ASSESSMENT OF FACTORS THAT PROVOKED ABUSE OF NURSES BY PATIENTS’ RELATIVES IN LAGOS UNIVERSITY TEACHING HOSPITAL

CHAPTER ONE

INTRODUCTION

1. BACKGROUND OF THE STUDY

The health sector is one of the key sectors and one of the workplaces most susceptible to abuse and violence. According to the International Labour Organization (ILO), health care employees have the second-highest risk of workplace violence (Ahmad, 2015). In 2012, the Bureau of Labor Statistics reported a 6% rise in abuse and violence in the private health care and social support sector in the United States of America (USA), totaling 19,360 instances (BLS, 2017).

Verbal abuse among healthcare professionals is a common and widespread phenomenon that has an impact on healthworkers' psychological health and job outcomes, such as lower commitment to work and a weaker intent to stay in the profession (Lamichhane & Bae, 2020).

Workplace violence in the healthcare industry has recently been a hot subject because to its prevalence and impact on victims' emotional and professional well-being, as well as the healthcare system as a whole (Najafi et al., 2016). Nonetheless, studies have found that of all health-care employees, nurses are the most vulnerable to workplace violence (Ferri et al., 2016). Workplace violence is a complicated and multifaceted phenomena, with various variables influencing its frequency (Rodriguez and Paravic, 2013).

In Europe, 26% of educational and health workers believed their safety or health was jeopardised. Yet, only 12% of them were exposed to intimidation (Paoli & Merllié, 2001). The WHO recorded 37% of incidences of physical and psychological violence against health care professionals in Bulgaria in 2002, 54% in Thailand, 61% in South Africa, and 41% in Lebanon (WHO, 2002). WPV in healthcare settings was recently detected in Jordan, when the presidents of the Jordanian Medical and Nurses Associations claimed that occurrences of violence against health care professionals had grown (Sameh, 2006). While any health care worker is exposed to WPV, nurses are the most vulnerable since they have close contact with patients, families, and relatives (El-Gilany, El-Wehady, & Amr, 2010; Kitaneh & Hamdan, 2012).

The prevalence of verbal abuse among registered nurses is reported to be 69.4% in the United States (Pompeii et al., 2015); 69.5% in Egypt (Abbas et al., 2010); and 52.7% in Saudi Arabia (Al-Shammari & Alzghool, 2020). In the Jordanian health sector, according to a 2014 report by the Supreme Health Council, 4577 nurses and 1442 midwives were employed by MOH hospitals, 1111 nurses and 20 midwives by university hospitals, and 3389 nurses and 200 midwives by the Royal Medical Services. Verbal abuse is one of the most prevalent forms of workplace violence faced by Jordanian nurses. Al-2013 Bashtawy's research of 227 nurses in the emergency departments of 12 various kinds of hospitals found that verbal abuse was nearly five times more prevalent than physical abuse, with the percentages standing at 63.9% and 11.1%, respectively (Al-Bashtawy, 2013). Another research of 11 hospitals in Jordan revealed that verbal abuse was more widespread than physical abuse (67.8% vs 52.2%, respectively) (Al-Omari, 2015). Verbal abuse is manifestly more widespread than other abusive behaviours in Jordan, indicating an immediate need for action to curb these events.

These unfavourable attitudes among nurses may impact patient safety and health outcomes (Beecroft et al., 2008). Negative job consequences may result if nurses fail to manage instances of verbal abuse effectively (Al-Bashtawy & Aljezawi, 2016; Alzoubi et al., 2021). Thus, they were chosen to take part in this investigation. Many contributing variables account for the high frequency of verbal abuse. The most prominent issues, according to a survey of 500 nurses, were unfavourable reputation (64%), lack of support from lawmakers for nurses (60%), and scarcity of nurses on shift (56.5%). (Ahmed, 2012) hence the need for this study.

