Health Promotion Strategies to Address Workplace Violence, the Roles of Nurses in Health Promotion Strategies - Literature review Example

Name: Lecturer: Course: Date: Health Promotion Strategies to Address Workplace Violence The concept of workplace violence is variedly defined in the nursing literature. Basically, it has been classified based on a range of variables and parameters, which however make it difficult to originate a definite operational definition. Iglesias and Vallejo (2012) suggest that despite the lack of a single acceptable definition, violence can variably be defined as an interactive process manifested as dissonance, disagreement or interactive process between or within social entities. In actual fact, occurrence of such aggressions at the workplace, typifies workplace conflict. In a study of conflict resolutions styles in community nursing, Iglesias and Vallejo (2012) observed that a more definite understanding of the factors underlying conflict resolution styles can lead to the promotion of better organisational management strategies (Kemppainen, Tossavainen and Turunen, 2012). Such responsibilities entail ensuring that workplace conflicts do not negatively affect workplace interrelation and client health outcomes. In which case, a healthy workplace consists of an environment where nurses can safely identify conflicts and implement strategies for its effective management (Khanaki and Hassanzadeh, 2010). In a recent survey aimed at outlining the roles of nurses in health promotion strategies, Kemppainen, Tossavainen and Turunen (2012) observed that nurses play a critical role in promotion of workplace interrelationships, despite their focus having been on prevention of diseases and behaviour change of individuals. According to Kemppainen, Tossavainen and Turunen (2012), despite their roles as promoters of health being complex (and because of their multidisciplinary experience and knowledge in dealing with the community), they can play a significant role in resolving workplace conflict. A study by Iglesias and Vallejo (2012) on common strategies by nurses on workplace conflict resolved that Thomas-Killman Conflict Mode Instrument (TKI) can be effective in managing conflict in work scenarios. The key strategies identified in the study included compromising, competing, avoiding, accommodating and collaborating. Khanaki and Hassanzadeh’s (2010) study in Sweden and Iran on the ideal strategies for workplace conflict management also suggested the use of KTI. A study by Iglesias (2012) examined the effects of different conflict management strategies that promote job satisfaction in rural healthcare settings. Graham (2009) discussed that, in healthcare environment in rural settings, conflict is extremely prevalent, citing a survey on 2,000 nurses that found that 75 percent confessed to being in a conflicting situation with their subordinates. Essentially, this implies that experienced nurses set up their inexperienced colleagues to fail. Graham (2009) further suggested that under such circumstances, the five strategies could effectively resolve conflicts based on Ruble and Thomas’ (1976) model. With regards to accommodating strategy, Iglesias and Vallejo (2012) posited that a substantial overall difference in strategies between community nurses in clinical setting and school settings existed, with the greatest being accommodating. These results were consistent with findings by previous studies, Graham (2009), which applied the TKI instrument. According to Khanaki and Hassanzadeh’s (2010), accommodating strategy involved giving the other conflicting party what it wants. In consistency with the findings, Iglesias and Vallejo (2012) noted that accommodating strategy is cooperative and assertive, where one party allows the other to dominate. However, the study found that accommodating strategy was infrequently used in clinical setting. Of the 130 nurses surveyed, the researchers found that the most frequently used strategies in workplace conflict resolution included compromising (at 27.7 percent), followed by competing (at 26.2 percent), avoidance (at 23.1 percent), accommodating (at 18.5 percent) and collaborating at (4.6 percent). With regards to avoidance strategy, Graham (2009) suggested that a substantial number of nurses deal with conflict through avoidance in a bid to prevent disrupting relationship and to maintain status quo. Khanaki and Hassanzadeh’s (2010) pointed out that the avoidance strategy seeks to defer conflict indefinitely through ignoring or delaying the conflict, where an individual expected the problem to resolve itself without confrontation. Iglesias and Vallejo (2012) however commented that avoidance of conflict has an extensively damaging impact on relationship building as it allows conflict to unaddressed in healthcare settings. The inclination towards using compromising strategy also reflected the choice of conflict management strategy in nursing. Graham (2009) observed that when nurses overuse compromise, it may lead to their long-term health promotion goals not being given serious consideration by the public or other heal professionals. Khanaki and Hassanzadeh’s (2010) commented that when managers use this model, they are basically asking what each employee can give up of what they desire so that a conflict can be resolved. Graham (2009) study also considered collaboration as an effective conflict management strategy. Iglesias et al (2012) observed that while ideal nurses should use collaborative strategies, they should also develop other approaches as back up strategies. Khanaki and Hassanzadeh’s (2010) defined collaboration as a mutually acceptable solution where each party to a conflict addresses some concern partially, exchanges concessions and finds a middle-ground position. Latham, Hogan and Ringl (2008) conducted a three-year study to examine conflict resolution styles among nurses in academic-hospital collaboration. The data indicated that collaboration equipped the nurses to handle workplace conflicts and to address professional work relationships. Khanaki and Hassanzadeh (2010) described competing as a situation where one person attempts to gain complete dominance. The strategy can be used by nurses in situations where quick decisions have to be made and in instances where there is no time for discussion, such as during cases of emergency. Iglesias and Vallejo (2012) observed that such situations are likely to lead to winners and losers or even encourage strained work relationships. While conflict management strategies among males and female nurses vary, males tend to use competing strategy approach more. Iglesias further commented that while males showed greater inclination towards competing, females showed greater tendency to use compromise strategy (Iglesias and Vallejo, 2012). Community nursing and how it is informed by selective rather than comprehensive primary care approach Shi (2012) approached the terms “primary health care” and “primary care” as distinct approaches. Shi (2012) used primary care to depict family medicine services provided by nurses to individual patients, commenting further that it is a person-oriented longitudinal care. Conversely, primary health care is a wider concept aimed at describing both population-focused and person-oriented approaches. Primary health care further incorporates social policies such as universal access to healthcare in addition to emphasis on health equity and collaboration. Indeed, large bodies of researches have used a similar approach to explore the work of a community nurse and how the work of a community nurse is to a greater extent informed by selective than comprehensive primary care approach (Leahy-Warren, 2012; Shi, 2012). Because of the high cost of comprehensive primary health care, Leahy-Warren (2012) observed that a more selective approach (disease-focused) is encouraged. Essentially, selective primary healthcare approach entails fighting a disease using cost-effective medical interventions. Leahy-Warren (2012) and Shi (2012) found that such a model was effective in the work of a community nurse due to its selective scope. On the other hand, comprehensive primary healthcare approach focuses on a prevention, control and treatment of a large number of health problems at the same time. In a study aimed at investigating the evolving public health roles in community nursing, Kulbok et al. (2012) observed that community nursing entails working with communities as equal partners, with the focus being on primary prevention of specific diseases. The study found that other distinguishing characteristics of community nursing have evolved in the context of philosophical and historical perspective on professionalization of nursing, preventive healthcare and nursing. A significant finding by the study is that community nursing roles entailed partnership and collaborating with communities to address certain health conditions and problems that were of a primary concern. Kulbok et al. (2012) noted that at advanced levels, community nursing competencies and knowledge prepared nurses to assume leadership roles to examine the needs and assets of communities and the public and to suggest health solutions for selected issues in collaboration. In the researcher’s view, community-focused solutions play a far-reaching impact on public health and illnesses patterns of various levels of clients such as families, groups, the wider population, individuals and communities. Despite this, using a selective approach was more applicable in community settings particularly in developing countries (Leahy-Warren, 2012; Shi, 2012). Kulbok et al. (2012) demonstrated that the focus of community nursing roles have evolved towards working with vulnerable populations in a range of settings such as schools, communities, homes, worksites and neighbourhoods. A survey of participation of nurses in communities in Paraguay, Mexico and Colombia by Nigenda et al. (2010) observed that community nurses play a critical role in health promotion and disease prevention and control, at community and population levels. The study found that despite the fact that the roles of the community nurses are publicly perceived to be restricted to be direct patient care, community nurses make significant contributions to community health on a daily basis by participating in disease surveillance, patient education and public health campaigns. Nigenda et al. (2010) further established that contributions are particularly crucial with regards to recent epidemiological and demographic shifts, shifts in health workforce and healthcare reforms across the Americas. Such findings are consistent with observations made by Kulbok et al. (2012) that the shifting roles of nurses are shaped by the evolving