behavioral learning in nursing

Topics: Nursing, Verbal abuse, Violence Pages: 14 (3359 words) Published: October 10, 2013

Journal for Nurses in Staff Development & Volume 27, Number 2, 65Y68 & Copyright B 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Interactive Theater
An Innovative Conflict Resolution Teaching Methodology
Anne L. Meng, MN, CPNP, RNC, AE-C


John Sullivan, MA

The incidence of verbally abusive families has dramatically
increased in pediatric hospitals. A workshop incorporating
interactive theater was designed to support staff in
developing assertive communication skills to manage
verbal abuse. Professional actors performed skits based on
clinical scenarios. Participants entered the scenarios at any point to change the communication style and affect a
positive outcome. Interactive theater enhances emotive
learning that is essential to affect behavioral change. This is a useful strategy for educators to include in any training
that is designed to change behavior.


orking in a healthcare facility is considered
the third most dangerous job in the United
States (Gilmore-Hall, 2001). An online survey
conducted by the American Nurses Association found
that 17% of nurses were physically assaulted in the previous year, and 57% reported verbal abuse (Distasio, 2002). In fact, nonphysical violence has become so common that it is considered normative (Lanza, Zeiss, & Reirdan, 2006). Most studies of workplace violence examine areas such as psychiatric or emergency room settings, where violence is known to be a problem.

However, a Canadian survey (Pejic, 2005) concluded
that verbal abuse is as common in pediatric settings as
it is in other nursing environments, with 91% of pediatric
nurses identifying themselves as victims of verbal abuse.
Pediatric nursing staff in a children’s hospital identified verbal abuse from parents as a significant stressor in their work environment. Staff often resorted to contacting campus police to manage parents, but this was clearly not an ideal first-line strategy. The identified

problem was a lack of assertiveness skills among staff.
The purpose of this article was to describe an innovative
staff development initiative that incorporated interactive

Anne L. Meng, MN, CPNP, RNC, AE-C, is Advanced Nurse Practitioner and Special Projects Coordinator, Department of Nursing Practice and Professional Development, University of Texas Medical Branch, Galveston. John Sullivan, MA, is Codirector, Public Forum and Toxics Assistance Division/NIEHS Center for Environmental Toxicology, University of Texas Medical Branch, Galveston.

Drive, League City, TX 77573 (e-mail:
DOI: 10.1097/NND.0b013e31820eee5b
Journal for Nurses in Staff Development

theater (IT) as an emotive learning strategy to enhance
application of assertiveness skills in clinical practice.

Workplace violence includes nonphysical acts such as
threatening behavior, verbal abuse, verbal threats, obscene telephone calls, intimidation, or harassment of any nature, including being followed, sworn at, or
shouted at (Anderson & Stamper, 2001; Distasio, 2002).
Verbal abuse is behavior that humiliates, degrades, or
otherwise indicates a lack of respect for the dignity
and worth of another individual (Pejic, 2005).
Verbal abuse is related to physical violence. Physical
violence increases sevenfold for those who experience
nonphysical violence. Risk of physical violence is high
in verbally abusive environments, even though different
individuals perpetrate these two forms of behavior. It is
theorized that nonphysical violence creates a culture of
disrespect that is conducive to the emergence of physical
violence, whether by the same or different individuals
(Lanza et al., 2006).
Most perpetrators are men, and the majority are patients (Anderson & Stamper, 2001; Gerberich et al., 2004); one in four is a visitor, but abusers can also be coworkers, managers, or physicians (Anderson & Stamper,...

References: Anderson, C., & Stamper, M. (2001). Workplace violence. RN,
64(2), 71Y74.
Arnetz, J. E., & Arnetz, B. B. (2001). Violence towards health care
staff and possible effects on the quality of patient care
Boal, A. (1979). Theatre of the oppressed. New York: Theater
Group, Inc.
Distasio, C. (2002). Protecting yourself from violence in the
Findorff, M. J., McGovern, P. M., & Sinclair, S. (2005). Work-related
violence policy
Gilmore-Hall, A. (2001). Violence in the workplace: Are you
prepared? American Journal of Nursing, 101(7), 55Y56.
Lanza, M. L., Zeiss, R. A., & Reirdan, J. (2006). Non-physical violence:
A risk factor for physical violence in health care settings
Pejic, A. R. (2005). Verbal abuse: A problem for pediatric nurses.
Ray, C. L., & Subich, L. M. (1998). Staff assaults and injuries in a
psychiatric hospital as a function of three attitudinal variables.
Sternberg, P., & Garcia, A. (1998). Sociodrama: Who’s in your shoes.
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