2. STATEMENT OF THE PROBLEM

There are a number of factors in the work environment of nurses that may be considered risk factors for violence, including demands for high quality of care, the need for specialised care and cost-effective nursing interventions, staff shortages, lack of boundaries and self-care, and professional burnout (Khowaja et al., 2020; Mrayyan, 2007; Shdaifat et al., 2020). Due to the presence of night shifts, exposure to abusive behaviours by patients and other health workers, long working hours, low salary compared to other professions and other countries, and the requirement to work in close proximity with colleagues and patients of the opposite sex, nursing is not viewed as a desirable profession in Jordanian culture. While the perception of nursing in Jordan has improved over time, some nurses opt to quit the profession due to dangerous working circumstances and bad working conditions (Nantsupawat et al., 2017).

Verbal abuse towards nurses may have detrimental effects on their psychological health, as well as their productivity and results at work. On a personal level, verbal abuse was proven to lower the self-esteem of nurses (Cengiz et al., 2018). It may also have a significant influence on the emotional state of nurses, who may face changes in their mental health and social challenges after the occurrence (Alomari et al., 2019). Oweis & Diabat (2015), found that evaluating and condemning nursing behaviours, accusing and blaming nurses, and abusive fury were the most often reported types of verbal abuse by RNs. In addition, nurses reported experiencing anger, shyness, irritation, shame, and engaging in high-risk activities in response to verbal abuse. Another Jordanian research indicated that 60.8% of verbally abused nurses had trouble sleeping and 61.4% felt exhausted following the encounter. Moreover, impaired communication and lack of trust were mentioned (Courcy et al., 2016) thus this study seeks to assess factors that provoked abuse of nurses by patients’ relatives in Lagos University Teaching hospital.

3. OBJECTIVES OF THE STUDY

This study seeks to assess factors that provoked abuse of nurses by patients’ relatives in Lagos University Teaching hospital. Specific objectives of this study are:

1. To determine the extent nurses are abused by patients’ relatives in Lagos University Teaching hospital.

2. To find out the types of abuse by patients’ relatives nurses face in Lagos University Teaching hospital.

3. To find out the effects of provoked abuse of nurses by patients’ relatives in Lagos University Teaching hospital.

4. To examine prevention measures abuse of nurses by patients’ relatives in Lagos University Teaching hospital can be prevented.

4. RESEARCH QUESTION

The following research questions will be answered in this study:

1. To what extent are nurses abused by patients’ relatives in Lagos University Teaching hospital?

2. What are the types of abuse by patients’ relatives nurses face in Lagos University Teaching hospital?

3. What are the effects of provoked abuse of nurses by patients’ relatives in Lagos University Teaching hospital?

4. What are the prevention measures abuse of nurses by patients’ relatives in Lagos University Teaching hospital can be prevented.

5. SIGNIFICANCE OF THE STUDY

Based on the results of the research, nursing managers and leaders must implement new rules and regulations that promote a stress-free workplace with zero tolerance for verbal abuse. Modify and monitor the system of communication between nurses and patients' families, nurses and patients, and nurses and nurses. To safeguard nurses from injury, lucid rules should be enacted, and sanctions should be administered if policies are violated. In clinical settings, nurses must be aware of the variables that lead to verbal abuse. This research will also demonstrate the necessity for nurses to use preventative measures in stressful circumstances and environments where verbal abuse is possible.

In addition, this study will emphasise why nursing managers should establish a training programme for newly hired RNs in order to inform them of the factors that contribute to verbal abuse, how to respond to the situation, and how to minimise the negative consequences on the personal and professional levels.

6. SCOPE OF THE STUDY

Broadly, this study focuses on the assessment of factors that provokes abuse of nurses by patients’ relatives in Lagos University Teaching hospital. Specifically, this study focuses on determining the extent nurses are abused by patients’ relatives in Lagos University Teaching hospital, finding out the types of abuse by patients’ relatives nurses face in Lagos University Teaching hospital, finding out the effects of provoked abuse of nurses by patients’ relatives in Lagos University Teaching hospital and examining prevention measures abuse of nurses by patients’ relatives in Lagos University Teaching hospital can be prevented.

7. LIMITATIONS OF THE STUDY

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.

8. DEFINITION OF TERMS

Nurses: a person trained to care for the sick or infirm, especially in a hospital.

Abuse: Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other types of aggression.

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