Driving Change in Nursing Professional

Driving Change in Nursing Professional

Introduction to the problem

Nurses among other health care employees largely encounter physical injuries and assaults, and verbal abuses while frequently trying to help the patients. According to OSHA, one in four nurses faces violence while protecting and helping patients in the hospital alongside other healthcare workplaces across the country, such as nursing homes. Violent behaviors resulting from the patients, visitors, as well as coworker cause a hostile working environment and causes the nurses to experience emotional trauma and physical injuries. More than 2034 injuries were reported in one hundred and twelve health facilities across nineteen states between 2012 and 2014, data that was gathered by OSHA (In Solheim et al., 2016). Acknowledging as well as preventing such form of violence in the nursing professional should become paramount for the state legislator, nurses as well as health organization (Palumbo et al., 2011). This can be prevented and decreased through nurses speaking with their team in developing procedures and policies for reporting violence related cases that need immediate remediation and action.  Violence in nursing professional has impacts on the health of the nurses since it decreases mental health, general health and vitality scores as indicated by nurses who experience threats. Some of the violence leading to psychological distress regarding verbal sexual abuse and bullying. This forms of violence are harmful to the health of nurses and as a result affects their life, such as family life and social life. Negative effects of physical abuse, physical assault, and injuries and verbal abuses are detrimental to the productivity of a nurse.

Evidence-based intervention

The nursing professionals need to work as an interprofessional team toward recognizing the moment when a patient, visitor, or coworker is moving toward a crisis, in which they are within the disaster continuum, and uses interventions that reduce the response of a patient, coworker, or other individuals to traumatic or stressful events. The crisis continuum entails four stages, where each has interventions that are useful in de-escalating negative consequences. Firstly, there is normal anxiety and stress level in stage one. In stage 2 there is increasing anxiety level. Both stages one and two, the demeanor and words of the nurses can neutralize tension; the nurses should be aware of their body language, choice of words, and tone of voice when responding to an individual in a crisis such the visitors, co-workers, patients among others.

Stage three entails a severe anxiety as well as stress with the person depicts signs loss of abilities to solve problem and loss of self-control. Interventions that are verbal and non-verbal are effective at this level and the concentration on the needs of turning to protect oneself as well as others around you (Yassi, Gilbert & Cvitkovich, 2005). The nurses need to enlist the assistance from others, such as security personnel and be prepared to apply their panic device. Restrict-setting techniques, for instance limiting the patient to a certain area, can be of help in this scenario.

Stage four consists of a crisis with the person who is out of control. A person in crisis is insensitive to non-verbal as well as the verbal intervention; the individual cannot fathom correctly or clearly, cannot communicate their concerns and needs, and shows the threat, anger, and fear. The nurses should make sure their safety and the safety of other is enhanced.  If the situation turns out to be worse to a level that any restraint is needed, then the nurses should be careful to follow the procedures and policies of the organization while applying any chemical of physical restraint to hold the person.

Analyze potential barriers and resistance to change

Upsetting behaviors by others nursing professional or coworkers, whether they are other health employees or nurses may tend to become unreported since the affected persons feel that their recourse of options is limited (Miranda et al., 2011). This do happen particularly when the target of violence sees the perpetrator as possessing more authority. On the course of considering violence between the nursing professional, there is a problem of differentiating an incident of violence at the workplace and a separate event that be as well described as character conflict. Despite the fact that the interprofessional violence can be a one-time thing, it often turns out to be a constant as well as persistent electronic or verbal abuse of the interprofessional team.

Another barrier and resistance to the before-mentioned interventions within the interprofessional team are threatening behaviors, these form of actions in a nursing field adversely influence the safety as well as the care of a patient. These forms of intimidating acts entail the physical threat and outburst alongside massive undertakings such as declining to carry out assigned task or quietly demonstrating ant-collaborative attitudes at the time for routine activities. This kind of resistance is the main reasons and roots for violence among the interprofessional team such as the peculiar of healthcares culture (Miranda et al., 2011). The latter entails a day-to-day alters in a shift, interdepartmental assistance staff, and rotations. All these barriers brought together with the perceived and real constantly changing responsibilities, and roles of the nursing professional bring a difficult setting and environment for effective interprofessional team building and communication concerning violence.

