Exam 25: Workplace Violence and Incivility

As a senior manager,you notice that there have been several resignations on a unit where a new charge nurse has been hired.You suspect that the new charge nurse may be demonstrating bullying behaviors,but staff say little about their relationship with the charge nurse.Your decisions about intervention would be based on which assumptions?

Residents in a new long-term care facility attend a large dining hall for meals.In reviewing reports of aggression and violence,you note that behaviors such as hitting,or attempting,to hit staff are increasing.Further investigation suggests that this behavior occurs most often at mealtimes.A possible intervention would be to:

A patient who has a history of involvement with drugs and weapons comes up to you in the hallway and asks you a question regarding directions in treatment.When you respond,he moves closer in to you and puts both hands up on either side of your neck.No one else is in the hallway.Your best response at this point is to:

In the Emergency Department waiting room,you notice a patient sitting,with his head in his hands,who has been waiting for about 5 hours for relief of his headache.When you approach him to ask him how he is doing,he says,"I can't believe that I have to wait this long for help! Do you know what it is like to be in pain for 10 hours?" Your response to him would be:

Sarah is involved in intervening when a patient attempts to harm herself on the unit.During the interaction,the patient slaps Sarah across the face.As a head nurse,it is important that you:

Becky,RN,works as a staff nurse in mental health; Sharon works as a data entry clerk in Admissions; Sarah is an emergency room physician; and Donna is a housekeeper in geriatrics.Which of these four is most at risk for violence and aggression?

Which of the following healthcare employees is MOST at risk for violence?

While working with an aggressive patient,it is important for the nurse to:

You note that Unit 64 has had a high turnover rate of staff during the past year.In selecting the appropriate action,it is important that:

Which of the following is NOT a factor in patient- and/or family-generated violence in healthcare settings?

Delaney,one of your staff nurses,confides that Marjorie,another nurse,has been actively telling others that you are incompetent and do not know what you are doing in relation to patient care,and that you lie to the staff about attempts to get more staffing.Delaney says that Marjorie is derogatory towards her in front of others and tells her "that she better shape up." Through telephone calls and conversations during breaks,she is recruiting other staff to her position.Delaney confides that most of the staff find you fair,honest,and knowledgeable.Marjorie's behavior can best be characterized as:

Linda,a staff nurse on nights,yells at Ali,another RN,and tells Ali that she is stupid and can't get anything right.In responding to this situation as head nurse,it is critical that you:

As a nurse manager,you realize that your unit has become a toxic environment in which horizontal violence and incivility has become common.In addressing the problem,you decide to implement which of the following?

Caroline asks family members to leave while she cares for the 16-year-old victim of a recent car accident.The father screams at her and tells her that she has no right to ask his family to leave,and that if she continues to do so,he will "throw her out of the room." Caroline is shaken and tells her head nurse,who tells her that this kind of thing is just part of the job.The guidance of the head nurse:

During coffee and other breaks,Rosalie,the new RN,is shut out of conversations with the other staff.When she approaches other staff on the unit to ask questions,they turn and walk off in the other direction.The behavior of the staff is characteristic of:

Your healthcare organization places a high value on workplace safety and integrates this into all aspects of administrative and patient care processes.As a unit manager,you thoroughly endorse this direction,and during the selection and hiring of new staff,you consistently:

At 3 AM,a man walks into your emergency department.He paces back and forth in the waiting area before he approaches staff to ask if he can see his wife,who is a patient on another floor.He speaks rapidly,his face is flushed,he glances around often,and he keeps his hand in his jacket pocket.A best initial response would be to:

In which of the following situations would you,as the head nurse,be concerned about potential safety issues?

You need to terminate Gregory,who has had a long-standing history of conflict with you and the staff,and who recently was charged with theft of patient belongings.You consult Human Resources,and together,you develop a plan,which includes:

You note that Unit 64 has had a high turnover rate of staff during the past year.In investigating this situation,an important source of data might include: