You think women are abused, right? Well, you haven’t thought about nurses!
The extent of the havoc: 90% of nurses have experienced work-related violence and abuse
For every nurse I have ever come across, there is a story of abuse or violence or both. Actually, personally, I have been abused for a thousand times! And this is no surprise for so many studies reveal that violence is higher in healthcare settings than in any other field on this planet. To be clear, the Emergency Nurses Association in USA reported that workplace violence in the healthcare setting is 3.8 times higher than all private industry, and that the emergency department is a particularly vulnerable setting (Emergency Nurses Association, 2008; Gacki-Smith et al., 2009). And you know what! I in emergency department.
Some statistics make it clear that nurses are prone to abuse and violence 12 times more than other professionals do. In his 2017 article now published on the conversation, author Jacqui Pich, a nursing lecturer in Sydney wrote; “Nurses are exposed to high levels of physical and verbal violence, to the point where this has become an expected and even accepted part of their job. She goes on and narrates; “worldwide, nurses are more likely to be attacked at work than prison guards and police officers. And yet such incidents remain under-reported and existing protections are not enough to ensure the safety of nurses and their patients.”
Some research reports of abuse and violence of nurses
A study by Lead author Dr Rose Chapman found out that “three out of four nurses have experienced violence while at work, and 9 out of 10 have suffered verbal abuse.” (Australia). Every place on this planet reports abuse and violence against nurses, including best places like Canada and Scandinavian countries.
In a study of about 121 nurses, researchers Asmaa Alyaemni and Hana Alhudaithi found out that 89.3% nurses had experienced some form of violence in just one year and 74.1% of the total violence was verbal abuse (that is 2016 in Saudi Arabia). The same study indicated that violence was associated with both gender and education level in which case males and lowly educated were more abused than their counterparts were. Patients and their caretakers were leading the list of abusers. In other studies, fellow health workers, and especially doctors were among the major abusers. In Iran, a study had been done on 1,317 nurses in 2008 and results were the same; 87.4% had experienced verbal abuse (Mahnaz at al., 2008).
While we always have the issue of ‘no data’ here in Uganda, some Ugandans did some job on work-related violence. Yes, researchers Lydia N. Wandera, John F. Mugisha, and Simon P. Katongole (by the way, the last two guys were my lecturers during my Bachelors degree at Uganda Martyrs University) did a study on work-related violence and revealed that more than 63% had experienced verbal abuse, physical abuse (31.6%), and 30.5% (tribal harassment).
Other forms of abuse are; emotional, sexual, and even gender-based. While their study had looked at general health workers and some hospital managers, they at least made it clear that nurses were the leading victims.
No one does anything about nurses’ abuse
And here is the surprising and annoying thing about it; all studies revealed that victims never find justice (in other words, nobody does anything about it). For example, in the first study (Saudi Arabia), more than 72% reported that nothing was done about their abuse (isn’t that almost all nurses? Remember, about 89% had been abused).
In the Iran study, the researcher is quoted saying; “the majority of cases reported that abuse was followed by either inaction or by actions which failed to satisfy the victim.” For God’s sake, that is the whole truth about violence and abuse against nurses.
In my practice, I have seen violence and abuse and their ‘children’ and ‘grandchildren’. I see doctors barking (I wanted to use the word ‘vomiting’ instead of barking but I remembered that would be some form of abuse) at their fellow doctors (mostly the interns). I see matrons (these are the worst) abusing and scrapping fellow staff as if they were the masters and the others are their slaves.
Up to now, there are nursing managers who do not know how to correct a wrong nurse without shouting about it all-over the ward or corridors. During my nursing college times, there were doctors who would even slap, forcefully pull nurses (both staff and students) and I think there is still slapping in that hospital (I am not sure about this).
The reaction to violence and abuse
As has been put up by the above researches, most hospitals do not have protocol to reduce violence and abuse and therefore there is nowhere to report such cases. And even if you reported, seriously who cares about a nurse being abused?
Considering my experience, I have never seen a senior nurse or matron or leader standing in to defend a nurse being abused by a doctor, a patient, a hospital administrator, or anyone; all they (nurse managers and leaders) do is to abuse, send off, or punish the already abused nurse (especially if this nurse is a student or young or has a low level education or, for my case, is a woman).
Yes, while many reports show that male nurses are more abused, I have seen the opposite in all my practice (in other words, if I have been abused a thousand times, female nurses have been abused twice as much!)
But what do nurses and midwives do when abused?
According to many studies I searched through, nurses respond by not doing anything, pretending that nothing has happened, telling a colleague, simply asking the perpetrator to stop, crying it off in a closed room or at home, and just taking time off or quitting the job, and reporting to supervisors.
All studies agree on these issues; nurses and midwives rarely report abuse and violence, no one does anything about abuse of nurses, and many nurses respond to violence and abuse by just swallowing it, accepting that it is part of the job and pretend everything is fine.
Reasons for not reporting; it is not important, felt ashamed, afraid of negative consequences, useless, nowhere to report to, felt guilty
This (inaction on violence) is so despite the same studies revealing that actually most of them later suffer emotional and psychological distress, quit jobs, or even lose lives for harsh physical violence involving guns and knives.
The consequences of violence and abuse of nurse
Besides the impacts of emotional and psychological distress, wounds, fractures, and even death, job quitting, and poor productivity and hating the profession, there is another serious consequence; poor management of patients resulting in death, accidents (both of drug errors and falls), and general poor customer satisfaction.
A study by Roche M. and friends (2007) in Sydney reported a perfect link between abuse of nurses and terrible patients care. As a nurse, this does not surprise me at all; how do you expect good care after a doctor or a patient or a caretaker or hospital administrator has pulled my hair? Really, let us be serious: Some managers abuse or mistreat a nurse or ignore to take care of her issues and yet these same managers expect good work from this same abused nurse! Isn’t it crazy?
NB: The above reminds me of the recent managerial proposition president had moved. According to president Museveni, district commissioners (called RDCs) and other chief executives should monitor nurses and doctors and report any misconducts. This was a joke, according to me. I mean, how do you expect a nurse to perform well when a guy with a gun or a stick is standing on top of her? Why would a nurse not, intentionally, give a wrong drug or at least introduce an infection during a procedure on a patient whose caretaker says he will shoot her brains out if she does not do the work? You are joking. Anyway, I do not know how far we are with this.
Way forward on work-related abuse and violence for nurses
The Uganda-based study came up with these recommendations; working on policies and committees within institutions to handle violence and abuse, training health workers on violence and abuse and their rights, putting in place community mechanisms and deliberate measures to deal with abuse, and coordinating these works with stakeholders, including individuals, police, community, and hospitals.
I personally agree with the above suggestions. If it really concerns us as nurses and management, then we should be practical and put in place some small institution-based policies on violence and abuse of nurses. These policies can be designed with details of what violence and abuse is, where to report, what to be done, and the general ways nurses and midwives can avoid or deal with violence in their workplace.
But instead of our leaders looking at these serious issues, they are busy quarreling over untied belts, open shoes, nurses missing head-capes, walking styles, and maybe the hair styles. Of course, these issues are relevant and can actually influence violence and abuse, but we can do more; act now.
What do you think? Have you ever experienced violence? What did you do about it? Share your story in the comment section below or simply write to thecompletey@gmail.com
