Health Priorities and Nursing 1

Health Priorities and Nursing 1










Health Priorities and Nursing 1

Aggressive behavior is the observable manifestation of hostility associated with destructive acts towards others and self. Aggressive people ignore other people’s rights and fight for their own interests. Healthcare professionals, especially nurses who are involved in medical and psychological care of patients, frequently encounter and sometimes serve as victims of aggressive behavior in the workplaces. Nurses are expected to have the knowledge of managing aggressive behavior from their patients. Appreciating risk factors of aggressive behavior can aid nurses in better design and implementation of prevention and treatment programs (Liu, Lewis, & Evans, 2013).

Occupational Health and Safety measures aimed at preventing work-related injuries, and human suffering. The classic approach of ensuring work safety is through enactment and legislation that ensures workplace safety for a smooth working environment. OSHA, Occupational and Safety Health Act, is the main statute protecting the health and safety of workers in the workplace. It has several clauses related to protection of workers, such as to adopt practices necessary and appropriate to defend employees, comply with standards and ensure they use protective equipment when required for safety and health. There are various tools necessary for primary health workers, teamwork, the occupational physicians and nurses must work together, avoid discrimination to ensure equitable treatment in all healthcare sectors.

Accessibility and affordability, an early system of occupational health ensures that cost of therapy is affordable. The establishment of the health Act at early stages makes services of high quality accessible and this translates to national economic growth. Occupational health focuses on giving curative services, provision of personal protection equipment while gain in health can be made through primary prevention (Meehan, McIntosh & Bergen, 2006). When establishing an effective occupational health system, several factors should apply. First, the creation of a support environment policy, a good background on the risk factors and the necessary tools to manage the risks. Occupational safety and health goals are to foster a pleasant and safe working environment. All organizations have a duty to protect their employees who may be affected in the line of duty, ensure they receive quick medical attention and mostly ensure their safety at all times.

Nurses come into physical contact with patients often. Professional policies and procedures should be enacted to minimize the risk involved. First, the hospital should devise a mechanism to identify the aggressive patients and come up with general principles of management. The safety of the victim during the aggression is the most important. All doors should be open from outside and not lockable from inside. A sound security system should be adopted. There should also be enough personal training on how to deal with the aggressors. The nurse should try to be compassionate, assess the physical environment and make necessary changes. Every nurse should develop a plan of care and try to implement it when faced with violent situations. Maintaining composure and calm against aggressors can also help the situation, and check body language in-order not to agitate the patient (Waschgler, Ruiz-Hernández, Llor-Esteban, & García-Izquierdo, 2013)

Violence can affect a nurse in a negative way. For example, the loss of confidence and the vigor for work, lack of job satisfaction and distrust of professional abilities and skills. High stressful levels and negative interpersonal relationship can all be a result of aggression. Sometimes death and rape can take place and affect the hospital in a negative manner. Similarly, hospitals lose their employee’s morale and motivation, which have impacts on delivery of the employee. Installation of a safer security becomes mandatory, and it is an expensive project. It is essential for hospitals to devise measures to prevent violent attacks. There are three key policies involved in order to achieve these. First, good hospital organization, timely response to violent cases, even the minor ones to prevent the build up of anxiety. Second, there should be the creation of a team that would help the health experts deal with aggressors in their service delivery. There is also a need to establish written policies that would apply to anyone who violates the hospital staff and have a clear reporting system. Secondly, the environment should be conducive in case such attacks take place. This will involve the implementation of sufficient lighting, enough seats in the emergency unit and the provision of distraction materials such as magazines to put off boredom. Moreover, the security personnel should be easily accessible, and the reception desk should be placed in a convenient place. Comfort should be ensured by the provision of good ventilation in all hospital rooms. Lastly, staff training and development is essential. Workplace violence is a risk employers have to deal with and try to minimize (McKenna, Poole, Smith, Coverdale, Gale & McKenna 2003). A training program establishment for the management of violent people and timely communication skills on the reception team should be encouraged. Nurses are knowledgeable and should always be ready for violent cases. Dealing with the issue in a mature professional way is expected.

