place in any type of work setting regardless of the occupation of the group; however, Chenier (1998) notes that these incidents are rarely isolated, but that there are few employers with preventive programs in place to sufficiently address the needs of their workplace.

The grim reality of violence in many healthcare settings does not mean there are not viable solutions though. According to Boyd, "There may be many situations in which providing staff with both education and in-service training can serve to reduce the risk of violence. Many nurses and health care workers complained that they have little information about the risks posed by specific patients" (492). Many hospitals and other healthcare facilities do not identify, or "flag" patients who are known to be violent, apparently because such an indicator has the potential to bias the caregiver. Nevertheless, Boyd insists that, "A flag is also an educational aid to the caregiver, a technology that, if employed, might result in significant reduction in assaults, with a minimal change in the kind or standard of care provided to the patient" (492). There are also some common-sense approaches to minimizing the potential of violence in healthcare settings: "All concerned know the prescription for dealing with hospital violence: Hospitals have been advised to hire more nurses, beef up the security staff, install metal detectors, control entrances and exits to limit access, keep patients and relatives informed about what's happening and remove from waiting areas all lamps, ashtrays and anything else that can be thrown or used as a weapon" (Gribbin 2002:29). The fact that these precautions are being considered at all is indicative of the current trend toward violence in healthcare settings, a trend that has profound implications for nurses today and in the future.

Problem definition or purpose.

The consequences of violence in the workplace are potentially enormous for nurses today. According to Deans, "The phenomenon of aggression as a stressor has the potential to have...

As a consequence nurses may experience lowered levels of concentration at work, and reduction in motivation and performance" (32). Identifying effective means of resolving these issues has assumed enormous importance in recent years, and this is the focus of the study by Deans.
Literature review.

In his study, Who cares for nurses? The lived experience of workplace aggression," the author cites 21 peer-reviewed studies in support of his analysis, with the majority of them being written in the last decade or so; however, the author also resorts to using several resources that are well over 30 years old, and one mental health reference that dates back to 1958; this is not to say, of course, that there is no scholarly merit in these publications; it is to say, though, that a study concerning a contemporary problem should most likely focus on resources that are more up-to-date than the mid-20th century. Otherwise, the literature review provided by Deans in support of his thesis appeared well-rounded and on-point.

Sampling protocols.

In his study, Deans used a convenience sample of 55 registered (Division 1) nurses who had been previously identified as having experienced workplace aggression who consented to be interviewed about their experiences. Out of the original 55 subjects, an additional subset of 33 participants were selected on the basis of their availability; of these, 26 were women and seven were men, ranging in age from 22 to 55 years.

Data collection strategies.

According to Deans, "Participants selected a venue suitable to them in which interviews were conducted, generally in their homes; twelve took place in their work environment. Eighteen participants resided in Melbourne while fifteen resided in rural or regional Victoria" (7) The interviews for the study were recorded and transcribed and generally required between 45 and 80 minutes to complete, with the mean length of 65 minutes (Deans 2004).

Data analysis strategies.

The author used a hybrid analysis of the data by adapting the method described by Colaizzi (1973) and merging it with the interactive model developed by Miles and Huberman (1994). According to Deans, this comprehensive approach provided a superior environment in which to collect the data for this study than either one used independently; the approach involved three primary steps.

The first step in Deans' data analysis strategy involved transcribing the data, listening to audio tapes, returning transcripts to participants and formulating meanings from the transcripts that were returned by participants. The second step required Deans to identify significant words, statements and emerging patterns and common themes. The final step was comprised of a participant check; at this point, the findings were once again returned to participants who were asked to add their own comments about the authenticity of the data. According to Dean, "The validity and reliability of the process was evaluated against four important concepts, namely, homogeneity, inclusiveness, usefulness, clarity and specificity" (33). The author notes that homogeneity was accomplished by ensuring that there was an internal consistency or harmony between the three shared themes in spite of the fact that each theme had separate and independent identities. To this end, the author concludes: "The themes of 'professional incompetency', 'expectation to cope' and 'emotional confusion', were also regarded as having achieved clarity and specificity as they are clear and stated in terms people can understand" (33).

