Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-25T16:51:16.551Z Has data issue: false hasContentIssue false
  • English
  • Français

Dealing with violent and aggressive patients: at what cost to nurses?

Published online by Cambridge University Press:  13 June 2014

Jillian Crabbe ,
David A Alexander ,
Susan Klein ,
Shona Walker  and
John Sinclair
Jillian Crabbe
Affiliation:
Medical School, University of Aberdeen
David A Alexander
Affiliation:
Department of Mental Health, Medical School, University of Aberdeen Aberdeen Centre for Trauma Research, Royal Cornhill Hospital, Aberdeen
Susan Klein
Affiliation:
Department of Mental Health, Medical School, University of Aberdeen Aberdeen Centre for Trauma Research, Royal Cornhill Hospital, Aberdeen, Scotland
Shona Walker
Affiliation:
Old Age Psychiatry, Royal Cornhill Hospital, Aberdeen
John Sinclair
Affiliation:
Grampian University Hospitals NHS Trust, Westburn Centre, Aberdeen, Scotland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: To determine the attitudes and experiences of nursing staff in relation to violent and aggressive patients.

Method: A self-administered questionnaire booklet was distributed to 289 nursing staff working in ‘high-risk’ units within two NHS Trusts. In addition to assessing the frequency of violent incidents, the degree of burnout and post-traumatic symptoms experienced were assessed by the inclusion of two standardised measures in the survey, viz, the Maslach Burnout Inventory and the Impact of Event Scale-Revised respectively.

Results: One hundred and fifty six (54%) nurses responded to this survey. Over two-thirds of nurses (72%) had been physically assaulted during the previous two years. The longterm psychological impact of these incidents was not related to whether or not a physical injury was sustained. A positive correlation between burnout and exposure to verbal abuse, threatened assault and violence was demonstrated.

Conclusions: Nurses in these Trusts are exposed to an unacceptable level of violence or aggression from patients, potential implications of which include post-traumatic reactions and burnout. However, nurses are reluctant to report incidents of verbal abuse or threats formally, and they rely upon the support of their colleagues following ‘distressing’ incidents. To protect the wellbeing of their staff, hospital management needs to consider preventative measures, such as training and personal alarms, and improved reporting systems to ensure all incidents are accurately recorded.

Keywords

AggressionAssaultBurnoutViolence
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 19 , Issue 4 , December 2002 , pp. 121 - 124
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Health and Safety at Work Act. London: HMSO, 1974.Google Scholar
2.Management of Health and Safety at Work Regulations. London: HMSO, 1999.Google Scholar
3.Stark, C, Paterson, B, Kidd, B. Incidence of assault on staff in the NHS. Nurs Times 1995; 91 (18): 12.Google Scholar
4.Whittington, R, Shuttleworth, S, Hill, L. Violence to staff in a general hospital setting. J Adv Nurs 1996; 24: 326–33.CrossRefGoogle Scholar
5.Fernandas, C, Bouthillette, F, Raboud, J, Bullock, L, Moore, CF, Christenson, JM, Rae, S, Ouellet, L, Gillrie, C, Way, M. Violence in the emergency department: a survey of health care workers. CMAJ 1999; 161 (10): 1245–8.Google Scholar
6.Coombes, R. Violence: the facts. Nurs Times 1998; 94 (43): 12–4.Google ScholarPubMed
7.Royal College of Nursing Scotland. Mental Health Nursing in Scotland: Future Challenges 16-24. Edinburgh: RCN, 1999.Google Scholar
8.Hobbs, FDR. Fear of aggression at work among general practitioners who have suffered a previous episode of aggression. Br J Gen Pract 1994; 44: 390–4.Google ScholarPubMed
9.Williams, MF. Violence and sexual harassment: Impact on registered nurses in the workplace. AAOHN J 1996; 44 (2): 73–7.CrossRefGoogle ScholarPubMed
10.Clark, J. A survey into violence against medical staff in Dundee psychiatric services and a survey regarding the safety of interview rooms used. Health Bull 1997; 55 (6): 413–21.Google Scholar
11.Budd, T. Violence at work: Findings from the British Crime Survey London: HMSO, 1999.Google Scholar
12.Findorff-Dennis, MJ, McGovern, PM, Bull, M, Hung, J. Work related assaults. The impact on victims. AAOHN J 1999; 47 (10): 456–65.CrossRefGoogle ScholarPubMed
13.Gates, DM, Fitzwater, E, Meyer, U. Violence against caregivers in nursing homes. Expected, tolerated and accepted. J Gerontol Nurs 1999; 25 (4): 12–22.CrossRefGoogle ScholarPubMed
14.Jenkinson, WR. Attacks on postmen in Northern Ireland. What features of the attacks are associated with prolonged absence from work? Occup Med 1993; 43: 39–42.CrossRefGoogle ScholarPubMed
15.Kamphuis, JH, Emmelkamp, PMG. Crime-related trauma: Psychological distress in victims of bankrobbery. J Anx Dis 1998; 12 (3): 199–208.CrossRefGoogle ScholarPubMed
16.Lee, V, Henderson, MC. Occupational stress and organisational commitment in nurse administrators. J Nurs Adm 1996; 26 (5): 21–8.CrossRefGoogle ScholarPubMed
17.Felton, JS. Burnout as a clinical entity – its importance in healthcare workers. Occup Med 1998; 48: 237–50.CrossRefGoogle Scholar
18.Hayter, M. Burnout and AIDS care-related factors in HIV community clinical nurse specialists in the North of England. J Adv Nurs 1999; 29 (4): 984–93.CrossRefGoogle ScholarPubMed
19.Maslach, C, Jackson, SE. The measurement of experienced burnout. J Occup Behav 1981; 2: 99–113.CrossRefGoogle Scholar
20.Alexander, DA, Gray, NM, Klein, S, Hall, G, Kettles, A. Personal safety and the abuse of staff in a Scottish NHS Trust. Health Bull (Edinb) 2000; 60 (6): 442–9.Google Scholar
21.Weiss, DS, Marmar, CR. The Impact of Event Scale – Revised. Assessing psychological trauma and PTSD (Eds. Wilson, JP and Keane, TM) 399–441. New York: Guilford Press, 1997.Google Scholar
22.Schnyder, Uet al.Early psychological reactions to life-threatening injuries. Crit Care Med 2000; 28(1): 86–92.CrossRefGoogle ScholarPubMed
23.Smith, ME, Hart, G. Nurses' responses to patient anger: from disconnecting to connecting. J Adv Nurs 1994; 20: 643–51.CrossRefGoogle ScholarPubMed
24.Nolan, P, Dallender, J, Soares, J, Thomsen, S, Ametz, B. Violence in mental health care: the experiences of mental health nurses and psychiatrists. J Adv Nurs 1999; 30 (4): 934–41.CrossRefGoogle ScholarPubMed
25.Alexander, DA, Klein, S. Ambulance personnel and critical incidents. Br J Psychiatry 2001; 178: 76–81.CrossRefGoogle ScholarPubMed
26.Rose, S, Bisson, J. Brief early psychological interventions following trauma: A systematic review of the literature. J Traum Stress 1998; 11 (4): 697–710.CrossRefGoogle ScholarPubMed
27.Ryan, J, Poster, E. Workplace violence. Nurs Times 1993; 89 (48): 38–41.Google ScholarPubMed
28.Firth, H, McKeown, P, McIntree, J, Britton, P. Professional depression, ‘burnout’ and personality in longstay nursing. Int J Nurs Stud 1987; 24 (3): 227–37.CrossRefGoogle ScholarPubMed