Women'space: Vol. 4, #4, 2000

Nurse Advocate

by Carrie Lybecker

The Internet:
An Agency for Liberation

"Words matter because words significantly determine what we know and what we do. Words change us or keep us the same. Women, deprived of words, are deprived of life. Women, deprived of a forum for words, are deprived of the power necessary to ensure both survival and well-being."
Andrea Dworkin¹

Healthcare workers are assaulted in the workplace more frequently than any other US worker group ². Similar figures exist in England, Canada, Australia, and New Zealand. Hundreds of articles, studies, reports, recommendations, and books have been published, and the subject supports a lucrative US cottage industry which has not reduced nurse-experienced workplace violence.

But I didn’t know any of this in 1997 when I was assaulted by a physician at work.

That night, I thought back over my 25 years as a registered nurse, about the times I had been assaulted by patients, physicians, and nurse managers, about the verbal abuse and all the dehumanizing experiences, although I didn’t call them that yet.

I wondered at the similarities to domestic and interpersonal violence. I recalled violence as a child, a young woman, an adult daughter, a wife. I asked myself how I could have left that all behind me and rejected violence in my personal life while failing to see the violence I experienced at work. I felt stunned, numb, without words.

I forced myself to post this humiliating story on the GlobalRN listerv. What followed was an unprecedented outpouring from nurses around the world writing about their own similar experiences, some occurring twenty years earlier yet recalled as if they happened yesterday.

Because Internet access enabled me to "speak" with others I would never have had contact with otherwise, I began to understand that violence is a global problem for nurses; that nurses are profoundly affected by workplace violence; that nurses experience this in isolation; and, that most nurses do not report workplace violence and in fact often do not name violence as violence.

When an enraged surgeon throws a drill (heavy, designed to penetrate bone, contaminated with body fluids and tissues) across an operating room at a nurse while screaming "If you can’t get me a fucking drill that works, then get your fat ass out of my operating room," this behavior is deconstructed by an oppressive institution as a regrettable event in which a talented and valuable (i.e., profitable) doctor momentarily lost control secondary to stress. It was unfortunate but understandable. It is not called assault, verbal abuse, intimidation, harassment, in short, violence.

Liberation is a process. It occurs as a result of: dialogue which unveils the world of oppression; reflection and critical analysis; and action. Through liberation, people transcend a world in which they are acted upon, and become actors who transform and thus create their own world.

But in 1997 I hadn’t yet given any thought to liberation theory.³,⁴ It didn’t have anything to do with me.

I taught myself HTML and created a web site,
Nurse Advocate: Nurses & Workplace Violence
http://www.nurseadvocate.org
Its subsequent evolution parallels my own.

The most important page of this site is What Nurses Say, a collection of hundreds of stories from nurses around the world about their own experiences. It is important because of the content, and more so because it creates an opportunity for nurses to break the silence and speak out, and allows nurses to realize that they are neither alone nor is their experience unusual, nor is it because they did something wrong or are fundamentally flawed.

Via the Internet, I have access to numerous government reports which document the high incidence of nurse-experienced workplace violence, the need for workplace reform, and recommendations for employers, as well as corroborate underreporting and implicate the many institutional factors which inhibit reporting. ²,^5-7 So, I have gathered and published links to these documents online.

As a consequence of Internet relationships with nurses, researchers, writers, and others, I organized and hosted the world’s first online live forum about nurse-experienced workplace violence in 1998. In 2000 I added an international email list.

Many online friends and associates have kindly mailed articles, theses, dissertations, news articles, books, and conference reports, which are reflected in an evolving online bibliography of the most essential materials.

After email discussions, an Australian nursing assistant reported gross negligence in a nursing home. This precipitated an investigation by the local health department. She resigned her position after she was harassed and shunned by her coworkers and managers. But she also wrote a compelling, thoughtful, incisive article and is in nursing school. She is one of our future nurses and already empowered with words and her own voice in spite of her experiences in an oppressive health care system.

Collaboration with an academic nurse researcher led to online publication of a survey tool investigating the incidence of verbal abuse, with participation supported by major national and international nursing organizations.

Last winter, a psychiatric nurse was assaulted by a patient. After her facility’s medical director told her that it was her job to be assaulted, she joined the Nurse Advocate email list. Within 3 months an RN coworker was critically beaten by another patient. The outrageous indifference of this administration was already known to list members and spurred an international email campaign which resulted in a legislative hearing and ongoing investigation. More importantly, nurses who had been assaulted, threatened, intimidated and silenced, i.e., denied basic human rights and thus dehumanized, not only found their voices and took action, but also the rest of us knew about and participated in these activities.

So, Nurse Advocate seeks to provide an opportunity for nurses to speak, and to redefine our experiences with our own words, as well as to ask ourselves constantly, "Why?" We share information and resources, discuss and argue, define, redefine, compare, strategize, theorize, challenge, demand. Some of us are troublemakers. We talk back.

Part of unveiling a world of oppression is discovering that all oppressions are related in that similar social and institutional structures maintain oppression for the purpose of advancing the goals of the oppressor at the expense of the oppressed. Once recognized, it is necessary to challenge all oppression wherever possible.

"I am continually distressed by the willingness of one group to repudiate domination in one form while supporting it in another." bell hooks ⁸

Therefore, one of the current tasks of nursing is to recognize other forms of oppression and human rights abuses, to support the efforts of others as they seek to secure elemental rights, and to promote recognition of the inherent dignity and worth of every person.

Women are utilizing the Internet in increasing numbers. We can use this tool to access information, communicate with each other, participate in mutual development, and to take action. We need to concern ourselves with the millions of women who are separated from us by lack of Internet access.

We can participate in established email lists. We can form our own lists, now more easily than ever via organizations such as Onelist. We can develop web sites, and publish articles online and in the print press. We can email letters to The Editor.

It matters that we have access to each other. It matters that we have access to information. It matters that we have words, that we can change those words, that we can find new meanings together, that we can voice those words to the international community, act individually and collectively, and transform our world.

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References