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VIOLENCE AGAINST NURSES IN THE WORKPLACE: WHO ARE RESPONSIBLE?
Ibrahim Haruna Abdullahi
1*, Kochuthresiamma Thomas
1, Fari Fatima Sanusi
21
NIMS Nursing College, NIMS University Jaipur, India.
2
Department of Nursing Sciences, Ahmadu Bello University Zaria, Nigeria.
ABSTRACT
Background:Violence against women is one of the oldest global public health issues that is still of great concern today even in light of various legislations and global united actions against it. The workplace where a woman goes to render services to others is another place where she gets abused even by the very consumers of her services.
Aim:The study was conducted to find out the prevalence of workplace violence against nurses working at Katsina General Hospital, Nigeria in the last 12 months and identify the perpetrators of workplace violence against the nurses.
Materials and methods: Descriptive research design was used for the study where a structured questionnaire was administered to a random sample of 150 nurses to collect data.
Results: The study revealed that, all the nurses (100%) have experienced some form of violence in their working place and patient relations were responsible for 87.2% of WPV perpetration against nurses followed by the patients themselves (7.7%) and working colleagues were also identified in 5.1% of cases to be violent against nurses.
Conclusion: It was concluded that workplace violence against nurses in the facility was pervasive and there is need for a very organize action in the facility to control its scourge with special attention on the patients and their relations being the major perpetrators of violence against nurses in the workplace.
Keywords: Violence, Nurses, Workplace, Perpetrators, Patient, Relations
I.BACKGROUND
Workplace violence refers to all incidents in which staff are abused, threatened, assaulted in circumstances associatedwith their work, including commuting to workplace and from the workplace that involves an explicit or implicit challenge to their health, safety, wellbeing or health. [1]
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Workplace violence is a pervasive phenomenon that exist across all countries of the world in an epidemic quantity with its bipartite effects of undermining the safety, dignity, wellbeing and happiness of workers as well as affecting organizations adversely through the payment of compensations, absenteeism, low productivity, dissatisfaction and high employee turnover rates among others. [2]In the health care sector, all categories of healthcare workers are at risk of violence though at different degrees.
[3,4,5,6,7]Although, the World Health Organization (WHO) projected the global prevalence of workplace violence
as 12.7%[8], studies from various regions of the world advanced remarkably higher figures such as that from a Nigerian study where it was reported that there was a high prevalence of violence in the health care sector of up to 88%[9] and bullying, harassment, and physical violence were more prevalent in the health sector than any other sector, with 54.4% of such acts taking place in the hospitalenvironment[10]. In another study conducted across the Northern region of Nigeria, it was reported that majority (86%) of female healthcare providers have experienced some form of violence in the workplace in the hands of mostly the relatives to their patients (56.1%
followed by the patients themselves (29%) [11]
As reported by many studies across the world, of all the people working within the healthcare industry, nurses have up to three times higher chances of being abused than others [3,4,5,6,7]
which was further reiterated by the International Labor Organization (ILO) in 2016, that nurses faced more violence and face all type of trauma, suffering and life altering events than any other health care worker. [12]
While Nigeria is a signatory to the 1979 United Nation’ (UN) convention for the Elimination of all Forms of Discrimination Against Women (CEDAW), its only recently the country made a legislative attempt to control the ever existing problem when Violence Against Persons Prohibition Act of 2015 was enacted though, Trafficking in Person Prohibition act 2003 is seen as the first attempt by many [13]. There are currently no Laws against Workplace violence in the country and almost absent policies in the healthcare facilities aimed at making the workplace a safe ground for the healthcare provider.
With the high prevalence of workplace reported in the previous studies conducted in the Nigerian health sector with nurses identified as having three times more chances of being the victims of workplace violence, this stud seeks to investigate the state of the problem and the perpetrators of such acts among nurses working in Katsina General Hospital located in one of the core Northern states of Nigeria.
II.MATERIAL AND METHODS Research Design:
A descriptive research design was used to explore the prevalence of workplace violence and identify the perpetrators of such act against nurses working at Katsina General Hospital.
Setting:
The study was conducted at General Hospital Katsina, Katsina state of Northwestern Nigeria. It is a secondary public healthcare facility located along Muhammad Dikko road in the heart of ancient city of Katsina.
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Population of the study:This comprises of all the 180 nurses working across the various wards and units ofGeneral Hospital katsina.
Sampling techniques
Formula for sample size estimation was used to arrive 128 respondents and 15% was in anticipation of possible attrition. Therefore, the sample size for the study was 150 respondents.
Simple random sampling technique was used to select the respondents with their duty roster serving as the sampling frame.
