Violence Prevention in the Workplace

Violence Prevention in the Workplace
CEUs available at: https://allceus.com/member/cart/index/product/id/1082/c/

Dr. Dawn-Elise Snipes, PhD, LPC-MHSP
Executive Director: AllCEUs Counselor Education
Podcast Host: Counselor Toolbox, Case Management Toolbox
Based in Part on
– Registered Nurses’ Association of Ontario (2012). Managing and Mitigating Conflict in Health-care Teams. Toronto, Canada: Registered Nurses’ Association of Ontario.
– Registered Nurses’ Association of Ontario (RNAO). Preventing violence, harassment and bullying against health workers. 2nd ed. Toronto (ON): RNAO; 2019.
Objectives
– Define types of violence in the workplace
– Explore best practices for prevention

Types of Violence
– Type I (Criminal intent): perpetrator has no relationship to the workplace
– Type II (Client or customer): perpetrator is a client at the workplace who becomes violent toward a worker or another client
– Type III (Worker-to-worker): perpetrator is an employee or past employee of the workplace
– Type IV (Personal relationship): perpetrator usually has a relationship with an employee (e.g. domestic violence in the workplace)
– Type V (Worker-to-client): perpetrator is an employee who becomes violent towards a client

Violence in the workplace

– Involves a misuse of power and control and it may take the form of physical, psychological or sexual abuse; and/or harassment, mobbing, bullying, or aggression.
– May involve action or withholding action.
– May be done unintentionally or intentionally.
– Often involves interactions between people in different roles and power relationships
– Is inevitable in the work setting due to inherent differences in goals, needs, desires, responsibilities, perceptions and ideas
Conflict Inevitability
– Conflict is inevitable in work settings.
– Perceived and actual differences that may contribute to conflict include:
– Professional identity and/or education
– Cultural identity
– Gender and gender identity
– Marital status
– Disability
– Work values
– Goals
– Interests
– Treatment approach

Other Factors Contributing To Conflict
– Effects of shift work
– Team composition and size
– Workload and staffing
– Role ambiguity
– Manager span of control
– Power differences
– Level of staff involvement in decision-making and provision of care
– Resource allocation
– Diversity in the workplace
– Physical space
– Diagnoses/stressors in the person’s life

Underpinnings of Violence Prevention
– Leadership is required across all organizational levels to create environments that practice management and mitigation of conflict.
– All conflict has a meaning and/or contributing underlying cause.
– Anger is often a response to a threat of loss of control, rejection, isolation, failure, the unknown
– Understanding, mitigating and managing conflict may result in positive outcomes such as new ideas and initiatives.
– Conflict is addressed in different ways depending upon who the conflict is with

Systems & Processes to Minimize Conflict
– Regular assessments (clients, employees, team, org)
– Improve emotional intelligence
– Develop conflict management skills
– Educate individuals, teams, and the organization regarding conflict management in specific settings and target groups.
– OP, detox, CSU, Alzheimer’s, psychosis, home visits, SOs
– Staff on staff; staff on client; client on staff
– Implementing refresher courses and/or updates
– Require managers to demonstrate accountability for effective conflict management, clear communication and transformational leadership
Transformational Leadership
– Leader works with teams to identify needed change and create a vision to guide the change
– Highlighting important priorities and creating win/win
– Connecting the follower's sense of identity to a project and to the collective identity of the organization
– Being a role model inspire and to raise their interest in the project
– Challenging followers to take ownership of their work
– Understanding the strengths and weaknesses of followers

Transformational Leadership
– Aligning followers with tasks that enhance their performance
– Creating an ethical climate (share values, high ethical standards)
– Encouraging followers to look beyond self to the common good
– Promoting cooperation and harmony
– Using persuasive appeals based on reason
– Providing individual coaching and mentoring for followers
– Allowing freedom of choice for followers

Systems & Processes That Minimize Conflict
– Foster intra and interprofessional collaboration
– Engage clients in
– Develop a culture that supports
– Practice accountability
– Autonomy
– Reflection
– Self-awareness
– Decision authority related to the work environment and patient care

