Abuse is the improper usage or treatment of a person or thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other types of aggression. To these descriptions, one can also add the Kantian notion of the wrongness of using another human being as means to an end rather than as ends in themselves. Some sources describe abuse as "socially constructed", which means there may be more or less recognition of the suffering of a victim at different times and societies.
Bullying is the use of force, coercion, hurtful teasing, comments, or threats, in order to abuse, aggressively dominate, or intimidate one or more others. The behavior is often repeated and habitual. One essential prerequisite is the perception that an imbalance of physical or social power exists or is currently present. This perceived presence of physical or social imbalance is what distinguishes the behavior from being interpreted or perceived as bullying from instead being interpreted or perceived as conflict. Bullying is a subcategory of aggressive behavior characterized by hostile intent, the goal of addressing or attempting to "fix" the imbalance of power, as well as repetition over a period of time.
Psychological abuse, often known as emotional abuse or mental abuse or psychological violence, is a form of abuse characterized by a person subjecting or exposing another person to a behavior that may result in psychological trauma, including anxiety, chronic depression, clinical depression or post-traumatic stress disorder amongst other psychological problems.
Verbal abuse is a type of psychological/mental abuse that involves the use of oral, gestured, and written language directed to a victim. Verbal abuse can include the act of harassing, labeling, insulting, scolding, rebuking, or excessive yelling towards an individual. It can also include the use of derogatory terms, the delivery of statements intended to frighten, humiliate, denigrate, or belittle a person. These kinds of attacks may result in mental and/or emotional distress for the victim.
Workplace bullying is a persistent pattern of mistreatment from others in the workplace that causes either physical or emotional harm. The tactics it may include are verbal, nonverbal, psychological, and physical abuse, as well as humiliation. This type of workplace aggression is particularly difficult because, unlike typical school bullies, workplace bullies often operate within the established rules and policies of both their organization and society. In most cases, workplace bullying is reported as being carried out by someone who is in a position of authority over the victim. However, bullies can also be peers or subordinates. When subordinates participate in bullying, this is referred to as ‘upwards bullying.’ The least visible form of workplace bullying involves upwards bullying where bullying tactics are manipulated and applied against a superior, often for strategically motivated outcomes.
Compassion fatigue is an evolving concept in the field of traumatology. The term has been used interchangeably with secondary traumatic stress (STS), which is sometimes simply described as the negative cost of caring. Secondary traumatic stress is the term commonly employed in academic literature, although recent assessments have identified certain distinctions between compassion fatigue and secondary traumatic stress (STS).
A health professional, healthcare professional, or healthcare worker is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician, physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.
A nursing shortage occurs when the demand for nursing professionals, such as Registered Nurses (RNs), exceeds the supply locally—within a healthcare facility—nationally or globally. It can be measured, for instance, when the nurse-to-patient ratio, the nurse-to-population ratio, the number of job openings necessitates a higher number of nurses than currently available, or the current number of nurses is above a certain age where retirement becomes an option and plays a factor in staffing making the workforce in a higher need of nurses. The nursing shortage is global according to 2022 World Health Organization fact sheet.
Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. Shortages of qualified nurses are found in many countries.
Workplace aggression is a specific type of aggression which occurs in the workplace. Workplace aggression is any type of hostile behavior that occurs in the workplace. It can range from verbal insults and threats to physical violence, and it can occur between coworkers, supervisors, and subordinates. Common examples of workplace aggression include gossiping, bullying, intimidation, sabotage, sexual harassment, and physical violence. These behaviors can have serious consequences, including reduced productivity, increased stress, and decreased morale.
Workplace safety in healthcare settings is similar to the workplace safety concerns in most occupations, but there are some unique risk factors, such as chemical exposures, and the distribution of injuries is somewhat different from the average of all occupations. Injuries to workers in healthcare settings usually involve overexertion or falling, such as strained muscles from lifting a patient or slipping on a wet floor. There is a higher than average risk of violence from other people, and a lower than average risk of transportation-related injuries.
Professional abuse is "a pattern of conduct in which a person abuses, violates, or takes advantage of a victim within the context of the abuser's profession." This typically involves a violation of the relevant professional organization's code of ethics. Organizational ethics or standards of behavior require the maintenance of professional boundaries and the treatment of people with respect and dignity.
Workplace incivility has been defined as low-intensity deviant behavior with ambiguous intent to harm the target. Uncivil behaviors are characteristically rude and discourteous, displaying a lack of regard for others. The authors hypothesize there is an "incivility spiral" in the workplace made worse by "asymmetric global interaction". Incivility is distinct from aggression. The reduction of workplace incivility is an area for industrial and organizational psychology research.
Patient abuse or patient neglect is any action or failure to act which causes unreasonable suffering, misery or harm to the patient. Elder abuse is classified as patient abuse of those older than 60 and forms a large proportion of patient abuse.
Workplace harassment is the belittling or threatening behavior directed at an individual worker or a group of workers.
Bullying in academia is a form of workplace bullying which takes place at institutions of higher education, such as colleges and universities in a wide range of actions. It is believed to be common, although has not received as much attention from researchers as bullying in some other contexts. Academia is highly competitive and has a well defined hierarchy, with junior staff being particularly vulnerable. Although most universities have policies on workplace bullying, individual campuses develop and implement their own protocols. This often leaves victims with no recourse.
Bullying in the medical profession is common, particularly of student or trainee physicians. It is thought that this is at least in part an outcome of conservative traditional hierarchical structures and teaching methods in the medical profession which may result in a bullying cycle.
Patient-initiated violence is a specific form of workplace violence that affects healthcare workers that is the result of verbal, physical, or emotional abuse from a patient or family members of whom they have assumed care. Nurses represent the highest percentage of affected workers; however, other roles include physicians, therapists, technicians, home care workers, and social workers. Non clinical workers are also assaulted, for example, security guards, cleaners, clerks, technicians. The Occupational Safety and Health Administration used 2013 Bureau of Labor Statistics and reported that healthcare workplace violence requiring days absent from work from patients represented 80% of cases. In 2014, a survey by the American Nurses Association of 3,765 nurses and nursing students found that 21% reported physical abuse, and over 50% reported verbal abuse within a 12-month period. Causes for patient outbursts vary, including psychiatric diagnosis, under the influence of drugs or alcohol, or subject to a long wait time. Certain areas are more at risk for this kind of violence including healthcare workers in psychiatric settings, emergency or critical care, or long-term care and dementia units.
Violence against healthcare professionals has occurred in the form of physical violence, verbal abuse, aggressive gestures, blackmail, and cyber-bullying. Violence against doctors has been observed in the United States, Australia, India, China, Pakistan, Nepal, Sri Lanka and others.
The COVID-19 pandemic has impacted healthcare workers physically and psychologically. Healthcare workers are more vulnerable to COVID-19 infection than the general population due to frequent contact with positive COVID-19 patients. Healthcare workers have been required to work under stressful conditions without proper protective equipment, and make difficult decisions involving ethical implications. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity.
