Mental Health Nurses' Experiences of Patient Assaults

Abstract

With the advancements in technology, there has been a significant reduction in the classical risk factors at the workplace like biological, chemical and physical harms. But with the turn of the era, much attention has been focused on psychosocial stressors at work which are thought to affect employees’ occupational functioning and health. Amongst all healthcare professionals, nurses are the most likely to be assaulted. Moreover, violence towards mental health nurses has been both a reality and concern due to increasingly violent patient population and the devastating effects of violence on the victim.

The study aims to explore and describe mental health nurses’ experiences of patient assaults. Thirteen Registered Nurses and one Enrolled Nurse working in different nursing positions within the Southern District Health Board (Otago region) - Mental Health Services were interviewed using a semi structured interview format. The data gathered from these interviews was interpreted using thematic analysis and coded into 24 sub-themes. The sub-themes were related to the sequence and impact of assaults on the participants. Through an ongoing interpretative process, three over-arching themes emerged. The themes were analysed further to allow conceptual meanings to be interpreted relating to the experiences of patient assaults.

The major findings of the study related to the nature and impact of assaults and supportive strategies associated with violence against mental health nurses. Perpetrator risk factors include mental health disorders, substance abuse and situational crises. The injuries sustained by the nurses include lacerations, head injuries, dislocations, asphyxia and bruises. Psychological harm has also occurred including Post Traumatic Stress Disorder. Some of the injuries sustained have required weeks of recovery. In other cases, nurses have chosen to change areas of practice because of their fears and concerns. Protective strategies for combating negative consequences of violence include practicing self-defence, social support, reporting violent activity or threats of violence to authority and police and a supportive and consultative workplace culture with access to counselling services and assistance in all aspects including finances.

Although physical injuries heal relatively quickly, emotional and psychological wounds linger for longer and can interfere with personal and professional lifestyles for months or years after the incident. Employers need to provide better support services to health care professionals who are assaulted and the legal system needs to acknowledge that assaults against nurses is a violation of human rights and violence is not to be tolerated as part of working in mental healthcare services.