Nurses are at high risk for workplace violence (WPV) in the workplace; 80% of nurses report having experienced verbal or physical abuse from a patient or colleague (Nowrouzi-Kia, Isidro, Chai, Usuba, & Chen, 2019). Nurses working night shifts have a higher risk of encountering WPV from patients, especially in emergency departments, psychiatric units, or critical care units (Nowrouzi-Kia et al., 2019). Nurses with less experience and who are females have a higher risk of WPV (Nowrouzi-Kia et al., 2019). New employees in acute hospitals are often required to work night shift until they have the seniority to move to desired shift. Nurses who work night shift are at higher risk for sleep disturbances, and burnout along with decreased well-being and resilience (Tahghighi, Rees, Brown, Breen, & Hegney, 2017).
There have been several initiatives aimed at decreasing violence in healthcare, but violence continues to escalate (Papa & Vanella, 2013). Nursing students may be taught how to address agitated, confused, or angry people in the classroom but they have limited opportunities to practice these strategies. Students who are exposed to incivility or bullying in clinical settings rarely report or seek help in dealing with this challenges (Anthony, Yastik, MacDonald, & Marshall, 2014). This silent behavior is common is nurse’s response to WPV, where nurses under report violence because they think it is ‘part of the job’ or the client has a medical diagnosis that alters cognitive ability.
Nursing students that have the opportunity to practice skills in simulation have decreased stress and increased self-efficacy regarding those skills (Megel et al., 2012). This suggests that a simulation scenario where students can de-escalation techniques to deal with WPV could alleviate some stress and increase self-efficacy in their skills if exposed to these situations as a registered nurse.
Methods:
Participants will be recruited from students who are enrolled in a baccalaureate nursing program. Institutional Review Board approval will be obtained from the University. Subjects will complete a pre-test survey that included demographic information, the General Self Efficacy (GSE) scale, the Perceived Stress Scale (PSS) and the Resilience Scale (RS). All students will complete an online module on how to communicate with difficult people and de-escalating volatile situations prior to the simulation. Students will complete a simulated nursing scenario that includes a family member (actor) threatening the staff, followed by a debriefing session. Research participants will complete a post survey, with the GSE and the PSS, after the simulation activity. The GSE and PSS will be compared before and after simulation using a t-test analysis. Linear regression will be used to examine the relationship of resilience on self-efficacy and stress. Research participants will also write a reflective journal describing their response to the simulation. The reflection journals will be analyzed using content analysis (Vaismoradi, Turunen, & Bondas, 2013).
Results: Research will be conducted September 24, 2019. Results pending
Conclusion:
WPV is a significant problem in the nursing profession. Educators need to find ways to prepare students to meet this challenge when they enter the workforce.