Date of Award

2012

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy (Public Health)

School

School of Exercise and Health Sciences

Faculty

Faculty of Computing, Health and Science

First Supervisor

Dr Janis Jansz

Abstract

Covert violence in the workplace has been extensively theorized amongst social scientists as having negative effects on the worker’s self esteem, job satisfaction and stress, resulting in increased absenteeism and a reduction in productivity, and yet it continues to fester in nursing. The purpose of this research was twofold. The first was to answer the question, ‘What are the characteristics of covert violence experienced by Western Australian nurses?’ and through the description of Western Australian nurses’ experience of covert violence and describe the characteristics related to this to form a definition of covert violence. The second question was ‘What are the causes of covert violence experienced by Western Australian nurses? This study explored nurses’ experiences of covert violence using an interpretive phenomenological approach as described by van Manen (1997). A literature review was conducted to establish the findings of studies in relation to covert violence in other countries and to compare similar works in Australia. Using literature review findings, interview questions were designed to identify episodes of covert violence amongst nurses, the background to the reported events and a comment by the participants as to how these episodes were dealt with. A proposed model of the causes of covert violence in nursing was developed from the literature review to be tested in relation to the research findings. Research participants were all Registered Nurses with the Nurses’ Board of Western Australia who were asked to identify and discuss their experiences of covert violence in their workplaces. The data collected was analysed using pattern matching for qualitative evaluation. Results obtained from the data analysis identified the most important factor leading to covert violence was the juxtaposition of power and powerlessness and how it was influenced by community expectations of healthcare, staffing and client characteristics, infra-staff issues and management systems. Based on the research findings a revised model of causes of covert violence was developed to identify how power and powerlessness affect the outcomes of patient care, staff morale and the ultimate retention of staff in the health service in particular and in the profession generally. To record the incidences of covert violence and how they can be dealt with, a risk action plan and a model of obligations to prevent covert violence in nursing was developed that would not only serve its purpose in the nursing profession. From these questions it was possible to develop a Risk Control Action Plan that can be applied in response to reports of covert violence and to prevent covert violence in the nursing workplace, and can be adapted to address a similar situation in any other workplace. The tools developed include ways of reducing patient stress, methods of improving staff relationships, and management tools for issues that need to be addressed by nurses and administrators. Recommendations for further research to extend this study and to test the covert violence prevention tools developed as a result of this research are made. It is anticipated that use of the revised model of covert violence in nursing, definition of covert violence and tools developed as a result of the research findings will minimise incidences of covert violence, resulting in greater job safety and satisfaction for nurses, a reduction in staff absenteeism due to job stress, and an improvement in nursing retention and productivity.

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