Management in Health Care Practice: Workplace Violence and Dealing with Difficult People

Student Name
INSTITUTIONAL AFFILIATION(S) |
Management in
Health Care Practice
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Literature review
Introduction
The continuous change and complexity seen within healthcare environment
challenges to evaluate and develop capabilities to cope with the identified issues strategically.
A strong leader stands out in providing a conducive environment for the development of
nursing professionals along with nurse’s teams. Ideally, in a healthcare facility, leadership
and management functions must be combined correspondingly, considering that leadership
role is recognised by leader’s ability to carry out every management responsibility as well as
leadership role. In literature, leadership is defined as ethical, dynamic and relational process
within people who desire enabling positive change in groups (Fernandes, Araújo & Pereira,
2018). Acknowledging multiple leadership and management concepts along with its
implications for nursing practices is the basic aim behind preparing this literature review.
Along with it, this paper will identify two critical issues like workplace violence and dealing
with difficult people that impacts nursing practices adversely while working in a healthcare
workplace. After reviewing current literature pertaining aforementioned issues and how they
are impacting nursing practices, this paper will analyse potential strategies that can address
the identified issues. For the same, this paper will utilise online credible sources that are
relevant for this study, majorly peer-reviewed articles that can aid in comprehending the
issues from multiple perspectives.
Workplace violence impacts on nursing practices
Workplace violence can be defined as incidents in which employees are threatened,
abused, assaulted or bullied under various circumstances that are related to their job role. This

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may include commuting for the work along with implicit or explicit challenges that effects
safety and well-being of the employees (Boafo, 2018). In present literature, it is been
identified that workplace violence is one of the major issues for the nurses worldwide as the
available evidences reveals that workplace violence rates against nurses have increased
considerably in past few years. Both non-physical and physical forms of violence results in
detrimental impacts on physical as well as psychological well-being of hospital nurses that
consequently reduces the quality of work provided by them. Alongside, many qualified
nurses tend to leave their job and even sometimes nursing profession due to such workplace
dilemmas that can potentially range from post-traumatic disorders to physical injuries
(Engeda, 2016).
Workplace violence against hospital nurses is a widespread and commonly discussed
phenomenon where World Health Organisation (WTO) discriminated workplace violence as ,
“physical assault, homicide, verbal abuse, bullying/mobbing, sexual and racial harassment,
and psychological stress” in which most commonly encountered violence includes verbal
abuse, racial harassment and mobbing (Leung, 2006). In fact, it can be seen that although
violence is prevalent to every workplace environment, nurses remains in the frontline within
healthcare systems as they are most closely contacted with patients as well as their families
and therefore are highly risked for getting abused. International studies reveals that
workplace violence against nurses varies from 10% to 50% that can even reach to 87%
sometimes and thus workplace violence calls for a recall period (Leung, 2006).
Mitchell, Ahmed & Szabo (2014) finds that when workplace tensions are high, it is
likely that nurses tend to under-perform that may result in poor care for patients along with
hampering organisational reputation and productivity. The author pinpoint that violence can
cause negative impacts and errors due to distraction caused among nurses that may further
impact nurses health in the long run. Therefore, the authors recommended that nursing

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leaders can play vital role in bringing a change to negative workplace environment by making
a unit examination of issues that are supported by disruptive behaviour. While nurses see any
issue within workplace, they must adopt an appropriate and immediate action that ensures
stoppage of abusiveness within predators and effective steps are taken to prevent repetitive
negative behaviours.
The Occupational Safety and Health Administration (OSHA) cites that workplace
violence “ranges from threats and verbal abuse to physical assaults and even homicide. It can
affect and involve employees, client’s customers and visitors” (Gustin, 2013, p. 14). The
author recognised that workplace violence to be one of the most critical issues in occupation
hazards that ranks among top four reasons for suicide in workplace in past 15 years. Around
3000 people died due to homicide in between 2006 and 2010 alone according to Bureau of
Labor Statistics (Gustin, 2013). Furthermore, a research undertaken by Teymourzadeh, et al.
(2014) reveals that out of 300 nurses who responded to their questionnaire, over 70% of them
felt disturbed due to workplace violence. The participant nurses reported that exposure to
verbal abuse, bullying and mobbing, including physical violence were faced by each one of
them at least once during previous years. Relatives of the hospital patients were responsible
most of the times especially for abusing the nurses who looked after outpatient clinics and
emergency department. Moreover, the nurses unlikely reported the violence to healthcare
managers and around 40% of them were not sure about existing safety policies that can
potentially reduce workplace violence.
Based upon recent publications related to workplace violence, Bordignon & Monteiro
(2016) reflects workplace violence consequences that directly affected healthcare institutions
through decreased organisational commitment which were associated to bullying and internal
emotional instability. The reflection made by the author concerned midwives and nurses
working in Australian hospitals and finds that besides impacting job performance, the