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Patient violence toward a nurse: predictable and preventable?
Journal of Psychosocial Nursing and Mental Health Services
|February 1, 1994
Summary
Half of healthcare professionals face assault. Predicting patient violence involves subtle boundary violations and the patient
Area of Science:
- Medical Sociology
- Clinical Psychology
- Healthcare Management
Background:
- Healthcare professionals are at high risk of workplace violence, with an estimated 50% experiencing assault during their careers.
- Predicting patient aggression requires considering overt threats alongside subtle boundary transgressions.
- A patient's perception of an unrealistic, "special" relationship with a clinician is a significant risk factor for violence.
Observation:
- Violence prediction involves not only overt threats but also subtle boundary transgressions.
- Examples include out-of-hours patient contact (phone, home visits) and perceived unrealistic special relationships.
Findings:
- Patient perception of a unique, special relationship with a clinician is a key danger indicator.
- Subtle boundary violations are as significant as direct threats in predicting potential violence.
Implications:
- Healthcare professionals should be trained to recognize subtle signs of escalating patient fixation.
- Open discussion of countertransference and boundary issues, without blame, is vital for prevention.
- Creating a supportive environment for staff to discuss challenging patient dynamics can mitigate risks.