Recent Research About Nursing, August 2014

Aug 12, 2014, 9:00 AM

This is part of the August 2014 issue of Sharing Nursing’s Knowledge.

Violence Against Emergency Nurses

For many nurses working in emergency departments, physical violence and verbal abuse is a common occurrence. One survey found that more than half of emergency nurses had experienced such incidents within the previous week. Research suggests a number of contributing factors, including long wait times and patients who have psychiatric problems or are under the influence of drugs or alcohol. According to a study published in the July 2014 issue of The Journal of Emergency Nursing, while data on the frequency of such incidents is readily available, less study has been devoted to nurses’ personal experiences with assaults, including the circumstances and consequences of the incidents.

With that in mind, a research team led by Lisa A. Wolf, PhD, RN, CEN, conducted a qualitative analysis of 46 nurses’ personal accounts of assaults. Several common themes stood out:

  • A number of nurses talked about what the researchers described as a “culture of acceptance” of an “unsafe workplace.” For example, hospitals discouraged nurses from pressing charges or prosecutors declined to pursue cases. Some nurses said safety measures such as security or panic buttons were not maintained. Others noted that despite signs being posted that warned that anyone who committed violence, made threats, or acted out in other ways would be ejected from the hospital, such behavior was tolerated.
  • Many nurses described the impact of assaults in personal terms, saying they had “lingering psychological trauma that continues to impede their ability to work in the emergency setting.” Some reported chronic pain from injuries sustained during violent incidents, but said they continued to work full time. Others reported having to leave the profession because of the extent of injuries.
  •  Nurses described what researchers identified as missed cues that violence was about to occur, usually from patients from whom such behavior might have been anticipated. One example is a patient taken to the emergency room for ingesting multiple drugs and placed only in soft restraints. Another example involved individual nurses being left alone with patients brought in for psychiatric evaluation who had been verbally abusive to paramedics.

The authors write that their study “describes the confluence of high-risk environments and persons as precursors to violence. The findings from this study identify some of the physical and psychological long-term consequences of violence experienced by nurses while they are providing patient care. These consequences lead to lost productivity, contribute to attrition from the emergency nursing profession, and impede nurses' ability to effectively deliver patient care.” They go on to write that further research should be devoted to interventions that would allow nurses and other hospital personnel to recognize potentially violent patients or circumstances.

Read an abstract of the study and a HealthDayNews story on its findings.

Letting the Sun Shine

While hospital architects generally make a priority of ensuring that patient rooms have exposure to sunlight, the same is not always true of nurses’ workspaces, which are frequently located in the middle of floors with patient rooms surrounding them. According to a study in the Summer 2014 issue of Health Environments Research & Design Journal, more sunshine for nurses would go a long way toward improving nurses’ well-being.

A group of Cornell University researchers led by Rana Sagha Zadeh, PhD, MArch, gathered data from an acute-care nursing unit with two wards. Both had similar patient populations, and environmental and organizational characteristics, but one had windows near the nursing station and one did not.

Researchers studied nurses’ blood pressure, body temperature and blood oxygen levels, and gathered data on their communication, laughter, sleepiness and mood. Sunlight improved nurses’ alertness and moods, they found. The data also showed improvements in blood pressure, body temperature, blood oxygenation, caffeine intake and self-reported sleepiness, but by levels not deemed clinically significant.

“The physical environment in which the caregivers work on critical tasks should be designed to support a high-performing and healthy clinical staff,” Zadeh said in a news release. “Improving the physiological and psychological well-being of health care staff by designing the right workspace can directly benefit the organization’s outcomes.”

Read an abstract of the study or a MedicalXpress story.

More Coverage of Recent Research About Nursing on the Human Capital Blog and RWJF Website

Nursing Shortage Offset by Older Nurses Delaying Retirement

Physical Work Environment in Hospitals Affects Nurses’ Job Satisfaction, With Implications for Patient Outcomes, Health Care Costs

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.