Introduction
Registered Practical Nurses (RPN) are at a high risk of experiencing violence in the workplace as they are often the first point of contact for patients and clients. Workplace violence has become a growing concern in the healthcare industry as it can significantly impact healthcare workers’ well-being. The threat of workplace violence can happen to anyone, and it ranges from verbal abuse to physical assault. The purpose of this paper is to explore the issue of workplace violence in the context of the RPN practice. The paper will examine the contributing factors, consequences, as well as strategies for prevention and management, with the ultimate goal of promoting a safe and healthy work environment.
Definition of the Topic: Workplace Violence
Workplace violence is a complex and multi-faceted issue that affects all healthcare workers. Workplace violence refers to any conduct, threat, abuse, or action that can cause danger or harm to a worker. Some examples of workplace violence in the healthcare setting include threats, bullying, harassment, intimidation, verbal abuse, and physical assault. Workplace violence threatens the safety and well-being of all healthcare workers. Compared to other healthcare professionals, nurses are at a higher risk of workplace violence as they are often the first point of contact with patients (Al-Qadi, 2021). While caring for patients, they may be exposed to clients who are mentally unstable, aggressive, or in crisis.
Workplace violence is an increasing concern in healthcare. Statistics show that the severity and frequency of workplace violence in healthcare settings have been increasing (Dadfar & Lester, 2021). Workplace violence affects the physical and emotional being of all affected parties. According to Dadfar & Lester (2021), workplace violence can cause increased job stress, anxiety, PTSD, job dissatisfaction, occupational burnout, and absenteeism. It also affects the patient’s outcomes and safety as it can cause clinical and therapeutic errors and affect the nurse-client therapeutic relationship. Because of this, all stakeholders must create a healthy and safe workplace with zero tolerance for violence.
Contributing Factors
The causes of workplace violence are complex and can sometimes be difficult to identify. However, some common contributing factors include job stress, personal stress, alcohol and substance abuse, and conflicts with coworkers or supervisors. In some cases, workplace violence can be escalated by environmental factors, such as workplace layoffs, financial difficulties, and community violence (Pagnucci et al., 2022). According to the College of Nurses of Ontario Practice Guideline: Conflict Prevention and Management guideline, the client’s mental or physical state is a significant contributing factor to nurse-client conflict (Conflict Prevention and Management – Practice Guideline (CNO) | Long-Term Care Best Practices Toolkit, 2nd Edition, 2018). For instance, patients who are intoxicated, fatigued, anxious, or have a history of aggressive behavior are more likely to be violent.
The PRN can also contribute to the escalation of workplace violence through communication. For instance, a nurse who does not communicate effectively with the patient may aggravate the patient and increase the risk of conflict. In other cases, nurses who judge, label, or misunderstand a patient may escalate workplace violence. Other communication mistakes that may contribute to workplace violence include the use of threatening tone, gestures, or body language (Wirth et al., 2021). Nurses who lack cultural competency may have incorrect perceptions of cultural differences or fail to identify language barriers, thus contributing to conflict. Furthermore, the PRN can contribute to workplace violence if they do not listen to the concerns of the family or fails to provide enough health information.
According to the College of Nurses of Ontario (2019) entry-to-practice guidelines, RPNs are expected to have the ability to understand and manage conflict. This makes them a critical component for preventing and managing workplace violence. The consequences of workplace violence are far-reaching and can harm the health and well-being of PRNs. Studies have established that exposure to workplace violence can result in physical injuries, emotional distress, psychological trauma, decreased job satisfaction, decreased productivity, and increased nurse turnover (Liu et al., 2019). Consequently, workplace violence harms patient safety and the quality of patient care.
Strategies for Resolution
To prevent conflict due to workplace violence, the PRN must anticipate conflict and create a plan of care to prevent its escalation. According to Yoder-Wise et al. (2019), the key to preventing conflicts from escalating is by providing patient-centered care. This entails understanding and respecting the needs and perspectives of patients and their families. Additionally, nurses can use communication strategies, such as active listening and appropriate body language, to de-escalate tense situations. At an individual level, the PRN should remain calm and avoid arguing or criticizing the client. If necessary, a nurse may step away from the client or withdraw services to protect themselves and other clients. These strategies will ensure that conflict does not escalate and affect the therapeutic nurse-patient relationship.
