Psychiatric nurses face aggression from patients and colleagues: study

A psychiatric patient at Bophelong Psychiatric Hospital, in Mahikeng, North West. Oupa Mokoena African News Agency (ANA)

A psychiatric patient at Bophelong Psychiatric Hospital, in Mahikeng, North West. Oupa Mokoena African News Agency (ANA)

Published Jul 16, 2019

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Johannesburg - The University of Johannesburg (UJ) said on Monday that research had shown that health professionals are at high risk of exposure to violence and aggression.

"Psychiatric nurses run a high risk of being exposed to aggression. They experience aggression from patients as well as fellow colleagues. Aggression in the work environment has an overt negative psychological effect on the nurse," said Professor Marie Poggenpoel. 

Professor Poggenpoel said health professionals often felt uncertain about how to deal with violence and aggression.

"Standing at the interface between medicine, psychiatry and law, the best actions may not be clear, and guidelines neither consistently applicable nor explicit."

According to her, a new study done by researchers from the Department of Nursing Sciences within the Faculty of Health Sciences at UJ, found that in a working environment with dysfunctional nurse-to-nurse relationships, stress and aggression in the work environment influenced factors such as low productivity owing to conflicts, recruitment and retention challenges, burnout, absenteeism, litigation and rapid staff turnover.

"To assess the extent of this contextual study, the population for this research consisted of the psychiatric nursing staff registered with the South African Nursing Council and were employed in an academic psychiatric hospital in Johannesburg."

She said the researchers utilised selective sampling and the criteria included participants who were professional nurses working in an academic psychiatric hospital, and who had been working there for a minimum period of two years.

"The psychiatric nurses needed experience in an academic psychiatric hospital in order to give a valid account of their experiences and to be familiar with the environment in which they work. They had to be able to speak English or Afrikaans."

Professor Poggenpoel said the UJ team found that the psychiatric nurses experienced aggression as subtle, passive and harmful in a verbal and non-verbal manner. They also reported that different types of aggression were present in their work environment, namely verbal and non-verbal aggression. 

Professor Poggenpoel and her co-authors also observed that education and socialisation at different levels exhibited different values and perceptions of professional identity.

She said the effect of violence and aggression in day-to-day living should not be underestimated.

A psychiatric ward in Dr George Mukhari Academic Hospital. The University of Johannesburg study warns that the effect of violence and aggression in day-to-day living should not be underestimated. Oupa Mokoena African News Agency (ANA)

"It is assumed that it could have severely harmful psychological consequences in the long term and that it can thus affect the psychiatric nurses’ self-esteem, social status and happiness," said Professor Poggenpoel 

"The importance of nursing staff’s roles and attitudes in the interaction with the psychiatric environment which should ultimately strive to create a therapeutic milieu. This implies that the psychiatric nurse’s interpersonal skills play an extremely important role in the creation of such an ideal milieu in the work environment."

Professor Poggenpoel said in general hospital settings, aggression was commonly assumed to be most prevalent in emergency departments, where dealing with aggression was a significant concern.

"The incident reports indicate that events are numerically more common on medical, geriatric and psychiatric wards," she said.

“It is clear that attention should be given to create opportunities for psychiatric nurses to master the management of experienced aggression from colleagues,” said Professor Poggenpoel.

Professor Poggenpoel has been a tenured professor in Psychiatric Nursing Science at the University Of Johannesburg since 1989 and was an expert regarding qualitative as well as quantitative research methodologies.

African News Agency (ANA)

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