Sep 28, 2017

Verbal Aggression: The Patient And The Nurse

Aggression of any kind will undoubtedly have a negative effect on the person who is receiving it.

And though nurses are in a position of care, they too often are the victims of their patients’ aggressive behaviours.

Almost every nurse has experienced it at some point in their career – they try to do their job, caring for a patient, and then that patient loses it at them; yelling, screaming, calling them names.

And this doesn’t just happen to nurses – it occurs to aged care staff, carers and other health care workers.

Though the patient might be in a great deal of pain, or simply frustrated at their condition and treatment, there is no justification for the suffering the nurse is put through by the abuse.

A new research by Birmingham City University has suggested that exposure to targeted, personal and verbal aggression by patients can adversely affect nurses.

Looking particularly at mental health nurses, it’s already known that exposure to physical aggression and self-harm can have negative consequences on nurses in regards to staff trauma.

But this latest research suggests that nurses who are subject to humiliating personal remarks experience higher levels of distressing emotions, including anger.

Led by Dr Rahul Jalil, the study rigorously assessed the nurses working at three different secure mental health units in the UK.

“Nurses who reported being the target of derogatory remarks reported higher levels of anger than their colleagues. What’s more, this was not true for those who had witnessed greater levels of physical aggression or self-harm,” said Dr Jalil.

Dr Jalil’s research suggested that aggression may even have an influence on the nurses’ decision-making processes, “the same nurses who experienced humiliating remarks were more likely to endorse coercive management techniques, such as restraint or seclusion.”

However, it should be noted that while individual nurses exposed to this behaviour were more approving of coercive interventions, this did not translate into an increased use of restraint or seclusion.

Professor Geoff Dickens, was the study supervisor and is a Professor in Mental Health Nursing at Abertay University.

“We already knew that exposure to aggression seems to be related to nurses’ approval of these less desirable interventions. What this study adds is that it is this particular type of insidious and seemingly less severe form of aggression that seems to play the largest role.”

Professor Dickens added that this has real implications for education and training for staff in the prevention of violence and aggression.

“Training provision largely focuses on managing physical aggression through techniques such as de-escalation. While this is great, more attention should be paid to how nurses regulate their own responses to this behaviour.

“This study shows that anger seems to be a mechanism that plays a unique role. While it is common to hear that nurses should ‘just deal with it’, it is unreasonable to believe that nurses are immune and can do this without help or support.”

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  1. This type of abuse is also happening within the homecare setting, as a community care manager we are now receiving this not from elderly client but from very demanding families with very demanding expectations. This also has a negative effect on how we deliver our services to our clients, this culture seems to be very much accepted within the HSE and there is little support in place to support homecare agencies. This week alone we logged 26 calls from 1 family member with all sorts of demands , HSE informed but no response, where does it end, it’s no wonder there is no carers out there opting to work in homecare, it’s a very troubled sector at present.

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