Effective workplace violence resolution strategies should include measures such as risk assessments, workplace training and education, and the development of clear policies and procedures. According to the Workplace Violence Prevention in Health Care Progress Report, employers have a key role in promoting safe workplaces. They should provide employees with the training, resources, and support they need to manage conflicts and workplace violence (Preventing Workplace Violence in the Health Care Sector | Ontario.Ca, n.d.). This can include access to counseling and support services, clear reporting procedures, and effective follow-up and resolution processes.
RPNs can use the College of Nurses of Ontario Practice Guideline to access a comprehensive framework for conflict prevention and management in the workplace (College of Nurses of Ontario, 2018). This guideline will help them develop a proactive and strategic approach to prevent workplace violence. They can utilize the online Workplace Violence Toolkit that is available from the Canadian Federation of Nurses Unions website (“Workplace Violence Toolkit,” n.d.). The toolkit provides prevention policies, de-escalation skills, and strategies that can be used to prevent workplace violence and harassment.
Reflection on Learning
Before starting my research on workplace violence, I was already aware that it was a serious phenomenon affecting nurses globally. However, through my research, I have learned the crucial role that healthcare systems and leaders play in preventing workplace violence and supporting its victims. However, I need to learn more about my behavior and values and how they can contribute to workplace violence. I now understand the importance of creating a safe and supportive work environment and the various measures that can be taken to achieve this. As a Registered Practical Nurse, I plan to create a safe and respectful work environment. I will also ensure that I am well-informed about the policies and procedures in place to prevent workplace violence and support its victims. Additionally, I will strive to continually reflect on my behavior and values and make changes where necessary to promote a safe environment for patients and healthcare providers.
Conclusion
In conclusion, workplace violence is a complex and growing concern in the healthcare industry, particularly for Registered Practical Nurses. Exposure to workplace violence can lead to physical injuries, emotional distress, psychological trauma, decreased job satisfaction, decreased productivity, and increased nurse turnover. To prevent and manage workplace violence, RPNs must use communication strategies, such as active listening and appropriate body language. Employers should provide training, resources, and support to their employees. By promoting a safe and healthy work environment, the quality of patient care and safety can be improved while protecting the well-being of healthcare workers.
References
Al-Qadi, M. M. (2021). Workplace violence in nursing: A concept analysis. Journal of Occupational Health, 63(1), e12226. https://doi.org/10.1002/1348-9585.12226
College of Nurses of Ontario. (2019, April). Entry-to-Practice Competencies for Ontario Registered Practical Nurses. https://www.cno.org/globalassets/docs/reg/41042_entrypracrpn-2020.pdf
Conflict Prevention and Management—Practice Guideline (CNO) | Long-Term Care Best Practices Toolkit, 2nd edition. (n.d.). Retrieved February 14, 2023, from https://ltctoolkit.rnao.ca/node/949
Dadfar, M., & Lester, D. (2021). Workplace violence (WPV) in healthcare systems. Nursing Open, 8(2), 527–528. https://doi.org/10.1002/nop2.713
Liu, J., Zheng, J., Liu, K., Liu, X., Wu, Y., Wang, J., & You, L. (2019). Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals. Nursing Outlook, 67(5), 558–566. https://doi.org/10.1016/j.outlook.2019.04.006
Pagnucci, N., Ottonello, G., Capponi, D., Catania, G., Zanini, M., Aleo, G., Timmins, F., Sasso, L., & Bagnasco, A. (2022). Predictors of events of violence or aggression against nurses in the workplace: A scoping review. Journal of Nursing Management, 30(6), 1724–1749. https://doi.org/10.1111/jonm.13635
Preventing workplace violence in the health care sector | ontario.ca. (n.d.). Retrieved February 14, 2023, from http://www.ontario.ca/page/preventing-workplace-violence-health-care-sector
Wirth, T., Peters, C., Nienhaus, A., & Schablon, A. (2021). Interventions for Workplace Violence Prevention in Emergency Departments: A Systematic Review. International Journal of Environmental Research and Public Health, 18(16), 8459. https://doi.org/10.3390/ijerph18168459
Workplace Violence Toolkit: Policies & Resources – Workplace Violence Prevention Policies. (n.d.). Canada’s Nurses. Retrieved February 14, 2023, from https://nursesunions.ca/workplace-violence-toolkit-policies-resources-workplace-violence-prevention-policies/
Yoder-Wise, P. S., Waddell, J., & Walton, N. A. (2019). Leading and Managing in Canadian Nursing. Elsevier – Health Sciences Division. https://books.google.co.ke/books?id=WgoQwwEACAAJ
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