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Taylor, K. (2014). Managing conflict. Practice Nurse, 44(10), 32-34.
We live in an increasingly demanding and vociferous society and incidents of conflict and aggression are sadly commonplace. Kate Taylor, Clinical Risk Manager at the Medical Protection Society offers advice on how to deal with the problem Working in general practice is busy and demanding, with increased workloads, stretched time and some patients having greater expectations of care. At times, when expectations are not met, we can find ourselves in conflict with patients - and in some situations this can turn to aggression. As nurses, how should we deal with potentially difficult situations? This article aims to increase our understanding of conflict and provide strategies to deal with it effectively. It also includes practical tips to reduce risks associated with managing conflict and aggression. DEFINITIONS
Conflict means different things to different people. The Health and Safety Executive defines workplace violence as 'any incident where staff are abused, threatened or assaulted in circumstances relating to their work, involving an explicit or implicit challenge to their safety, well-being or health'.1 Non-physical violence can be defined as the 'use of inappropriate words or behaviour causing distress and/or constituting harassment.'[ 2] The scale of the problem
There is limited documentation relating to violence against nurses working in general practice. However, a recent survey carried out by the British Medical Association, to which 20% of doctors responded, found:[ 3] * Violence is a problem in the workplace for half of doctors (same for GPs and hospital doctors). * 1 in 3 respondents had experienced some form of violence in the workplace in the last year (same for hospital doctors and GPs). * 1 in 5 doctors reported an increase in violence in the past year, but the level remained constant for the majority. * Among doctors who reported some experience of violence, most had been the victim of verbal abuse in the past year while more than half had received a threat, and a third had been physically assaulted. Most injuries were minor, but 5% were serious. In April 2011, NHS Protect was set up. It is responsible for leading on work to protect NHS staff and resources from crime in England.[ 4] According to its statistics, physical assault against NHS staff is steadily increasing. However, these statistics do not capture the incidents where staff have been subjected to non-physical violence. In general practice, members of staff are more likely to be subjected to non-physical violence. Imagine working as a practice nurse and an unhappy patient threatens you, telling you 'I know where you live
' We cannot underestimate the impact that such non-physical violence can have on individuals. CONTRIBUTORY FACTORS
* Members of the general practice team are particularly vulnerable as they often consult with patients alone. Doctors and practice nurses often work in small numbers. * Home visits are usually carried out alone.
System and Organisational Problems
* Delays, restrictions and mistakes such as lost prescriptions or delays in test results * Lack of appointments
* Patient disappointment often results from unmet expectations, whether realistic or unrealistic. Environment
References: Taylor, K. (2014). Managing conflict. Practice Nurse, 44(10), 32-34.