Internationally violence persists as a complex problem for nurses. While it is widely accepted that nursing staff in any health care setting can be the target of violence, in high acuity areas such as Emergency Departments (ED) nurses have an increased risk of violence. There is limited Australian research into violence experienced by nurses in the Australian Health sector, in particular the rural and regional Australian ED. Greater understanding of the phenomena of violence towards ED nurses, as it is manifest in the ‘real world’ rural and regional Australian setting is needed to enable development of context specific solutions for this problem. This thesis presents a contextual, specialty nurses’ assessment of violence risk, strategies for violence prediction and management, and the sequelae for the nurse. The aims of this study were to: Explore and describe the contextual assessment skills and preventative strategies rural and regional ED nurses use to understand and predict violent events, where the agent of violence is the patient, their family or friends, and understand the nature and scope of the sequelae of work place violent events from the nurse’s perspective. A mixed method instrumental case study was used to generate both qualitative and boundary for inquiry, and a structured process within which the chosen methods were able to define ‘the case’ and answer the research question. This study was undertaken in 2005, at a regional Australian ED. Twenty (20) Registered Nurses were recruited into the study and consented to being observed. Textual qualitative data were generated from two hundred and ninety (290) hours of participant observation, sixteen (16) semi-structured interviews, thirteen (13) unstructured field interviews, and researcher journaling. In addition, sixteen (16) violent events were observed and recorded via a structured observation tool. Textual data were analysed thematically assisted by the qualitative data management and retrieval software NVivo2, and numeric data were analysed using frequency counts. The participants used their nursing knowledge(s), experience and context to assess their risk of violence. Embedded in the practice of these ED nurses was their ability to convey caring and respectfully approach all people presenting to ED. The participants’ caring respectful demeanour underpinned their understanding of violence prevention strategies. Using this violence prevention approach, they attributed contextual meaning(s) to the violent event and agent of violence. The meaning(s) they attributed in turn shaped their response(s) to both the violent event and the agent of violence. A high level of observable collegial awareness supported and fostered their resilience towards the potentially negative affects of violence in the workplace. The five themes revealed by this study were; Conveying caring: Averting violence: Being alert: Recognising, assessing and responding to violence: Attributing meaning: Subjective understandings that shape responses to Violence : Collegial awareness: Forming trusting relationships to help manage violence: Fostering resilience: resisting the negative sequelae of violence. Violence was interpreted by these ED nurses in a more systematic and complex way than the current definitions make possible. Violence assessment, prevention and management skills were embodied in the participant ED nurses’ routine practice and their conceptualisation of caring. The meanings given to violence were contextually constructed and these ascribed meaning(s) and judgments informed the actions that the nurses took in response to both the violent event and the agent of violence. / Doctor of Philosophy (PhD)
| Identifer | oai:union.ndltd.org:ADTP/273602 |
| Date | January 2006 |
| Creators | Luck, Lauretta, University of Western Sydney, College of Health and Science, School of Nursing |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
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