Sources of Hostility within the Emergency Department – Care Example

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"Sources of Hostility within the Emergency Department" is a brilliant example of a paper on care. For a nurse working in an emergency department or even under any other organizational setting, aggression and hostility can result in many things. There are different sources of such hostility and aggression and include verbal abuse, horizontal hostility, workplace bullying, horizontal or lateral violence, racial abuse, etc. (Mapedzahama, Rug, and West).   It is critical to understand that bullying is often associated with the term aggression for nurses especially working in emergency departments. Whereas horizontal violence can occur when co-workers attempt to sabotage another co-worker and verbal abuse is often directed at other co-workers working in the same department.

(Cusack) Nurses can also suffer from bullying in the workplace. Bullying often happens at the same power level wherein a nurse continues to use degrading words and act in a degrading manner to actually undermine the self-esteem and confidence of another nurse. This form of aggression and hostility often results in anger and resentment and thus has an impact on the quality of services delivered by a nurse.

Similarly, horizontal hostility is often directed at co-workers in the emergency department which can result in a risk to health and safety of a nurse. (LIM) For Medical Officers, one of the key element which contributes towards hostility and aggression is the gap between their theoretical understanding and their practical experience. This skill gap therefore can often force medical officers to engage in behaviors that may be termed as hostile and aggressive. The over-crowded patient activity can also Though anger is considered a normal human emotion, however, hostility and aggression are rather inappropriate displays of anger.

Anger, under normal circumstances, occurs when one is frustrated or hurt and also forces the body to react in the form of fight or flight. Hostility and aggression, however, can occur suddenly though they can be experienced in stages. It is critical to understand that hostility and aggression can, however, result in actions such as verbal abuse, threats, deliberate violation of rules, etc. (Murray) Acute Psychotic patients or patients experiencing mental health-related problems may also be one of the sources of hostility and aggression within an emergency department.

The inability to cope with the requirements of such patients therefore can create resentment and anger in service providers. Q#2 In order to effectively transition through an environment that is hostile and aggressive towards Greg, it is critical that he must use some strategies to cope with the situation. Nurses facing such situations also need to make sure that their overall behavior remains within their professional boundaries and any effort directed at provoking a reaction should be managed through the application of proper tools. (Cox). Assertive communication is one of them in order to ensure that sources of hostility are kept at limited levels.

By improving eye-contact as well as modifying the tone during communication can effectively shield nurses from hostility in the workplace. Facial expressions as well as proper posture can further assert a nurse’ s position if facing any hostility. Especially, confident-looking posture can actually help nurses to stamp their individual authority as well as pose as confident looking workers. Giving respect, fair treatment and active listening can be employed as effective strategies to deal with such a transition in a hostile environment.

  (Amos, Hu, and Herrick) It is also critical to understand that Greg is working as a GRN therefore he must also clearly understand his actions to cope with the situation must be coming under the law. The scope of practice for a GRN should therefore be observed while showing any reaction towards any hostile or aggressive behavior at the workplace. Identification of theory-practice gaps and subsequent re-modification of the same can allow Greg to effectively observe professional boundaries while the use of ANMC standards can also be used to inform practice.                       Maintaining an up to date knowledge and to remain pro-active can allow Greg to effectively work within the department.


Amos, M, H. Hu, and C Herrick. "The impact of team building on communication and job satisfaction of nursing staff." Journal for Nurses in Staff Development 21.1 (2005).

Cox, K. "The Effects of Intrapersonal, Intragroup, and Intergroup Conflict." Nursing Administration Quarterly 27.2 (2003).

Cusack, Lynette. "Power Inequalities in the assessment of nursing competency Within the Workplace: Implications for nursing management." The Journal of Continuing Education in Nursing 41.9 (2010): 408-412.


Mapedzahama, Virginia, et al. "Black nurse in white space? Rethinking the in/visibility of race within the Australian nursing workplace." Nursing Inquir (2011): 1-12.

Murray, John S. "Workplace Bullying in Nursing: A problem that Can’t Be Ignored." MEDSURG Nursing 18.5 (2009): 273-276.

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