Controlling Violent Health Care Patients Term Paper

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[. . .] Taking the perspective of the physicians acting as employers, they can well assess the number of risk factors; both the obvious as well as those appear from time to time. Having assessed the nature of the various risk factors, it is for the physicians to develop necessary strategies through the adoption of adequate policies, procedures all aimed at primarily preventing, and in the case of the dispute or conflict having already risen, or ensued, intervening to address and end it effectively (Lipscomb 1999).

One of the most important strategies to be adopted by the physicians as employers should be to keep the line of communication duly open between himself or his management and their employees with a focus on reporting of events as and when they occur. This would allow the management in general, and the physician in particular to take immediate action, and effectively end the conflict or dispute that may risen from the fault of either the patient, his family of the staff of the health care institution. Then, there is the element of allowing the staff to take full advantage of the requisite holidays and days off, allowing the employee to come in and engage in his or her work with a fresh mind, instead of making or forcing him or her to overwork, in turn creating conditions more adverse for all concerned than a truly amiable working environment (Lipscomb 1999).

For the employees, including nurses and their aides, adequate training, and learning to control their anger and limitations of their patience can also serve to greatly reduce any chances of violence, as they will be more than prepared to handle conditions of violence and patients acting out their grievances and problems respectively.

The surrounding environment of the health care setting too offers and alters behaviors amongst the patient populations, and setting that include a pleasant, comfortable waiting areas; adequate and properly ventilated seating arrangements; access to restrooms, refreshments and telephone facilities all not only serve to create a truly comfortable setting for the patients, the same also tend to create a neighborly environment with the patients and their families least likely to indulge in any hostile or violent acts. (Lipscomb 1999).

Identifying and Controlling Violence in Employees

According to the survey carried out in the United States by the Bureau of Labor Statistics (BLS), and duly confirmed by the National Institute for Occupational Safety and Health (NIOSH), workplace assaults continues to lead as the number two cause of all fatalities, with an average of 20 workers being murdered, and more than 18,000 employees being assaulted every week. These statistics are more than sufficient evidence as to the nature and extent of violence at the workplace, and the following part of the paper will strive to identify some of the factors that become or are a cause for large scale fatalities and casualty amongst the nation's workforce, as well as suggest some controlling measures to curb, and possible limit the expansion of these statistics, and precious lives (Nabb 2000).

A general concept of violence is construed be physical violence, whether at the workplace or at home. Yet, violence could be applied to a number of other acts including but not limited to verbal abuse, threatening behavior, intimidation, and physical assault at the workplace. A broader explanation of each reveals that verbal or written threats could include any expressions with the intention of harming or inflicting harm; threatening behavior may include such acts as showing fists, or the more physical forms such as destruction of other individual's property, or simply throwing the other individual's objects; intimidation, or harassment may include such acts as all behaviors that are meant to embarrass, demean, humiliate, annoy, alarm, or even verbally abuse the other individual including but not limited to bullying, annoying gestures and verbal abuses; and physical attacks can include kicking, pushing, shoving or even hitting the other person.

Some other examples of workplace violence can include such acts as murder, rape, arson, anger related incidents, causing psychological trauma, physical assaults, sabotaging property, vandalism, or as simple acts as swearing and using prank language. (Nabb 2000).

Yet another important aspect in the identification of workplace violence is that it is not the workplace alone that is witness the violence, as work related violence's can also occur at such places as off-site business related functions, conferences, trade shows, or even social events that are some how or the other related to work.

Factors That Give Rise to Workplace Violence

Having briefly discussed the nature of violence at the workplace, and work-related violence, it is imperative to present some of the salient factors that tend to increase as well as initiate violence at the workplace. These may include such factors as employees working during the intermediate periods of organizational change such as strikes and downsizing; working as a taxi-driver; working in health care institutions for example hospitals, social workers and those community workers assigned to visit homes as part of their community work; working in isolated environments such as highway petrol pumps, storage go-downs, and utility rooms; working in locations where alcohol is served such as food and beverage outlets; working with mentally ill or unstable patients such as hospitals, penitentiaries and prisons; working with the public; and working at places where cash, or other valuables, or even drugs are handled, such as cashiers or pharmacists (Simonowitz 1996).

Yet another set of factors that can give to increasing violence at workplace may include late hours, tax return seasons, at the time of performance appraisals; pay days, and important holidays such as Christmas.

Controlling/Preventing Violence at Workplace

One of the most sought after strategies adopted by numerous professionals and management experts alike in controlling and/or preventing violence is provided in the management's commitment, and approach adopted for employees. This commitment is perhaps best exhibited in a written policy statement outlining the primary objectives, aims, and most important of all the responsibilities assigned to each employee, either through an independent contract, or through an agreement with a group of employees (Yody et al. 2000).

Some of the features that should constitute a part of such a written policy may include making a commitment for a regular monitoring and review of the organization's policy; offer employees such incentives as an 'Employee Assistance Program' that can allow the employee to freely discuss and come forward for seeking advice or help for a personal problem; making a commitment for providing support services and assistance in times of violence against the employee; ensure as to how information about any potential risks of violence can be averted; providing assurances with respect to reporting of violence by co-workers or senior employees; providing that no reprisals will be taken when reporting any violence; and most important of all explicitly stating the conditions and consequences when any threatening behavior is adopted or acts of violence committed (Southcott & Howard 2002).

In discussing measures for the prevention of violence at the workplace, with a focus on the employees, it is a general notion that since violence can be predicted, the same can be prevented as well, hence the above set of measures mentioned in the preceding paragraphs. However, there are conditions where violence prevention calls for an altogether different set of strategies including for employees working if far off locations. These prevention strategies can include such activities on the part of the management as keeping a daily roster and keeping a contact person informed about the whereabouts the employee in the field; using/providing a cellular phone enabling the employee to remain in constant touch with headquarters; or if the employee is assigned at a sensitive location, he or she must be provided with adequate protective equipment, devices and if need be arms. (Southcott & Howard 2002).

From the administrative perspective, the employee should be accompanied with other equally able employees, thus reducing the chances for the employee to work alone and inviting violence; and provision of security escorts for late night or early morning workers and keeping the primary working area with suitable lighting arrangements to ward off possible intruders (Yehuda 1999).

From the above, it is thus evident though the principles, strategies and acts at preventing violence at the workplace differ according to the workplace, so do the requisite policies and effective measures for controlling the same. A combination of these measures, some of which have been mentioned in the above paper, thus each measure however effective and practical that may be, entirely depends upon the respective organization and the relationship with the employees. Hence, the best strategy is one that reduces the risks of violence as well as provides maximum set of preventive measures, in turn providing for an ideal working environment.

References

Erickson L. Williams-Evans SA. Attitudes of emergency nurses regarding patient assaults. J Emerg Nurs. 2000; 26(3):210-215.

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