Violence and Aggression in the Workplace: a Practical Guide for All Healthcare Staff PDF
Preview Violence and Aggression in the Workplace: a Practical Guide for All Healthcare Staff
Violence and Aggression in the Workplace A practical guide for all healthcare staff Paul Linsley Senior Lecturer in Nursing The Faculty of Health, Life and Social Sciences The University of Lincoln Foreword by Professor Dame June Clark Radcliffe Publishing Oxford Seattle • CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2006 by Paul Linsley CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20160525 International Standard Book Number-13: 978-1-4987-9992-8 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are per- sonal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. 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Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword iv Preface v About the author vi Acknowledgements vii 1 Violence and aggression 1 2 Theories of aggression 15 3 Managing violence and aggression: risk reduction and prevention 25 4 Managing an aggressive incident 45 5 Staff support 79 6 Special considerations: care in the community 95 7 Special considerations: gender, violence, health and healthcare 103 Julie Dixon, edited by Paul Linsley 8 Special considerations: legal issues 119 Index 131 iii Foreword The first time it happened to me I was stunned. It was just so unexpected. I was a newly qualified health visitor, working in a 'nice', middle class area, visiting a 'nice' family with a new baby in the middle of a Monday morning. I didn't expect the 'eyeball to eyeball' tirade from the smartly dressed father about how health visitors were nosey government spies and anyone who worked in the public sector was a lousy parasite on the nation's economy. I wasn't physically hurt, but I was certainly shaken, and it affected my practice as a health visitor for quite a long time. So I was delighted to read this book, and I commend it to you. In those days violence and aggression were expected only by those working in acute psychiatric settings, or big city accident and emergency departments, or as community nurses in 'tough' areas. Nowadays we know it can happen to any health worker, any place, any time, and all of us need, like the boy scouts, to 'be prepared'. This is not a book to be carried around in the back pocket and whipped out in an emergency. It ought to be read by everyone during their initial preparation, used during CPD and in-service education, and kept handy for reference. I would have also found it helpful to read afterwards, to help me better understand what had happened and why, and to come to terms with it. Professor Dame June Clark DBE PhD RN RHV FRCN Professor Emeritus University of Wales Swansea May 2006 iv Preface The following book is aimed at all healthcare staff that may have cause to come into contact with the patient or their family, including reception staff and those that deal with complaints. It is designed to reflect good practice which is in use throughout the NHS and other organisations to help protect healthcare staff from the risk that is violence and aggression. While the book aims to be as com prehensive as possible, such work cannot cater for every situation that may or may not occur within a working environment. As such the book should be used as a reference source and general guide only. Specific interventions and procedures will be provided by individual employers, and these should be adhered to in the event of an incident occurring. The author has been keen to avoid the word victim, as this implies a degree of helplessness, and would instead ask the reader to replace this with the word target, as this better describes the role in which the individuals find themselves as part of the assault process. Within each chapter there are a number of differ ent types of information and activities that are highlighted within the text. This includes keywords and concepts to help structure thinking and understanding around the topic. Paul Linsley May 2006 v About the author Paul began his career as a general nurse working within acute medicine. Following conversion to mental health nursing he gained valuable experience in a variety of clinical settings, and is a nurse specialist within acute mental health care. He has held a number of managerial and educational posts, teaching on a number of courses for the University of Nottingham, and now works for the University of Lincoln as a Senior Lecturer in Nursing. In addition to this Paul sits on a number of national forums for the Royal College of Nursing as well as being a nurse advisor to the Department of Health. He has had a number of articles published and is actively involved in the research of violence and aggression within the healthcare setting. Chapter 7 of this book was written by Julie Dixon who is health lecturer with the University of Nottingham, teaching mental health and gender theory. She works within a life-course perspective, and her current research and interests focus around women as recipients and providers of healthcare, particularly with regards to those suffering from a mental disorder. She teaches on a number of modules that explore the relationships between gender, the family and health, as well as being involved in a number of outside agencies seeking to promote equality within healthcare service provision. vi Acknowledgements Thanks to Vicki, Andrew and Adel for their continued love and support. Thanks also to Rodney, Andy and Carol for their friendship and encouragement. I would also like to acknowledge the help of Julie and Jan in putting this book together. vii TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk Chapter 1 Violence and aggression Introduction The level of violence and aggression against healthcare staff has become an 1 important issue in recent years. Indicators would suggest that anyone who works for the health and social care sector and who has contact with the general 2 public is at risk from such behaviour. This is not a new problem and reflects wider concerns about violent crime in society generally. More and more healthcare staff face the prospect of violence and aggression in the workplace, not only from the people that they care for, but from strangers and within families. 3 People who behave in ways that bring them into conflict with others make 4 special demands on a service and its staff who are already under pressure. Violence and aggression raise special concern because they significantly increase the risk of injury and harm. This can have an impact on staff confidence and morale as well as patient care. Threats, aggravation and tension caused by potential aggressors can lead to stress-related problems, emotional burnout and result in some staff leaving the service altogether. 5 Appropriate interventions from healthcare staff are crucial to the immediate 6 physical and psychological safety of themselves and those that they care for. As with other risks, reducing violence and aggression requires a systematic approach involving a number of strategies. Measures to reduce violence and aggression need to be based on sound risk assessment and risk management, underpinned by effective strategies worked out in collaboration with other 7 agencies such as the local police department and prosecution service. Defining violence and aggression One of the difficulties in addressing violence and aggression is that they are not easy to define.3 Violence and aggression are subjective terms that mean different things to different people and groups. This means that the same kind of violent incident may have quite different impacts according to the individual involved. Because of this, healthcare organisations and staff groups have defined violence and aggression in different ways for different purposes. However, in order to recognise, address, and prevent violence and aggression, healthcare staff must have a clear understanding as to what these terms mean. This requires a description that encompasses the different forms that violence and aggression can take, while allowing for personal interpretation and understanding. In doing this, it allows staff to take ownership of the problem and goes some way to acknowledging their concerns. 1
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