Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
J Nurs Manag. 2016 Mar;24(2):164-73. doi: 10.1111/jonm.12281. Epub 2014 Dec 26.
This study explores nurse managers' experiences in dealing with patient/family violence toward their staff.
Studies and guidelines have emphasised the responsibility of nurse managers to manage violence directed at their staff. Although studies on nursing staff have highlighted the ineffectiveness of strategies used by nurse managers, few have explored their perspectives on dealing with violence.
This qualitative study adopted a grounded theory approach to explore the experiences of 26 Japanese nurse managers.
The nurse managers made decisions using internalised ethical values, which included maintaining organisational functioning, keeping staff safe, advocating for the patient/family and avoiding moral transgressions. They resolved internal conflicts among their ethical values by repeating a holistic assessment and simultaneous approach consisting of damage control and dialogue. They facilitated the involved persons' understanding, acceptance and sensemaking of the incident, which contributed to a resolution of the internal conflicts among their ethical values.
Nurse managers adhere to their ethical values when dealing with patient violence toward nurses. Their ethical decision-making process should be acknowledged as an effective strategy to manage violence.
Organisational strategies that support and incorporate managers' ethical decision-making are needed to prevent and manage violence toward nurses.
本研究探讨了护士长在应对患者/家属对其员工暴力行为方面的经验。
研究和指南强调了护士长管理针对其员工的暴力行为的责任。尽管针对护理人员的研究强调了护士长所使用策略的无效性，但很少有研究探讨他们在处理暴力行为方面的观点。
本定性研究采用扎根理论方法，探讨了 26 名日本护士长的经验。
护士长使用内化的伦理价值观做出决策，这些价值观包括维护组织运作、保障员工安全、倡导患者/家属权益和避免道德违规。他们通过反复进行整体评估和同时采取控制损害和对话的方法来解决伦理价值观之间的内部冲突。他们促进了相关人员对事件的理解、接受和意义建构，有助于解决伦理价值观之间的内部冲突。
护士长在处理患者对护士的暴力行为时坚持自己的伦理价值观。他们的伦理决策过程应被视为管理暴力行为的有效策略。
需要制定支持和纳入管理人员伦理决策的组织策略，以预防和管理对护士的暴力行为。
