Nursing violent patients: Vulnerability and the limits of the duty to provide care

The duty to provide care is foundational to the nursing profession and the work of nurses. Unfortunately, violence against nurses at the hands of recipients of care is increasingly common. While employers, labor unions, and professional associations decry the phenomenon, the decision to withdraw care, even from someone who is violent or abusive, is never easy. The scant guidance that exists suggests that the duty to care continues until the risk of harm to the nurse is unreasonable, however, “reasonableness” remains undefined in the literature. In this paper, I suggest that reasonable risk, and the resulting strength of the duty to provide care in situations where violence is present, hinge on the vulnerability of both nurse and recipient of care. For the recipient, vulnerability increases with the level of dependency and incapacity. For the nurse, vulnerability is related to the risk and implications of injury. The complex interplay of contextual vulnerabilities determines whether the risk a nurse faces at the hands of a violent patient is reasonable or unreasonable. This examination will enhance our understanding of professional responsibilities and can help to clarify the strengths and limitations of the nurse's duty to care.

Opinions of staff working in workplace-violence-related units on violence against nurses: A qualitative study

The aim of this study was to assess the opinions of staff working in workplace-violence related units on violence against nurses. A qualitative and descriptive design was used. The participants were seven nurses, one biologist, and one social worker who agreed to attend an interview and worked in employee rights unit or occupational health and safety unit. Data were collected from June to December 2017. The interviews were analyzed with content analysis. Four main themes were identified, and the themes were the following: (1) risk factors; (2) reporting of violence; (3) consequences of violence; and (4) prevention and control. In summary, factors related to the patient, the nurse, and the physical structure of the hospital were determined.

Workplace violence against emergency versus non-emergency nurses in Mansoura university hospitals, Egypt

Workplace violence (WPV) against nurses is a common but neglected problem in Egypt. The objectives are to estimate the prevalence and associated risk factors of different types of violence against nurses working in the emergency hospital compared with those working in non-emergency clinics, circumstances of violence, type of perpetrators, and victims' response. This cross-sectional comparative study was carried out at Mansoura University Hospitals, Egypt, during January 2013. The data were collected through the adapted version of a self-administered questionnaire developed by the International Labor Office/International Council of Nurses/World Health Organization/Public Services International on WPV in the health sector. All types of WPV are common among nurses. Precipitating factors for violent incidents identified by respondents are emergency specialty, having work shift, and younger age. Violent incidents result in work dissatisfaction and consequently impair work productivity. Nurses working in emergency hospital experienced a higher level of different types of WPV. There is an urgent need to formulate and implement a policy for dealing with violent events.