The lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution

Abstract

Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch’s (Creswell, 2004:256) method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an “I don’t care” attitude.

Nurses’ experiences and understanding of workplace violence in a trauma and emergency department in South Africa

“…This trend is confirmed by studies that have investigated this type of violence in emergency settings (Gacki-Smith et al 2009:340;Gates, Ross & McQueen 2006;Kasangra et al 2008Kasangra et al :1274Kennedy 2004), general hospitals (Hahn et al 2008;Magnavita & Heponiemi 2012), community health settings (Kajee-Adams & Khalil, 2010) and psychiatric settings (Bimenyimana et al 2009;Khalil 2010). Gates et al's (2006:333) investigation into type 2 workplace violence at emergency units in the U.S.A. confirmed that patients were the largest perpetrator group.…”

Psychiatric nurses’ experience of aggression amongst colleagues

“…Various studies done internationally and nationally focused on the violence and aggression of professional nurses in their work environment (Bimenyimana et al 2009;Yildirim 2009). Yildirim (2009) stated that nurses ran a high risk of being exposed to violence in the work environment.…”

“…Bimenyimana et al (2009) states that violence means any act, word or attitudes, such as an intimidating facial expression, that create fear or negative feelings, leading to or resulting in physical, psychological and social unwanted results.…”

“…Psychiatric nurses experience violence and aggression from not only their colleagues, but also from their patients which have negative psychological effects (Bimenyimana et al 2009;Yildirim 2009). Violence and aggression in psychiatric hospitals have been widely researched internationally and nationally (Bilgin 2009;Bimenyimana et al 2009). …”

“…Yildirim (2009) states that nurses are at a high risk of being exposed to violence and aggression in the work environment. Both Yildirim (2009) and Bimenyimana et al (2009) indicated that violence and aggression ultimately had an overt negative psychological effect on the nurses.…”