Cases of abuse, both patient on nurse, and nurse on patient, are growing worldwide.
“While no statistics are available for Barbados, the International Council of Nurses reports that 95 per cent of nurses are bullied and 75 per cent are exposed to sexual harassment from patients, but only 15 per cent of them actually report these incidents,” said Consultant Psychiatrist at the Psychiatric Hospital, Dr Joy Sue.
The revelation came as members of the Barbados Nurses Association (BNA) were given insight into this problem and potential solutions during a Nursing Forum at the Queen Elizabeth Hospital.
Speaking on the topic, Assault and Abuse in the Workplace: Psychological and Emotional Strategies for Coping, Dr Sue continued: “88 per cent of those who were exposed to violence did not report the matter, because they did not sustain any injuries or take time off work, some did not think anything would be done to resolve the problem. More alarmingly, according to the surveys, about 44 per cent of nurses accept patient on nurse violence as a natural occupational hazard, and this should not be the case.”
Dr Sue outlined some potential causes of the abuse, including hospital budget cuts, fewer nurses having to deal with a greater influx of patients, inadequate security personnel and equipment, and increased waiting time leading to irritability in patients or relatives.
“Most cases of patient-to-nurse violence occur in hospital emergency rooms,” she said.
When it comes to nurse on patient abuse, the psychiatrist said a survey in the UK showed this was a more common occurrence in privately owned facilities, primarily those catering to the elderly. “This survey showed sexual abuse was most common, and another interesting statistic was that 90 per cent of nurse on patient abuse involved male nurses, even though male nurses only represented nine per cent of the overall nursing population,” the psychiatrist said.
Dr Sue stated that nurses sometimes resorted to this type of behaviour owing to organizational issues (feeling overwhelmed by the amount of work and inadequate financial compensation), professional insecurity, a need to feel in control, and “in some instances nurses abuse patients because they feel superior to them, especially if the patient is from a certain socio-economic background,” according to one survey in South Africa.
In one of the surveys, she said the researchers used trainee nurses to “report on their superiors,” because one of the problems experienced was “When newcomers see their older peers indulging in such behaviour without any sanction, they might think that is the norm and continue the cycle.
“Nursing home incidents may be on the increase because there are more patients now presenting with the many conditions associated with dementia, and sometimes the caregivers do not have enough training to cope with that,” Dr Sue said.
The psychiatrist outlined some potential coping strategies for both institutions and their staff. She said nurses who had experienced patient abuse often experienced anxiety, sadness and depression, and in extreme cases, symptoms similar to post-traumatic stress disorder, so it was important that they receive ongoing counselling to help them readjust, she added.
She also gave the nurses some advice on how to cope with work-related burnout, including “exercise, adequate sleep, developing a level of emotional intelligence and showing more empathy to the patients”.
She also suggested that hospital and clinics must conduct risk assessments, and where necessary improve security in high-risk areas like emergency rooms, by deploying more security personnel and closed-circuit TV cameras, and addressing any reported incidents seriously.