Steve Geoffrion

Nightly variation of disorder in a Canadian nightclub

Objective: This paper aims to study nightly disorder within a single bar over an extended period, in order to analyse variations across time (n = 258 nights). Methods: The security staff of a large Canadian nightclub agreed to note detailed information on every intervention in which they were involved. Bouncers wrote detailed narratives of each incident of aggression and incivility that occurred in the bar. Environmental characteristics (e.g. number of admissions and alcohol sales) were collected by one of the co-authors. Results: “Hot nights” were observed. The number of problem events was particularly high on Tuesday nights, which had the highest number of customers admitted and higher alcohol sales. The average alcohol sale per customer was also higher during long weekends, and alcohol sales were positively related to problem events. Finally, path analyses revealed that the presence of more bouncers was a deterrent. Conclusions: The level of disorder in a bar varies greatly over time. Contrary to what is often postulated, bars are not always high- or low-risk. The results strongly support responsible alcohol-serving policies and highlight the benefits of adequate surveillance.

Rethinking Compassion Fatigue Through the Lens of Professional Identity: The Case of Child-Protection Workers

Compassion fatigue is currently the dominant model in work-related stress studies that explain the consequences of caring for others on child-protection workers. Based on a deterministic approach, this model excludes the role of cognition a priori and a posteriori in the understanding of the impact of caregiving or providing social support. By integrating the notion of professional identity, this article adds a subjective perspective to the compassion fatigue model allowing for the consideration of positive outcomes and takes into account the influence of stress caused by accountability. Mainly, it is argued that meanings derived from identity and given to situations may protect or accelerate the development of compassion fatigue or compassion satisfaction. To arrive at this proposition, the notions of compassion fatigue and identity theory are first reviewed. These concepts are then articulated around four work-related stressors specific to child-protection work. In light of this exercise, it is argued that professional identity serves as a subjective interpretative framework that guides the understanding of work-related situations. Therefore, compassion fatigue is not only a simple reaction to external stimuli. It is influenced by meanings given to the situation. Furthermore, professional identity modulates the impact of compassion fatigue on psychological well-being. Practice, policy, and research implications in light of these findings are also discussed.

Post-traumatic Reactions and Their Predictors among Workers Who Experienced Serious Violent Acts: Are There Sex Differences?

Background Serious violent acts (e.g. physical violence, robbery, sexual aggression and death threats) are among the most visible and notable examples of workplace violence. Although women are commonly found to be at higher risk for post-traumatic reactions following workplace violence, little is known as regards sex differences concerning the types of post-traumatic reactions and their predictors. Objective This study aimed to describe sex differences in the post-traumatic reactions of serious violent acts and the predictors of such reactions. Methods The study was conducted among a convenience sample of 2889 French-speaking workers from Quebec, Canada by using a self-administrated survey. Linear regression modelings and post-hoc comparisons of coefficients according to the sex of the respondents were used to achieve the objective. Results Preliminary results confirmed that while men are more exposed to violence at work, women experience a greater number of post-traumatic reactions. Women were more affected by flashbacks, avoidance, and hypervigilance than men. The results also showed that being victimized by a male aggressor was associated with a greater number of post-traumatic reactions for women, whereas being victimized by an insider (e.g. colleague, supervisor, employee) was associated with a greater number of post-traumatic reactions for both sexes. Implications These findings highlight the necessity to better consider sex as a potential determinant of mental health in studies on workplace violence.

Workplace aggression against health care workers, law enforcement officials, and bus drivers: Differences in prevalence, perceptions, and psychological consequences

ABSTRACT Investigations into workplace aggression (WPA) remain largely occupation specific, with few studies using a comparative approach. The aim of the present study was to compare the health care, law enforcement, and public transportation sectors with regards to the prevalence of different types of WPA, the perceptions of workers toward WPA, and the psychological consequences of such acts. A cross-sectional survey was completed by 1,774 workers in Canada. Multinomial regressions were utilized to address the objectives. Findings revealed that verbal abuse victimization was particularly common in bus drivers, witnessing death threats was most frequent among law enforcement officials, and witnessing all types of WPA was most common among health care workers. Although bus drivers did not normalize WPA, they feared complaining about violence to their employer and thought it useless to talk it about unless wounds were visible. Fear of complaining about violence to colleagues was prevalent in health care and law enforcement, both sectors in which WPA was normalized. Finally, flashbacks and irritability following WPA were most likely to affect bus drivers whereas health care workers experienced hypervigilance to a greater extent. Strategies to tailor primary, secondary, and tertiary prevention according to these distinctions are suggested to offer a better-informed response to WPA.

Impact of a Program for the Management of Aggressive Behaviors on Seclusion and Restraint Use in Two High-Risk Units of a Mental Health Institute

The Omega Program for the Management of Aggressive Behaviors aims to reduce patients’ dangerous behaviors, towards themselves or others, and to reduce the use of seclusion and restraint (S/R). A previous study in a Mental Health Institute (Montreal, Canada) showed that implementing this program allowed employees of the intensive care and emergency units to gain confidence in coping with patients’ aggressions and to reduce their psychological distress. The present study, conducted in the same high-risk units, assesses the effect of the program on S/R use. We hypothesize that the incidence and duration of S/R should diminish significantly following the implementation of the program in both units. This naturalistic, prospective study covered archival data between April 2010 and July 2014. Pre-training data (April 2010–December 2011) were compared to data during training (January 2012–October 2012) and to post-training data (November 2012–July 2014) for both units. In the intensive care unit, we confirmed an increase of both mean daily number and duration of S/R by admissions in pre-training, followed by a decrease during the training and post-training. In the emergency unit, a decreasing trend is seen during the entire period thus suggesting that the decrease in S/R may be independent of the training. These findings suggest that Omega is a promising intervention program to use in an intensive care unit. However, a more global approach, including institutional changes in culture and attitude, can be important factors to develop to increase the positive outcomes.

Experiencing violence in a psychiatric setting: Generalized hypervigilance and the influence of caring in the fear experienced

BACKGROUND Exposure to violence in the mental health sector both affects employees and has implications for the quality of care provided. OBJECTIVE This phenomenological study aims to describe and understand the ways in which acts of aggression from a patient might affect workers in a psychiatric institute, their relationships with the patients and the services offered. METHODS Two semi-structured interviews were conducted with each of the 15 participants from various professions within a psychiatric hospital. RESULTS Our analysis reveals four themes: hypervigilance, caring, specific fear toward the aggressor and generalized fear of all patients. A state of hypervigilance is found among all participants. An emphasis on caring is present among the majority and unfolds as a continuum, ranging from being highly caring to showing little or no caring. A feeling of fear is expressed and is influenced by the participants place on the caring continuum. Caring workers developed a specific fear of their aggressor, whereas those showing little or no caring developed a generalized fear of all patients. Following a violent event, caring participants maintained this outlook, whereas those demonstrating little to no caring were more inclined to disinvest from all patients. CONCLUSIONS Hypervigilance and fear caused by experiences of violence impact the quality of care provided. Considerable interest should thus be paid to caring, which can influence fear and its effects.