Violence and Aggression in the Health Care Sector

This chapter focuses on the causes of violence between a patient (or his relative) and a healthcare professional. It aims at defining variables affecting such situations in nursing. Nurses are involved in the most conflicts – the doctor has to pop out to another patient; hospital attendant goes for a sample to a laboratory; a paramedic passes a patient on and leaves for the next ambulance trip, but, a ward nurse has to do managing tasks particularly but a general nurse stays all the time of her shift next to her patient (Weinreb, 2014[1]). Situations in which we “get angry”, affect our emotions.  Increasing negative emotions decrease our ability to use our reason and to avoid the conflict. This is amplified by stress resulting from an unpleasant situation. The close link between violence and stress is mentioned in almost all studies dealing with violence in the health service and at the workplace.  As soon as the stress is intensive and exceeds a common frame, it becomes a negative factor and an employee who is not able to cope with it; therefore, it may lead to both physical and mental problems (reduced self-control, non-professional communication). Nevertheless it doesn´t mean, that every negative stress also involves violence (Hoel, 2000).  The behaviour of some healthcare professionals that is sometimes poor or non-professional may provoke potential attackers to attacks. Insufficient knowledge of anamnesis may result in using words or behaviour of medical personal that unconsciously evokes unpleasant memories or experiences for the patient that can cause disturbing feelings leading to violent behaviour. Such behaviour can be evoked by tiredness or by such situations when a healthcare professional thinks he has to accept “all”. Therefore, it is important to always consider not only the patient´s viewpoint but also the view of the healthcare professional, who also has  feelings and emotions.  

We can divide violence sources in the contact between a healthcare professional and a patient/his relative in two levels:  the first level, when a healthcare professional can evoke negative emotions at a patient and the second level, when a patient can evoke negative emotions at a healthcare professional. Final consequence of these both levels could be violence.