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A suggestion to refer to one of the chapters in Workplace Violence edited by Michael R. Privitera

By Rose Constantino posted 01-21-2015 20:09

  
In Privitera, MR (2011). Workplace Violence in Mental and General Healthcare Settings is chapter 3: Constantino, RE and Privitera, MR (2011). Prevention Terminology: Primary, Secondary, Tertiary, and an Evolution of Terms. The chapter defines prevention as "to come before, anticipate, forestall, to be in readiness for, to meet or satisfy in advance, to look ahead, arrive before, to go before with guidance, to hinder or stop and to interpose an obstacle or event". I would like to suggest as an advisory group member that as the committee develops or drafts the white paper, to use the three levels of prevention as one of the organizing models in framing the strategies in preventing, intervening, and follow-up activities in WPV and incivility.

Primary prevention is defined as lowering the rate or potential new cases in a community over a certain period of time by counteracting signs and symptoms of violence or incivility before they cause any harm or injury through information sharing and gathering, education, policy development, and quality improvement. Each member/person is considered unique and has the potential to participate in preventing any violence from occurring. The specific strategy in primary prevention could be implemented or even planned way before the violent event occurs.

Secondary prevention includes early identification, diagnosis and treatment of participants (perpetrator and patients) in a violent episode/event. The goal in secondary prevention is to reduce the duration and severity of the violence once it has occurred. The aim is to meet the immediate, proximate emergent need of the injured including a wide net of collateral patients or victims of the WPV and silent witnesses to the event.

Tertiary prevention is rehabilitation or gathering of strategies that could hasten full recovery by rehabilitating and preparing them for living, working and functioning after experiencing WPV. As in patients coming out of surgery (secondary prevention), tertiary prevention strategies are early ambulation, occupational, psychological and physical therapies, and other rehabilitative strategies to hasten, promote and lengthen recovery.

I look forward to reading the work of the committee.    

 
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Donna Fountain
02-17-2015 20:54

Yes, policy change and reversing the culture of bullying on an organizational level starts from the top down.
Nursing leadership with support of the board of directors, as outlined in the mission statement should provide the resources to support work environments that empowers and values the employees. This philosophy would need to recognize nurses on all levels from novice to expert, from diploma/associate to doctoral prepared.
Yes, I personally believe although, few in numbers, such organizational structures exists. Currently, too fellow nurses report that they work in civil/good environments, where nurses take care of the patients and each other. Nurses know one another and work to make each others day better. They work as a unit/team and feel like family.
I too, have worked in such an environment. It was the best nursing experience of my career. It was located in NYC, the hospital was founded on a spiritual / religious doctrine, however, it was highly professional and it exercised inter-disciplinary weekly meetings, case conferencing and discharge planning of acute care clients to be transitioned back into the community. I recall- during reports each discipline member respectively spoke and we listened to each other and did whatever it took to ensure the patient's best interest in health and healing was met, yet we remained focused on meeting regulatory and fiscal objectives.
I believe, it is possible to have strong leadership, that meet organizational goals, and maintains a work environment which supports employees doing what they were hired to do best. Nurses providing the highest level of professional practice and patient's receiving the highest levels of care. I am so proud to know that there are so many more nurses who still believe, as they continue to do their jobs everyday knowing that they are making a positive difference.
Why did I leave that dream job? Unfortunately, the hospital expanded to join a health system (back in the early 1990's) and the core of patient care coordination and support of inter-disciplinary communication and collaboration was dismantled. Critical processes and procedures were streamlined and the chaos was never replaced by a new organizational structure. Much money was lost, and eventually the hospital was closed.
Sometimes, we may need to keep things simple and processes minimal to encourage compliance and sustainability.
Thanks for your blog,
Donna