Systems & Processes That Minimize Conflict
– Sustain effective staffing and workloads
– Ensure a climate of appreciation, trust and respect
– Value the potential positive outcomes of conflict
– Identify common situations that are likely to lead to conflict including
– Establish a safe environment to express diverse opinions

Systems & Processes That Minimize Conflict
– Examine how your behavior impacts others and how the behavior of others impacts you.
– Practice and collaborate with team members in a manner that fosters respect, trust and prevents violence.
– Refrain from gossiping, bullying (bus), harassment, or socially isolating others
– Fully adhere to organizational policies, procedures and practices related to preventing, identifying and responding to workplace violence.
– Follow organizational processes related to mandatory reporting, seeking support and providing support to others when potentially violent situations are identified or occur.
Systems & Processes That Minimize Conflict
– Ensure open communication
– Provide constructive support and feedback
– Set clear and objective goals for client care
– Use a transparent decision-making process
– Encourage active participation on the team
– Emphasize the notion that the work environment is created by each member of the team (from administrative staff to the CEO)
Conflict Management Skills
– Remain relaxed and calm
– Focus on the present
– Identify the issue(s).
– What is the real problem-
– Pick your battles
– Is your perception of the problem different-
– Perceptions + Experiences + Priorities = Point of View #1
– Perceptions + Experiences + Priorities = Point of View #2
– Allow the other person to express their concern.
– Examine your part
– Empathize
– Pay attention to nonverbals
– Recognize your own emotions
– Acknowledge and take responsibility for your part in the situation
– Use open, honest and transparent communication.
– Handle conflict sooner not later
– Seek a resolution through compromise
Self-Care Related to Conflict
– Seek support.
– Obtain information.
– Provide support to others.
– Listen, ask questions, and commit to resolving the conflict.
– Choose to listen and learn – both to your own internal voice and to the voice of your colleague or the client.
– Explore options to deal with conflict
– Separate problems from people
– Explore the reasons for your own reactions when in conflict.
– Learn from difficult behaviors
Signs of Potential Threat
– Abusive language or aggressive statements
– Agitation, restlessness or pacing
– Anxiety
– Auditory/visual hallucinations
– Cognitive impairment
– Drug/alcohol intoxication/withdrawal or a history of SUD
– History of violence/positive attitudes toward violence
– Mumbling
– Prolonged or intense glaring
– Resistance to staff

Signs of Potential Threat
– High levels of stress or triggers of stress
– Lack of space/privacy
– Poor self-care and functioning (such as poor hygiene or lack of orderliness)
– Poor social functioning and limited life skills
– Social isolation

Signs of Potential Threat
– Client Specific
– admission to new, unfamiliar environment
– being in isolation room
– quality of treatment/care received
– use of restraints
– Homelessness

STAMPEDAR
– Staring
– Tone
– Anxiety/Agitation
– Mumbling
– Pacing
– Emotions—dysphoric
– Disease process (intoxication, psychosis, cognitive impairment)
– Assertive/nonassertive
– Resources (staff knowledge, wait times, inappropriate communication)
De-Escalation
– Assume a calm, firm stance
– Speak in a clear voice but calmly and at normal volume.
– Acknowledge feelings and paraphrase what the person is saying
– Do not interrupt or try to problem-solve until the person has calmed down.
– Take care not to sound patronizing or sarcastic.
– Once they are calmer, ask what they want to have happen and how they might go about seeking a solution
RESPECT
– Recognize the inherent worth of all with whom you work.
– Eliminate derogatory words and phrases from your vocabulary.
– Speak with people – not at them – or about them.
– Practice empathy. Walk awhile in others’ shoes.
– Earn the respect of colleagues and co-workers through your behaviours.
– consider your impact on others before speaking and acting.
– Treat everyone with dignity and courtesy.
Summary
– Conflict is inevitable
– Violence prevention involves
– Creating an environment that supports open communication and respect
– Maintaining self awareness of stressors and our impact on others
– Maintaining awareness of other’s reactions, behaviors and stressors
– Educating staff and clients regarding effective conflict resolution strategies
– Minimizing triggers for conflict
– Being willing to learn from conflict