Workplace violence and intentions to quit: results from a survey of London nurses

Study Objective: Work-place violence, harassment and abuse is an increasing feature of nurses’ experience of work in many countries. There is some evidence that the experience of workplace violence affects levels of job satisfaction (Hesketh et al 2003) and career decisions (e.g. Mayer et al 1999, Fernandes et al 1999). This paper reports on verbal and physical abuse by patients, relatives and carers, as well as racial and sexual harassment in Acute Hospitals in London and investigates whether workplace violence affects nurses’ intentions to leave either their current job or the nursing profession, controlling for a number of other factors that are known to affect career decisions, such as workload, pay and own health. Method: A questionnaire designed by two of the authors (Reeves and West) to assess many different aspects of nurses work life was used in a postal survey of nurses grades A to I practising in twenty London acute trusts in 2002. A total of 6,160 clinical nurses were mailed the questionnaires and 2,880 returned completed questionnaires, resulting in an overall response rate of 47%, discounting undelivered questionnaires. Respondents worked in a wide variety of clinical settings but mainly in acute medical and surgical wards. In addition to descriptive statistics, results were analysed using logistic regression with robust standard errors: the appropriate test when the dependent variable is dichotomous and the individual respondents clustered within units (nurses working within hospitals are not statistically independent). Results: Our results show high levels of racial (%), sexual (%) and other, unspecified forms of harassment (%), as well as verbal and physical abuse (14% had been physically assaulted with 5% being assaulted more than once), over the previous 6 months. A very small number (1%) reported experiencing all three forms of harassment; 12% two forms and 29% one form. Only 45% of this sample intended to stay in nursing for at least 3 years; 40% were undecided and 15% intended to leave. Logistic regression estimates showed that reported levels of abuse and harassment had a significant impact on respondents’ career intentions, even in models that controlled for known factors affecting career decisions. About 70% of our respondents reported that they had had too little training in dealing with aggressive behaviour—or none at all—but there was no statistical relationship between lack of training and reported assaults. Conclusions: The international shortage of health care workers is due at least in part to low retention rates. It is crucial to investigate nurses’ experiences of work to identify the factors that shape their career decisions. Workplace violence is increasingly acknowledged as an international, service-wide, health care problem. This paper adds to the literature that shows that workplace violence has an impact on nurses’ career decisions. The implications for managers and policy makers are that strengthening systems of security and providing nurses with training in interpersonal relationships including dealing with aggressive patients could slow nurse turnover.

The creative masses of digital Britain

The present recession has prompted scholarly and journalistic questioning of the contributions of the cultural industries to the economy. The talent-rich metropolitan clusters of London and New York are well-placed to ride out a thoroughgoing shakeup of the media markets if they manage their infrastructure, space and resources strategically, as Richard Florida has recently argued. This seems to be the assumption behind the recent Digital Britain interim report, and Gordon Brown's remarks that a digital revolution "lies at the heart" of Britain's economic recovery and that broadband and the media industry can play a leading role in pulling the UK out of the recession. Focusing on the Digital Britain report and consultation documents, this presentation seeks to unpack some of the fundamental assumptions behind this link between digital infrastructure, creativity and profitability. In particular the implicit notion of an engaged audience of users, generating "content" as well as shaping new media platforms calls into question long-held theoretical constructions of the mass audience of consumers as spectators; instead, the audience emerges as a potential economic powerhouse, an underused resource for tomorrow's cultural industries.

Rats, floods and flowers: London's Gothicized nature

AUTHOR's OVERVIEW This chapter attempts a definition of London eco-gothic, beginning with an ecocritical reading of the ubiquitous London rat. Following Dracula, popular London gothic has been overrun, from the blunt horror-schlock of James Herbert’s 1970s Rats series to China Miéville’s King Rat. Maud Ellman’s elegant discussion of the modernist rat as a protean figure associated with a ‘panoply of fears and fetishes’, underlines how the rat has always featured in anti-urban discourse: as part of racist representations of immigration; as an expression of fear of disease and poverty; or through a quasi-supernatural anxiety about their indestructible and illimitable nature which makes them a staple feature of post-apocalyptic landscapes. Even so, the London rat is a rather more mundane manifestation of urban eco-gothic than the ‘city wilderness’ metaphors common to representations of New York or Los Angles as identified by eco-critic Andrew White. London’s gothic noses its way out through cracks in the pavements, grows from seeds in suburban gardens or accumulates through the steady drip of rainwater. However, I will suggest, in texts such as Maggie Gee’s The Flood and P. D. James’ Children of Men, London eco-gothic becomes less local and familiar as it responds to global environmental crisis with more dramatic tales of minatorial nature.