cultures, politics, economics, determinants of health and psychosocial problems. Despite this level of evolution, community nursing has tended to focus on selective disease prevention and control (Leahy-Warren, 2012; Shi, 2012). Taking a similar perspective, Perry and Hoffman (2010) observed that community nurses can improve their cultural competences in light of shifting cultural paradigms by using participatory practices in diverse community settings. Kulbok et al. (2012) observed that an ideal approach for such changing scenarios in community nursing roles could be approached using ethnographic and community participation that is based in local knowledge, which is derived from community members of diverse races, value, beliefs, attitudes and ethnicity. Consistent with the approach, Perry and Hoffman’s (2010) study indicated that adopting a community participatory approach in changing the role of a community nurse enabled the nurses to work in diverse cultural settings particularly when they integrated community insiders to participate in community nursing program planning. Thomas et al. (2009) took a similar perspective in a study that surveyed the roles of community healthcare in reducing substance abuse in tribal communities in American Indian/Alaska Native communities. Thomas et al. (2009) demonstrated that community nurses could control and prevent drug abuse at community levels by achieving culturally sensitive knowledge of the strengths, history and tradition of the community through encouraging insiders of the community to participate in nursing planning programs. Sambala, Sapsed and Mkandawire (2010) commented that in order to ensure access to health services within the structure of primary health care, nurses had to assume the role of being collaborators within the diverse cultures of a community to solve selective health problems. Sambala, Sapsed and Mkandawire’s (2010) study was based on the premise that the primary goal of primary healthcare to make universal healthcare to be available to all people has become increasingly neglected due to emerging trend towards globalization, foreign policy and trend. The researchers found that primary health care can unlock barriers to healthcare services and contribute immensely towards collective health by promoting universal basic health services. Based on the above literature analysis, it can indeed be argued that primary health care has been affected by a shift in socioeconomic status, highlighting on basic health services and focus on health system. Some critics have considered primary healthcare to be too expensive and replaced it with selective models (disease-focused). Despite this, following years of investment in vertical interventions, preventable diseases have remained a major challenge. Although selective model has failed to respond favourably to the interrelationship between social and economic factors and health, its cost-effectiveness and practicability in community nursing has made it the more ideal approach. Based on this premise, it is critical to note that the work of a community nurse is to a greater extent informed by selective than comprehensive primary care approach. References Graham, S. (2009). "The Effects of Different Conflict Management Styles on Job Satisfaction in Rural Healthcare Settings.” Economics & Business Journal 2(1), 71-85 Iglesias, M. & Vallejo, B. (2012). "Confl ict resolution styles in the nursing profession." Contemporary Nurse 43(1), 73–80. Khanaki, H. & Hassanzadeh, N. (2010). "Conflict Management Styles: The Iranian General Preference Compared to the Swedish." International Journal of Innovation, Management and Technology, 1(4), 419-426 Kemppainen, V. Tossavainen, K. & Turunen, H. (2012). "Nurses' roles in health promotion practice: an integrative review." Health Promot. Int. 28(4), 1-12 Kulbok, ulbok, P.A., Thatcher, E., Park, E., Meszaros, P.S. (May 31, 2012) "Evolving Public Health Nursing Roles: Focus on Community Participatory Health Promotion and Prevention" OJIN: The Online Journal of Issues in Nursing 17(2) Latham, C. Hogan, M., & Ringl, K. (2008). “Nurses supporting nurses: Creating a mentoring program for staff nurses to improve the workforce environment.” Nursing Administration Quarterly, 32(1), 27–39. Leahy-Warren, P., Clancy, A., Day, M. & Mulcahy, H. (2013). "Primary Health Care: Comparing Public Health Nursing Models in Ireland and Norway." Nursing Research and Practice, 2013 Article ID 426107, 9 pages Nigenda, Q., Magaña-Valladares, L., Cooper, K. & Ruiz-Larios, J. (2010). "Recent Developments in Public Health Nursing in the Americas." Int J Environ Res Public Health, 7(3), 729–750. Perry, C. & Hoffaman, B. (2010). “Assessing tribal youth physical activity and programming using a community-based participatory research approach.” Public Health Nursing, 27(2), 1-17 Sambala, E., Sapsed, S. & Mkandawire, M. (2010) "Role of Primary Health Care in Ensuring Access to Medicines." Croatian Medical Journal, 51(3), 181–190. Shi, L. (2012). "The Impact of Primary Care: A Focused Review." Scientifica, 2012, Article ID 432892, 22 pages. Retrieved: Thomas, L. R., Donovan, D. M., Sigo, R. LW., Austin, L., & Marlatt, G. A. (2009). “The community pulling together: A tribal community-university partnership project to reduce substance abuse and promote good health in a reservation tribal community.” Journal of Ethen Substance Abuse, 8(3), 1-13. Read More