Health-care professionals in the mental facilities face the risk of encountering violent and aggressive behavior from patients, which can affect their service delivery. The risk of dealing with mentally challenged patients among nurses necessitates the need for their protection by the occupational and health administration. Specific techniques are important to nurses when it comes to dealing with the patients. These include, observing for signs and symptoms of anger and agitation. (Kim, Ideker, & Todicheeney-Mannes 2012). Approaching the patients calmly and in a controlled manner and mostly withdrawing from the situation can help solve the situation. In avoiding health risks and ensuring a safe working environment, the level of training is crucial. There is the need to maintain ethics in approaching violent cases in the hospital environment. In mental hospitals, nurses face physical assaults from their aggressive patients. There is a need for occupational measures to protect them anytime. The occupational health and risk team needs to train nurses on the correct mechanism of handling the mentally ill patients, these patients are violent in nature, and external factors push them to react in such manners. The need to understand them is a virtue. The risk team should establish safety mechanisms for all its nurses as a way of dealing with emergencies and injuries and hazards.

Mentally ill patients often violate their bodies and cause physical violence to the other patients. A safe environment for them is necessary (Amore, Tonti, Esposito, Baratta, Berardi & Menchetti, 2013). The occupational team allows safety policies and procedures to satisfy legislative requirements. Providing resources to allow the effective implementation of the safety management system and ensure all programs are in place is important. Other occupational policies include providing information, instruction, training and supervision to employees. All nurses and working personnel are responsible for working to their capacities, ability and experiences, taking action to avoid and eliminate hazards, ensure all work is performed according to OSHA policies (Victoria, 2003).

The use and maintenance of all safety equipments and personal protective equipments in all wards, in accordance to instructions provided. Nursing team identifies all hazards, by having risk assessments that are completed on a regular basis and checked for compliance with OSHA laws and policies. The implementation of consultative mechanisms with employees and health and safety representatives is necessary, involving the nurses in all major decision of safety is mandatory (Ketelsen, Zechert, Driessen & Schulz, 2007).


Amore, M., Tonti, C., Esposito, W., Baratta, S., Berardi, D., & Menchetti, M. (2013). Course and Predictors of Physical Aggressive Behaviour after Discharge from a Psychiatric Inpatient Unit: 1 Year Follow-up. Community Mental Health Journal, 49, 4, 451-6.

Ketelsen, R., Zechert, C., Driessen, M., & Schulz, M. (2007). Characteristics of aggression in a German psychiatric hospital and predictors of patients at risk. Journal of Psychiatric & Mental Health Nursing, 14, 1, 92-99.

Kim, S.C., Ideker, K., & Todicheeney-Mannes, D. (2012). Usefulness of Aggressive Behaviour Risk Assessment Tool for prospectively identifying violent patients in medical and surgical units. Journal of Advanced Nursing, 68, 2, 349-57.

Liu, J., Lewis, G., & Evans, L (2013). Understanding aggressive behavior across the lifespan. Journal of Psychiatric and Mental Health Nursing, 20, 2, 156-68.

McKenna, B. G., Poole, S. J., Smith, N. A., Coverdale, J. H., Gale, C. K., & McKenna, B. (2003). A survey of threats and violent behavior by patients against registered nurses in their first year of practice. International Journal of Mental Health Nursing, 12, 1, 56-63.

Meehan, T., Mcintosh, W., & Bergen, H. (2006). Aggressive behavior in the high-secure forensic setting: the perceptions of patients. Journal of Psychiatric & Mental Health Nursing, 13, 1, 19-25.

Victoria. (2003). Occupational Health and Safety Act 1985, no. 10190: An act to promote and improve standards for occupational health, safety and welfare. Melbourne, Vic: Govt. Printer.

Waschgler, K, J.A Ruiz-Hernández, B Llor-Esteban, & M García-Izquierdo. (2013). “Patients’ Aggressive Behaviors towards Nurses: Development and Psychometric Properties of the Hospital Aggressive Behaviour Scale Users.” Journal of Advanced Nursing. 69.6 1418-27. Print.









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