Nurses are on the front lines and the back bones in the health sectors . Workplace violence is becoming an important issue that all organizations, these behaviours , especially that of bullying are detrimental and effect staff , patients , and outcome. Violence are defined as ( an incident that results in physical injury).(Duncan, Hyndan 2001 as cited in Denise,2009). Regarding to many research I found that nurses in emergency department and in mental health sectors are the most high risk staff who are facing violence form patients , their families and visitors because of many factors that I will discussed on my paper .

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The aim of my research is review background of workplace violence . In addition to, identify situations and specific patient groups susceptible to being involved .Furthermore , identify the most health care sectors that are more susceptible to violence and factors leading to violence in these sectors depend on research articles to support my paper .Besides, identify the best nursing practice in the management of patient hostile behaviour and violence because nurses play a major role and the most staff dealing with different type of patient and cases. Finally, identify the role of health sector to minimize the risk of violence against nurses and the recommendation need it to prevent violence in health sectors .
Violence against Nursing in Health sectors
Work place violence is a serious occupational risk towards nursing.(International Council of nurses 2002 , Mc paul and Moore 2004 as cited in Jessica, Altair ,Lara, Cathy, Linda and Susan,2009).In hospital violence occurs most frequently in psychiatric wards, emergency departments ,waiting room ,and geriatric units.(Sofield and Salmond 2003 as cited in Jessica et al., 2009) they conducted studies and found that 35% to 80% of hospital staff suffering from violence either if its verbally or physically..
The causes of work site violence are multifaceted and diverse .In hospitals ,clinics, health home setting, co-workers ,family members, patients or visitors may cause or contribute to violent events.(Maggie&Terriy,2005).The escalating risk in emergency department environment are reflective of patient under influence of drugs and alcohol abuse are often associated factors in patient-initiated violence on nursing staff , miscommunication and low staff levels leads to anger and long waiting times for patient.( Chalermrat , Virasakdi ,Suparnee ,Teem &Rassamee,2008 ).Beside, related to emergency situation and increasing number of patient with dementia and psychosis .Other risk factors are prevalence of guns and weapons that being carried by patients and their family or friends. (Gordan,Donna,Margret&Patricia,2010).In addition , lack of staff training or visible security ward. For instance, patients illnesses and unpleasant feeling ,as well as, the anxious and stress by patients and their family member and also visitors are often escalated by not enough space All these factors contributing and may incite physical and verbal abuse against emergency department staff.
On the other hand, nurses working in psychiatric setting have a higher risk for becoming victims of violence too. According to Gordon and Donna and Margared and Patricia,2010 was conducted a research about Workplace Violence in Health care Setting : Risk factors and protective Strategies and identify the risk factors in to perpetrator ,worker and setting environment risk factors. The perpetrator risk factors such as patient with mental health disorder like dementia, schizophrenia and alcohol and drug abuse have been associated with risk for workplace violence .However, setting and environmental factors that were related to increase risk for violence included day time versus evening and nighttimes hours .Equally important, work factors that were associated with violence include workers’ gender , the research show that women experienced a higher risk of verbal violence ,in contrast, men experienced physical violence.Besides,other characteristics of worker factors are number of hours worked per week and marital status.
Employees in health care settings can’t prevent all violent events,however,they can use vary strategies to protect themselves against consequence of workplace violence.
Management of patient violence Nurses
Violence against nurses can be dangerous aspect of one’s nursing career. By providing the greatest amount of direct services to patients. nurses play a very great degree valuable role in the quality and efficiency of care and curative services.(Myduc,Stephen,Jay,Carri,Kenneth,2009).
Violence can be prevented and avoided by nurses who are aware ,well trained and in control .Nursing care should be in corporate activities within the domains of providing physical, psychological and emotional support through assess physical and emotional and psychological needs for violent .In addition to maintain privacy and personal safety. Besides physical and emotional support , the nurses should enhance safety of the patient and their family by focusing on the needs of family as a whole ,also full assessment for patient and family . In addition , a calm environment and greeting can stop noisy arguments ..(Maggie and Terry,2005). Moreover, good communication skills and proper intervention are more important to reduce the effects on mental health people and performance because some patient who are violence under the influence of drugs and alcohol even the visitors of patient.(Chalermrat et al.,2008). Finally, promote self efficacy by provide patient care plan ,health education and provide information about local and national help and support and available opinion. Further-more ,encourage safety planning and recognizing the patient’s experience regarding their situation and respecting and support patient and their family decision.(Gordon,2008).
Violence preventing training for hospital is one step in reducing the incidence of violence in hospital emergency rooms. Potentially, violence patients and visitors can be recognized by the hospital staff by attending training in violence prevention .Also, alert supervisors to any concerns about safety and report all incident immediately in writting.(Tessa,Sue,Maureen,John,Martha,Sabina,Sandra,Greg,2010). Staffs work together or with a professionally trained individual to provide an open atmosphere in which to discuss the critical violent incident and need to learn don’t meet aggression with aggression.
Role of health care sector
All of the government initiatives in arrangement in light fixture and making the manager responsible to ensure well-being of their staff and put place reporting and monitoring systems ,but more emphasis is need in identity of the trigger factors to patient behaviour and appropriate management.
Similarly, the nurse play major role with violent patient ,of course the health sector play a major role to protect their staff and preventing violence .Facility administrator should provide a culture of support to those person who experience violence exposures in the work. In addition , can use a conventional and a credible system data to develop programs that increase staff safety and reduce the occurrence of violence exposure.
To prevent and avoid violence , staff need to understand both violent activities and their development in the workplace . Education the staff regarding the function , role and responsibilities of the emergency nurse and the department may reduce the tension between staff. Also, education and training staff in the administration regarding the appropriate response to aggression behaviour if necessary. Moreover, close relationship with the police to tackle violence against staff to deal with the abuse behaviour once occurs.(Magie,2005). Equally important, provide enough staff member including nursing, medical officer support and security staff , besides , reduction of waiting time and the development policies and procedures to deal with the situation in case of emergency. Finally, provide video camera in emergency department to be used as evidence if necessary.(Ontario Nurses association,2008).
Conclusion
Nursing is a hard profession its physically and intellectually demanding. It requires patience and ability to relate to diverse types of patients ,communication skills and flexibility.
Violence at work place is a complex problem which demand multifunctional actions and cooperation even with safety policies and procedures in place ,hospital and other health care setting can be dangerous places ,filled with individuals who are under stress .Part of nurses job to raise awareness in the health and aged care sectors and the community about the incidence of violence and its unacceptability as a workplace hazard are beginning to empower nurses to report violent incidents, to act to minimize risk , and to ensure their employers accept their legal obligations to provide a safe place for nurses to work and to provide care for the community.
Work place violence is unacceptable not only in nursing place ,but also in all workplace .
An important planning ,systematic assessment and effective responses strategies are necessary to deal with mental health illness and violent patient in any sectors ,some times its difficult, but by training sessions and copying strategies it could help to prepare nurses for violence in workplace.
Failure to prevent workplace violence , it could result in prosecution , loss of valuable employees , productivity and efficiency. (Stella,Malcolm&Jan,2008).