1 copyright © 2011 by mosby, inc., an affiliate of elsevier inc. chapter 17 personal workplace...

1Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Chapter 17

Personal Workplace Safety


Workplace Violence

Nurses have a right to a safe workplace Workplace violence ranges from offensive or

threatening language to homicide


Perpetrators of Workplace Violence

Strangers Clients (patients) Co-workers Personal relationships


Risk Factors Leading to Violence

People under the influence of alcohol or drugs Working understaffed Long waiting times Overcrowded waiting rooms Working alone Unlimited public access Poorly lit corridors, rooms, parking lots Contact with public Exchange of money Working in community-based settings Hospitalized prisoners Isolated work with patients during exams and treatments

(Tomey, 2006)


Maintain Behavior That Helps Diffuse Anger

Present calm, caring attitude Do not match the threats Do not give orders Acknowledge the person's feelings (e.g., "I know you

are frustrated") Avoid any behavior that may be interpreted as

aggressive (e.g., moving rapidly, getting too close, touching, or speaking loudly)


Be Alert…..

Evaluate each situation for potential violence when you enter a room

Consider staff members, patients, or visitors to have a potential for violence

Be vigilant throughout encounters Do not isolate yourself with a potentially violent

person Always keep an open path for exiting—do not let the

potentially violent person stand between you and the door


Take these steps if you cannot diffuse the situation quickly….

Remove yourself from the situation Call security for help Report any violent incidents to management


Conflict Resolution Techniques

Avoiding—If you avoid the problem, you can trick yourself into believing that there is no problem.

Withholding or withdrawing—In this situation, one party removes themselves from participation in a solution; this does not resolve a conflict.

Reassuring—Parties do not withdraw but try to make everyone feel good. In this situation, reassuring strategies are used to diffuse strong conflicts; this may be a way of hindering open communication.

Accommodating—This is often used in vertical conflict when there is a power differential. It may also be used when one individual has a vested interest in a solution that may be relatively unimportant to the other individual.


Conflict Resolution Techniques (Cont’d)

Competing—This is an assertive strategy where one individual’s needs are satisfied at another’s expense.

Compromising—This strategy is when both individuals play a part in the decision. It is a basis of conflict management.

Confronting—Individuals will speak for themselves in a way that the other individual hears the concern.

Collaborating—Parties work together to find a mutually beneficial solution.

Bargaining and negotiating—This involves both parties in a back-and-forth discussion to reach a level of agreement.

Problem-solving—The goal is to find a workable solution for all parties.


Horizontal Violence in the Workplace

Horizontal violence is an act of aggression towards another colleague

May be verbal, emotional or physical abuse Can be belittling, withholding information or

excluding a colleague from a group activity This type of behavior can occur between

physicians and nurses as well


Vertical Conflict

Vertical conflict relates to differences between managers and their staff


How can you manage vertical or horizontal violence???

Observe for verbal and nonverbal cues in behavior Name the problem when you see it and use the term “horizontal

violence” Discuss horizontal violence at staff meetings; help break the

silence Be responsive when issues are brought to your attention Engage in self-awareness activities to ensure that your

leadership style does not support horizontal violence Provide staff training about conflict management skills Empower others to defend themselves against bullying


Sexual Harassment

Sexual harassment is a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964.

It is defined as unwelcome sexual advances, request for sexual favors, or other verbal or physical conduct of a sexual nature when this conduct explicitly or implicitly affects an individual’s employment, unreasonably interferes with an individual’s work performance, or creates an intimidating, hostile, or offensive work environment (The U.S. Equal Employment Opportunity Commission, 2009)


As a nurse or a nurse manager….

Develop a culture where violence is not tolerated Incidents should be promptly addressed and

managed Comprehensive support for coworkers who

experience violence should be provided Advocate for enforceable violence management

policies in the workplace and hold others accountable for their behavior

Participate in educational training Mentor colleagues on how to respond to incidents


Violence: Occupational Hazards in Hospitals

OSHA has identified 8 essential components for a violence prevention plan:1. Management commitment2. Employee involvement3. Work site analysis4. Prevention of hazards5. Training and education6. Prompt recognition, control, and monitoring7. Record keeping8. Evaluation


Impaired Employees

7% of nurses in the United States are impaired by alcohol or drugs (ANA, 1998)


Common Job Performance Changes of the Chemically Impaired Employee

Difficulty meeting schedules and deadlines Illogical or sloppy charting High frequency of medication errors or errors in judgment

affecting patient care Frequently volunteers to be medication nurse Has a high number of assigned patients who complain that their

pain medication is ineffective in relieving their pain Consistently meeting work performance requirements at

minimal levels or doing the minimum amount of work necessary Judgment errors Sleeping or dozing on duty Complaints from other staff members about the quality and

quantity of the employee’s work


Common Time and Attendance Changes of the Chemically Impaired Employee

Increasingly absent from work without adequate explanation or notification; most frequent absence on a Monday or Friday

Long lunch hours Excessive use of sick leave or requests for sick leave after days

off Frequent calling in to request compensatory time Arriving at work early or staying late for no apparent reason Consistent lateness Frequent disappearances from the unit without explanation


Employee Assistance Programs

EAP services provide counseling to employees and their families for the following: Personal issues Job stress Relationship issues Eldercare, childcare, parenting issues Harassment Substance abuse Separation and loss Balancing work and family Financial or legal Family violence

1 copyright © 2011 by mosby, inc., an affiliate of elsevier inc. chapter 17 personal workplace...

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