TY - JOUR
T1 - Workplace violence
T2 - Examination of the tensions between duty of care, worker safety, and zero tolerance
AU - Beattie, Jill
AU - Innes, Kelli
AU - Griffiths, Debra
AU - Morphet, Julia
PY - 2020/7
Y1 - 2020/7
N2 - BACKGROUND: Workplace violence (WPV) remains an international problem. This raises challenges for staff in meeting their duty of care to consumers while enforcing zero tolerance for violence directed toward them. PURPOSE: The aim of the study was to expose the values and beliefs underpinning practice and reveal any flawed assumptions or evidence, upon which decisions related to WPV are made. By increasing staff awareness, the secondary aim is to decrease staff stress when confronted with conflicting policies and duty of care responsibilities. METHODOLOGY: Explanatory research as part of a larger descriptive study was used. Semistructured interviews with a sample of managers and staff (n = 99) in Victorian Health Services (Australia) were performed. Initial descriptive analysis identified a tension between duty of care, worker safety, and zero tolerance. This article reports the secondary analysis to examine these relationships in depth. FINDINGS: Feeling obligated and providing care for aggressive patients was difficult while maintaining own safety: "You cannot do both." Although there were contrasting views about the merits of zero tolerance, policies were rarely enacted: "We cannot refuse to treat." Incongruency between legislative requirements creates confusion for decision-making: "Which Act trumps what?" CONCLUSION: Despite policies supporting zero tolerance, staff do not enact these because they prioritize duty of care to consumers before duty of care to self. Zero tolerance, with incongruent legislation, compounds this tension and impairs decision-making. PRACTICAL IMPLICATIONS: This article exposes the underlying values, beliefs, and flawed assumptions underpinning practice related to WPV. Managers need to amend policies to reduce staff confusion, adopt a trauma-sensitive and resilience approach, and develop a clearly written framework to guide decision-making related to duty of care to consumers and staff safety. Incident reports and staff well-being/satisfaction surveys need to evaluate the effects of zero tolerance on staff and consumers. Regulators need to ensue legislative requirements are congruent with staff safety and well-being.
AB - BACKGROUND: Workplace violence (WPV) remains an international problem. This raises challenges for staff in meeting their duty of care to consumers while enforcing zero tolerance for violence directed toward them. PURPOSE: The aim of the study was to expose the values and beliefs underpinning practice and reveal any flawed assumptions or evidence, upon which decisions related to WPV are made. By increasing staff awareness, the secondary aim is to decrease staff stress when confronted with conflicting policies and duty of care responsibilities. METHODOLOGY: Explanatory research as part of a larger descriptive study was used. Semistructured interviews with a sample of managers and staff (n = 99) in Victorian Health Services (Australia) were performed. Initial descriptive analysis identified a tension between duty of care, worker safety, and zero tolerance. This article reports the secondary analysis to examine these relationships in depth. FINDINGS: Feeling obligated and providing care for aggressive patients was difficult while maintaining own safety: "You cannot do both." Although there were contrasting views about the merits of zero tolerance, policies were rarely enacted: "We cannot refuse to treat." Incongruency between legislative requirements creates confusion for decision-making: "Which Act trumps what?" CONCLUSION: Despite policies supporting zero tolerance, staff do not enact these because they prioritize duty of care to consumers before duty of care to self. Zero tolerance, with incongruent legislation, compounds this tension and impairs decision-making. PRACTICAL IMPLICATIONS: This article exposes the underlying values, beliefs, and flawed assumptions underpinning practice related to WPV. Managers need to amend policies to reduce staff confusion, adopt a trauma-sensitive and resilience approach, and develop a clearly written framework to guide decision-making related to duty of care to consumers and staff safety. Incident reports and staff well-being/satisfaction surveys need to evaluate the effects of zero tolerance on staff and consumers. Regulators need to ensue legislative requirements are congruent with staff safety and well-being.
KW - Aggression
KW - duty of care
KW - legislation
KW - managers
KW - nurses
KW - qualitative research
KW - safety
KW - trauma informed care
KW - workplace violence
KW - zero tolerance
UR - http://www.scopus.com/inward/record.url?scp=85085905083&partnerID=8YFLogxK
U2 - 10.1097/HMR.0000000000000286
DO - 10.1097/HMR.0000000000000286
M3 - Article
C2 - 32358237
AN - SCOPUS:85085905083
SN - 0361-6274
VL - 45
SP - E13-E22
JO - Health Care Management Review
JF - Health Care Management Review
IS - 3
ER -