Evidence-based solutions

The nurses should be encouraged to become more proactive in preventing violence at the place of work through volunteering to take part workplace violence prevention interprofessional teams and taking part in prevention training given by the organization. They should also become familiar with the policies and programs for prevention of violence at the place of work.  They should also report all events including those witnessed.

Prevention of violence committed by patients entails recognizing the risk present in certain regions within the place of work, for instance, moveable furniture, the configuration of room and tools appropriate for use as a weapon can help the nurses in making a personal prevention plan. During last risk times within a day, such as medication period, changes in shift, and meals must also entail in the individual prevention program. Upholding a mindfulness of non-verbal and verbal behaviors shown by the visitors and patients within an immediate scope in very crucial in stopping violence at the place of work (Miranda et al., 2011).  This is because a huge number of patients, coworkers, and other individuals give warning signs before carrying out an act of violence at the health facilities, for instance, verbal expression of frustration and anger or nonverbal intimidating gestures.

Nursing professionals carrying out their duties and responsibilities within non-institutional environments, for example, home health care providers, have extra risks related to an individual within the home of the patients as well as neighborhoods with the high rate of crime (Palumbo et al., 2011). A checklist of safety should be filled before the initial visit to the household; this is vital for confirmation that of background check such as the past crime or violence, alcohol, and substance abuse, or mental health cases. This should be completed by the family of patient and patients themselves. Moreover, extra safety policies, measures, and procedures for the OSHA guidelines should be incorporated. For instance, the nursing professionals should be accompanied by a co-worker when a home scenario is a potential risk. It is also important for the interprofessional team to make sure that their team member travels with a cellphone that will enable them to know where the field nurses are, and making use of a code word to let the organization aware of any trouble.

Develop a plan to implement evidence-based interventions

• Publication and adoption of the policy for zero tolerance concerning physical injuries, violence, harassment and threat in the place of work.  Fostering respectful setting within the interprofessional team through consideration of law enforcement outreach and community and Training of law enforcement at the organization.
• Reviewing and updating of background checks to highlight in the form of potential problem that may be faced by nurses. Conducting background check for the patients, visitors, and coworkers.
• Preparation and utilization of release forms for personnel records from the past of patients, visitors, co-workers and other workers, also records for a criminal conviction.
• Updating of personnel policies alongside the worker’s handbook to incorporate safety policies concerning violence at the place of work.
• The organization to review with the interprofessional team the procedure they use to screen the patients, visitors, and other workers for potential violence problems at the place of work.
• Carrying out a periodic audit of security as well as risk assessments of healthcare. Provision of enough security consisting of accessing control in places such as common areas and reception among others.
• Preparation of inclusive crisis management plan that entails prevention programs for nursing professional through consideration of a prepared and distributed list of entire local emergency agencies. Carrying out an assessment of hazard within the organization and placing of crisis kits.

References

Yassi, A., Gilbert, M., & Cvitkovich, Y. (2005). Trends in Injuries, Illnesses, and Policies in          Canadian Healthcare Workplaces. Canadian Journal of Public Health / Revue            Canadienne De Sante’e Publique, 96(5), 333-339.

Palumbo, M., Mclaughlin, V., Mcintosh, B., & Rambur, B. (2011). Practical Nurses’ Health And Safety In Nursing Homes. Journal of Health and Human Services Administration, 34(3),         271-301.

Miranda, H., Punnett, L., Gore, R., & Boyer, J. (2011). Violence at the workplace increases the    risk of musculoskeletal pain among nursing home workers. Occupational and         Environmental Medicine, 68(1), 52-57.

In Solheim, J., & Sigma Theta Tau International. (2016). Emergency nursing: The profession,        the pathway, the practice.