Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2016 Te Afermath of Violence: Te Lived Experience Phenomena of Assault in Nursing Kathleen Clark Walden University Follow this and additional works at: htps://scholarworks.waldenu.edu/dissertations Part of the Nursing Commons, and the Psychiatric and Mental Health Commons Tis Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact Walden University College of Health Sciences This is to certify that the doctoral dissertation by Kathleen Clark has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Robert Hoye, Committee Chairperson, Health Services Faculty Dr. Jeanne Connors, Committee Member, Health Services Faculty Dr. Raymond Thron, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract The Aftermath of Violence: The Lived Experience Phenomena of Assault in Nursing by Kathleen Clark MSN, University of Pennsylvania, 1999 BSN, Seton Hall University, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University February 2016 Abstract Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in- depth interviews from purposeful sampling. Nine registered nurses working in the high risk areas of inpatient psychiatry and emergency departments provided detailed descriptions about the phenomena. Data management was an inductive, iterative analysis completed and facilitated by the use of NVivo 10 software program. The study found that participants had a brief emotional response post assault mitigated by the community of nursing personnel from their immediate surroundings and felt that assault was “part of the job.” Providing a true culture of safety would include enhancements to the internal community of bedside nursing practice. In addition, research is needed on interventions that can effectively enhance the internal community after assault by patients. This study contributes to positive social change by providing registered nurses, an oppressed group, a voice to mitigate negative consequences associated with assault in the hospital setting. The Aftermath of Violence: The Lived Experience Phenomena of Assault in Nursing by Kathleen Clark MSN, University of Pennsylvania, 1999 BSN, Seton Hall University, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University February 2016 Dedication This study has been dedicated to my father, William A. Berth, who passed away in 2011. A brilliant man with no formal education continually focused on assuring his children’s success, despite being unable to read, he guided me in a love for continuous inquiry. I also dedicate this accomplishment to my husband David Clark, who believed in me, when in times I doubted myself. Acknowledgments I would like to acknowledge and thank Dr. Hoye for assisting me along my journey as both a mentor and faculty chair. Dr. Hoye consistently guided me in accomplishing my goals, even during times when I thought that I could not. He continued to my aid in me evolving as both a researcher and a person always holding me to the highest standards as set forth by Walden University. I would also like to acknowledge the members of the research forum, who have journeyed with me throughout the years. Their accomplishments and support have been inspiring. Table of Contents List of Tables ..................................................................................................................... iv Chapter 1: Introduction to the Study ....................................................................................1 Background ....................................................................................................................2 Statement of the Problem ...............................................................................................4 Purpose of the Study ......................................................................................................5 Research Questions ........................................................................................................6 Conceptual Framework ..................................................................................................6 Nature of the Study ........................................................................................................9 Definition of Terms......................................................................................................10 Assumptions .................................................................................................................11 Scope and Delimitations ..............................................................................................12 Limitations ...................................................................................................................13 Significance of the Study .............................................................................................15 Summary ......................................................................................................................16 Chapter 2: Literature Review .............................................................................................18 Introduction ..................................................................................................................18 Workplace Violence in Nursing Research ...................................................................19 Consequences of Workplace Violence towards Nurses...............................................28 Preventative Strategies to Workplace Violence ...........................................................32 The Position of Nursing in Health Care .......................................................................38 Conceptual Framework of Resiliency ..........................................................................43 i Review of the Current Literature Exploring Resiliency and Workplace Violence ...........................................................................................................48 Conclusion ...................................................................................................................51 Chapter 3: Research Methods ............................................................................................52 Introduction ..................................................................................................................52 Research Design...........................................................................................................53 Role of the Researcher .................................................................................................56 Methodology ................................................................................................................57 Data Collection Procedures ..........................................................................................59 Data Analysis ...............................................................................................................63 Issues of Trustworthiness in Data ................................................................................65 Ethical Procedures .......................................................................................................67 Summary ......................................................................................................................69 Chapter 4: Data Analysis ...................................................................................................70 Introduction ........................................................................................................................70 Sampling Strategy ........................................................................................................71 Data Collection ............................................................................................................72 Demographic Profiles ..................................................................................................73 Research Questions ......................................................................................................74 Evidence of Trustworthiness........................................................................................75 Data Analysis ...............................................................................................................76 Presentation of Themes ................................................................................................77 ii Themes Associated with Research Question #1 ................................................... 77 Themes Associated With Research Question #2 .................................................. 88 Themes Associated With Research Question #3 .................................................. 97 Themes Associated With Research Question #4 ................................................ 104 Summary ....................................................................................................................108 Chapter 5 ..........................................................................................................................111 Introduction ................................................................................................................111 Interpretation of Findings ..........................................................................................112 Answers to Research Question #1 ...................................................................... 112 Answers to Research Question #2 ...................................................................... 114 Answers to Research Question #3 ...................................................................... 118 Answers to Research Question #4 ...................................................................... 119 Conceptual Framework and Implications ..................................................................122 Limitations of the Study.............................................................................................125 Recommendations ......................................................................................................126 Implications for Social Change ..................................................................................129 Conclusion .................................................................................................................131 References ........................................................................................................................133 Appendix A: Script ..........................................................................................................150 Appendix B : Letter of Cooperation ................................................................................152 Appendix C : University of Pennyslvania IRB Approval ................................................153 iii