Background Of The Problem

It has been found that nurses who are specialised in the practice of dealing with mental health nurses often have to deal with aggression and violence from patients and hence become victims of the same. In mental health nursing practice, nurses have to face quite a lot of challenges which involves a lack of support along with dissatisfaction at the workplace. The impacts of violence and aggression cannot be anticipated by the people whom it affects, but the victims may suffer from mental issues that are crucially serious and hence leads to post-traumatic stress, depression and anxiety.

Nurses dealing with mental health patients are the ones who are highly dedicated and devoted to their duty for the patients who are suffering from mental health illnesses. However, their dedication often causes harm to their profession, where they end up having to deal with patients exhibiting aggression and violence to these nurses. Aggression in the work environment affects mental health nurses, and their environment of work ultimately leads to the decline of the quality of services provided to patients. This happens as aggression and violence causes overt psychological influence on the mental health of nurses and ultimately end up facing burnout. Research on this problem is vital as it may give yield recommendations of tactics that can bring down the suffering caused to mental health nurses due to aggression and violence.

Nurses treating mental health patients are exposed to a diverse work environment where the psychiatric nurses experience aggression and violence not only from the patients but also from their colleagues to some extent. The importance of ongoing violence and aggression faced by the mental health nurses should not be ignored, and hence there has been quite a lot of studies being carried out for mitigating such issues both at a national as well as international level.  Violence And Aggression In Mental Health Nursing Practice Example Paper

The research question to explore the impact of aggression and violence on mental health nurses are as follows:

• What are the factors which lead to violence and aggression faced by mental health nurses in their area of practice?
• What are the impacts of violence and aggression faced by mental health nurses in their workplaces?
• What is the impact of violence and aggression on mental health nurses in a wider community?

Every individual has the right of living with a free mind and remain tension-free at the end of the day. Just as overworking causes exhaustion and imbalance of work-life balance among mental health nurses, repeated violence and aggression received by mental health nurses also leads to loss of productivity of work because of the dissatisfaction of job which they are facing (Foster, Cuzzillo & Furness, 2018). This study or proposal is significant as proper research might lead to the recommendation of ways that might provide a solution to the mental health nurses to reduce the ways of facing aggression and violence. When effective ways of dealing with such episodes of violence and aggression can be learnt, burnout among mental health nurses may get reduced to a great extent.

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Problem Statement

According to Roets, Poggenpoel & Myburgh (2018), psychiatric nurses obtained a lack of support when the aggression they faced were not acknowledged by their colleagues as well as the management of their organisation. Aggression and violence in the environment of work not only affected their delivery of service but also affected the care the nurses take of the patients they are dealing with. Some studies have revealed that mental health nurses often do not stand responsible for their own actions. Harassment and conflicts, bullying, violence and other damaging effects are some of the factors which lead to emotional distress among patients.

As opined by Thomas (2016), aggression and violence are considered to be challenging aspects for clinical practices among mental health nurses in their areas of practice. It has been found that patient-inflicted injuries lead to the occurrence of anguish and post-traumatic stress disorder as the victims of aggression and violence are often not supported properly by their coworkers. It has been found that mental health patients are not the only patients who inflict violence and aggression upon nurses, but studies have revealed that assaults by such patients upon the nurses are far too often. A survey has revealed that there were 14877 injurious harms and assaults by mental health patients on their care nurses in the hospitals of the US within the range of 2007 to 2013 (Staggs, 2015). The registered nurses were mostly the victims. Hence, nurses practising in mental health practice settings find measures of security to be insufficient on this issue.

A survey conducted among mental health nurses has revealed that around 25% of the nurses have received heinous assault in their career with serious injuries incurred upon them. Such injuries included eye injuries, fractures along permanent disability. It has been found that inwards keeping patients with acute psychiatry, around 24 to 80% of nurses face at least one episode of violence and aggression throughout their career. Around 46 to 79% of the staff faced verbal assaults while 43-78.6% of staff faced threats and a very nominal percentage of staff faced cases of sexual harassment (d’Ettorre & Pellicani, 2017). Psychiatry diagnosis has revealed that mental disorders with profound symptoms have led to the occurrence of aggressive behaviour among patients who actually pose the violations of nurses taking care of the patients. Schizophrenia, anxiety, acute reaction to stress, cognitive impairment, personality disorders, ideation of suicidal thoughts, impulsiveness, psychopathy and other forms of mental retardation are some of the risk factors that aggravate violence among patients, which need to be endured by nurses working in the mental health care setting. Lanza (2016) opined that it is mostly the elderly patients suffering from dementia or any other mental disorders who are the perpetrators who are most likely to resort to any sort of violence- whether verbal or physical. Their likely targets are the nurses. Around 75% of the nursing staff in the geriatric inpatient units have reported experiencing aggression upon themselves or any of their coworkers in almost all the shifts they work in.