Inclusion criteria
Nurses who voluntarily consent for participation in the study
All nurses working at General Hospital Katsina
Exclusion criteria
Nurses who were absent during the period of data collection
Nurses who were not on duty during the period of data collection
Instrument and method for data collection:
Structuredself-administered questionnaire was used to collect data from the respondents over a period of 12 days during which the questionnaires were administered to the selected respondents and were encouraged to fill and submit the filled questionnaires on the spot.
Ethical Consideration
Ethical clearance and permission for the conduct of the study were obtained from the Ethical Committee for Operation Research of General Hospital Katsina. Informed consent was obtained from each respondent that volunteered to participate in the study after explaining what the study entails and that all information will be treated as confidential and used only for academic purpose.
IV.RESULTS
Socio-Demographic Data of Respondents
Table 1: Frequency distribution of respondents based on socio-demographic data.
1 a b
2
Gender Male Female Total Age
Frequency 39
111 150
Percentage 26
74 100
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ab c d e f g h
20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-60 Total
25 40 23 22 10 13 14 3 150
16.7 26.7 15.3 14.7 6.7 8.6 9.3 2 100 3
a b
4 a b c d
5 a b
6 a b c d
Religion Islam Christianity Total Ethnicity Hausa Yoruba Igbo Others Total
Marital status Married Single Total
Edu. Qualification RN
BSc MSc PHD Total
125 25 150
118 6 17 9 150
106 44 150
104 36 7 3 150
83.3 16.7 100
78.7 4 11.3 6 100
70.7 29.3 100
69.3 24 4.7 2 100 7
a b c d e f g
Years of service 1-4
5-10 11-14 15-19 20-24 25-30 31-35 Total
52 24 28 13 13 12 8 150
34.7 16 18.6 8.7 8.7 8 5.3 100
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Majority of the respondents were female (74%) and within the range of 25-29 (26.7%). Muslims were the majority (83.3%) and 78.7% of the respondents were Hausa by tribe. Large proportion of the respondents (70%) were married, 69.3% had NRN certificate as highest educational qualification, and 34.7% of the respondents had 1-4 years of experience.Prevalence of Workplace Violence among Nurses
Table 2: Frequency distribution table showing the prevalence of WPV.
S/N Experience of WPV Frequency Percentage (%)
1 Yes 150 100
2 No 0 0
From the table above, all the respondents (100%) reported the experience of some form of violence at work.
Perpetrators of WPV
Table 3: Frequency distribution showing the Perpetrators of WPV based on reported episodes of abuse.
S/N Perpetrators Frequency Percentage (%)
1 Patient 82 7.7
2 Patient relation 924 87.2
3 Colleague 54 5.1
Total 1060 100
The nurses reported the experience of 1064 episodes of various forms of workplace violence in the last 12 months of which patient relations were responsible for 87.2% of the perpetration and working colleagues were only responsible for 7.7%.
V.DISCUSSION
As shown in table 2 above, all the nurses (100%) reported the experience of some form of violence in their working places. This is remarkably higher than the global prevalence of workplace violence (12.7%) reported by the WHO, [8] but the findings were in agreement with those of a lot of other studies including those conducted within Nigeria which reported an incidence of 88% in the Southern part of the country [9] and 86% in the Northern part.[10] Although these findings all reveled a high level of workplace violence against the woman folk working in the health facilities in Nigeria, they made it obvious that the prevalence of WPV in the healthcare industry vary between the various regions of the country and even between facilities and professional groups in a particular region.
As depicted in table 3 above, Patient relations are by far the most violent group of people nurses interact with in the working place taking responsibility for 924 (87.2%) episodes of violence perpetration against nurses
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working at General Hospital katsinain the last 12 months followed by the patients themselves (7.7%). Although this is slightly higher but it supports the findings of another study conducted in the same Northern Nigeria that identified patient relations as the most violent people female healthcare providers interact with as they were reported to have been responsible for 56.1% of violence perpetration followed by the patients themselves(29%).[10]Although patients and their relations account for 94.9% of violence perpetration against nurses, working colleagues have also been implicated in violence perpetration against nurses which calls for a very comprehensive policy direction and effort to control violence against nurses in the working place as every other person is simply a potential abuser waiting for the opportunity to strike.VI.CONCLUSION
Violence against nurses is pervasive in the facility and with their safety compromised it will certainly affect their wellbeing and limit their motivation, and output in patient care with attending secondary consequences that may have negative reflection on their health and working habits as well as the hospital administration.This a big call for organized efforts toward combating the burden of workplace violence against nurses with special emphasis on the patients and their relations being the major perpetrators of WPV against nurses.
CONFLICT OF INTEREST:
The researchers hereby declare that they had no conflict of interest from the conduct of the study to the final stage.
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