Interpretation of findings, conclusions, recommendations.

There were no earth-shattering revelations in this study, but the author managed to highlight one of the most pressing problems facing healthcare administrators today: "Perhaps the most important implication emanating from this study is that the profession as a whole should become aware of the extent of the problem and the role that nurse colleagues, nurse managers and medical staff play in its genesis" (Deans 2004:35).

Ethical issues.

The author was sensitive to the traumatic nature of the subject matter under investigation and took appropriate steps to ensure that the ethical issues involved in the study were satisfied. According to Deans, "A considerable period of time was spent at each interview developing a rapport and trust with participants. It was obvious a number of participants continued to have negative experiences as a result of workplace aggression" (Deans 2004:34). A requirement of the University Human Research and Ethics committee that all participants were given the name and telephone number of a psychologist to contact if they felt they needed ongoing support; identities, locations of individuals and places are concealed, data…

Sources used in this document:
Works Cited

Antai-Otong, Deborah. (2001). Critical Incident Stress Debriefing: A Health Promotion Model

for Workplace Violence. Perspectives in Psychiatric Care, 37(4):125.

Boyd, Neil. (1995). Violence in the Workplace in British Columbia: A Preliminary

Investigation. Canadian Journal of Criminology, 37(4):491-519.
Cite this Document:
Copy Bibliography Citation

Related Documents

Aggression Questionnaire the Buss-Perry Aggression Questionnaire...
Words: 1076 Length: 3 Document Type: Essay

Aggression Questionnaire The Buss-Perry Aggression Questionnaire consists of twenty-nine statements designed to assess four factors: physical aggression, verbal aggression, anger, and hostility. It is a self-scoring test, and subjects are asked to evaluate themselves according to the degree to which they agree with the statements. The questionnaire uses a five point scale, with one point indicating a statement is "extremely uncharacteristic" and five points indicating "extremely characteristic." A score of three

Aggression and Violence
Words: 659 Length: 2 Document Type: Essay

Aggression and Violence Expression of aggression: Japan Although the aggressive impulse may be hard-wired into the human brain, the various ways in which cultures view what constitutes aggression can be quite subjective. In Japan, for example, direct confrontation is frowned upon, in contrast to the United States, which emphasizes the need to 'tell it like it is.' Even the agency of the aggression is viewed differently in collectivist vs. more individualistic societies.

Aggression and Violence in This Day and
Words: 629 Length: 2 Document Type: Essay

Aggression and Violence In this day and age, just about everything is rated. From movies to television shows and even video games, forms of media are given ratings to depict who they are approved for and what type of content the viewer or user can expect. One of the main reasons for this rating system is the prevalence of violent movies, television shows and video games and the psychological theories that

Aggression an Examination of the
Words: 2738 Length: 10 Document Type: Term Paper

Population The mean age of participants was 33 years. The ICS was selected because of its superior internal consistency with an alpha of.96 and "strong factorial validity as well as fair construct validity," correlating in the predicted direction with the Generalized Contentment Scale and Index of Family Relations (Abell, 1991). The asst or Assertiveness Self Statement test, a "32 item instrument designed to measure self statement in assertion related problems" was also

Aggression Workplace Violence
Words: 1346 Length: 5 Document Type: Term Paper

Aggression, Violence in the Workplace Studies suggest that violence and aggression are an increasingly common occurrence in organizations large and small across the globe (Repetti, Seeman & Taylor, 1997; Waldron, 2000; Coombs & Holladay, 2004). Aggression and violence are serious problems that can have short- and long-term consequences on individuals and organizations. As such it is vital that organizations become aware of the problem and take steps to prevent them. In this

Aggression Comparison Between Two Races
Words: 2351 Length: 7 Document Type: Research Proposal

Race on Aggression Race and Aggression The roots of violence are of interest because of the toll it takes on the lives and minds of all citizens. Each year, an estimated 50,000 citizens die from violence in the United States and another 2.2 million will need medical treatment for injuries (reviewed by Corso, Mercy, Simon, Finkelstein, and Miller, 2007). Although the costs on a personal level are incalculable, the costs to

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now