Research Questions

According to Schablon et al. (2018), employees in the welfare of healthcare workers are subjected to the enormous stress of the mind due to different kinds of physical and verbal violence. Very few employees considered leaving their profession. Risk factors involving improper evaluation of the work capacity were also facing violence and aggression along with the increasing age. Staffs working in a disabled care setting are at the upper hand rather than working in geriatric departments. There are other pressures such as low staffing pressure of time are some of the reasons which play an important role in aggravating violence in mental health nurses. It has been found that employees working in the psychiatric care sector have worsened their health status drastically, thus giving way to lower capacity of work though their mental capacity was far better before.

Nurses working in the psychiatric wards along with the emergency wards are at more risk of facing any kind of workplace violence because the contact between nurses and patients is high in these wards. There is a cyclical model of describing violence posed to mental health nurses, which says that nurses who are not available to the patients at times of their need were more likely to face violence than the ones who spent more and more time with the patients (Aguglia et al., 2020). The model also explained that when a nurse experiences an assault, it will cause the nurse to suffer from an episode of post-traumatic stress, which in turn would influence the mental health of the nurse. There are two main reasons behind the occurrence of aggression and anger among patients (Itzhaki et al., 2018). One is the social distance that is created between the patientand the nurse and her behaviour which is annoying to the patient.

The attitudes of nurses working in the mental health practice areas are highly influenced regarding violence and aggression received at workplaces, and it is with the help of training programs that their attitudes can be changed by waiving off their fear regarding aggression of the patients and their management. Heckemann et al. (2015) stated that aggression management through various training and development could not successfully develop the perception of the traumatised nurses and their attitudes. Making them cope with the management as well as the patients emotionally remains a challenge. There has been the enhancement of theoretical knowledge on the community of nurses, but it did not lead to the implementation of any new strategies that could manage the aggression of the patients (Tonso et al., 2016). The situational awareness of the nurses could be improved, and they could deal with the hazardous situation more effectively.

Significance Of The Proposal

Conclusion

It can be concluded that irrespective of the fact that there is actually any rise in the incidence of violent attacks and aggressive attacks upon mental health nurses or not, the sensitisation of the issue has led to a change in the perception of some of such problems. It was once considered to be common in nursing institutions but has been evaluated as an issue that needs to be overcome at the earliest as it cannot be tolerated. An increase in violence and aggression will ultimately cause stress at the workplace, which in turn is related to stress at workplaces. Therefore, employers should implement strategies that would prioritise safety to staff and protect the health of the workers.

Reference List

Aguglia, A., Belvederi Murri, M., Conigliaro, C., Cipriani, N., Vaggi, M., Di Salvo, G., … & Amore, M. (2020). Workplace violence and burnout among mental health workers. Psychiatric services, 71(3), 284-288. https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201900161

d’Ettorre, G., & Pellicani, V. (2017). Workplace violence toward mental healthcare workers employed in psychiatric wards. Safety and health at work, 8(4), 337-342. https://doi.org/10.1016/j.shaw.2017.01.004

Foster, K., Cuzzillo, C., & Furness, T. (2018). Strengthening mental health nurses’ resilience through a workplace resilience programme: A qualitative inquiry. Journal of psychiatric and mental health nursing, 25(5-6), 338-348. https://doi.org/10.1111/jpm.12467

Heckemann, B., Zeller, A., Hahn, S., Dassen, T., Schols, J. M. G. A., & Halfens, R. J. G. (2015). The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature. Nurse education today, 35(1), 212-219. https://clok.uclan.ac.uk/13607/1/13607_Hahn_The%20participants.pdf

Itzhaki, M., Bluvstein, I., Peles Bortz, A., Kostistky, H., Bar Noy, D., Filshtinsky, V., & Theilla, M. (2018). Mental health nurse’s exposure to workplace violence leads to job stress, which leads to reduced professional quality of life. Frontiers in psychiatry, 9, 59. https://doi.org/10.3389/fpsyt.2018.00059

Lanza, M. (2016). Patient aggression in real time on geriatric inpatient units. Issues in mental health nursing, 37(1), 53-58. DOI: 10.3109/01612840.2015.1086910

Roets, M., Poggenpoel, M., & Myburgh, C. (2018). Psychiatric nurses’ experience of aggression amongst colleagues. Health SA = SA Gesondheid, 23, 1086. https://doi.org/10.4102/hsag.v23i0.1086

Schablon, A., Wendeler, D., Kozak, A., Nienhaus, A., & Steinke, S. (2018). Prevalence and consequences of aggression and violence towards nursing and care staff in Germany—A survey. International journal of environmental research and public health, 15(6), 1274. doi:10.3390/ijerph15061274

Shea, T., Sheehan, C., Donohue, R., Cooper, B., & De Cieri, H. (2017). Occupational violence and aggression experienced by nursing and caring professionals. Journal of nursing scholarship, 49(2), 236-243. doi: 10.1111/jnu.12272 .  Violence And Aggression In Mental Health Nursing Practice Example Paper