Australian nurses' suggestions for the management of violence in the workplace: 'The people who make the policy are not the people on the floor'.

ABSTRACT

AIM(S) To ascertain nurses' perceptions about, and suggestions for, management solutions to workplace violence perpetrated by patients. BACKGROUND: Violence towards nurses from patients in the workplace is high in Australia. There is a need for good management responses, and experienced nurses can provide logistical suggestions about effective strategies. METHOD(S) This study uses an exploratory qualitative design. Focus group interviews were undertaken with 23 nurses working in a regional public hospital in Queensland, Australia. The COREQ research reporting checklist was followed, and the qualitative data were transcribed and thematically analysed manually and by NVivo. RESULTS: Policy implementation, training, staff movement, seclusion, debriefing and a full reporting cycle were identified as central themes. Workplace violence management happens before, during and after a violent event. CONCLUSION(S) Weak processes undermine management; staff training on de-escalation is needed. Affected staff need freedom to move from the ward. Better medical orders should be in place before an event. A full debriefing and feedback cycle are required, along with easier reporting processes. IMPLICATIONS FOR NURSING MANAGEMENT Nursing management can reduce violence by ensuring better institutional support, consistent follow-up and complete feedback procedures. Legal support, follow-up mechanisms and staff training in de-escalation are key points.