Violence in healthcare is rising. When nurses go to work, their primary concern is to provide quality care. However, violence in the workplace may keep them from performing their tasks. Nurses need to stay aware of potentially dangerous situations, and healthcare facilities must shield their employees from the violence.
What is Considered Workplace Violence?
Workplace violence is any act that is threatening or can inflict injury. The threat can be physical or verbal. The following are examples of workplace violence:
- Menacing, disruptive behavior
- Physical violence
Who Is at Risk?
In a healthcare environment, staff, patients and their families as well as visitors are all at risk of violence.
What Are Examples of Workplace Violence?
Those who perpetrate violence may include patients, family members, visitors and coworkers. Here are some possible scenarios:
- An angry patient attacks a nurse by biting, kicking, pushing, scratching or punching
- A distraught family member becomes verbally aggressive by shouting, cursing, and using derogatory or demeaning language
- Perpetrators of gang violence or domestic disputes that result in a stabbing or shooting
- Coworker dispute or bullying turns into a physical fight or intent to harm
Why is Violence Increasing?
After the Great Recession, both public and private hospitals trimmed expenses by cutting staff, which included nurses and security. Simultaneously, people were also losing their jobs and healthcare benefits. In addition, some states began restricting funding for preventive mental health services.
The sequence of events created an increase in patients seeking medical assistance at hospitals due to their lack of insurance. Patients with mental health issues are prone to violent outbursts leaving nurses susceptible to abuse or injury. Factors that can increase the frequency of workplace violence include:
- Patients under the influence of drugs and alcohol or who suffer from Alzheimer's or dementia
- Long waits
- Inadequate security
- Poor building design
How Are Healthcare Facilities Confronting the Problem?
Typically, nurses are not taught how to cope with violent attacks in school, so it is up to healthcare facilities to ensure the safety of their nurses. According to the report Workplace Violence in Healthcare published by the Occupational Safety and Health Administration (OSHA), workplace violence on average is four times more common in healthcare than in private industry. Many hospitals are engaging in efforts to lower the occurrences of violence. They are taking steps such as:
- Offering self-defense classes
- Providing training exercises that simulate violent scenarios
- Incorporating protocols and procedures for dealing with violence
- Addressing design flaws in the workplace, such as poor lighting, blocked visibility, insufficient escape routes and a shortage of barriers to separate nurses from violent offenders
- Recording incidents and evaluating responses
How Are Nurses Protecting Themselves?
On a daily basis, nurses can encounter people who are impaired by drugs, alcohol or mental illness. Nurses also can be victims of robbery, assault, rape or even murder due to the types of people they interact with and the late hours they may work. Violence in nursing mostly happens in psychiatric wards, emergency rooms, waiting areas and geriatric centers.
To safeguard themselves, nurses should participate in violence-prevention training. In a training program, nurses may discover ways to decrease the possibility of violence by learning about:
- Causes of agitation
- Intimidating posture
- Perceived interrogative behavior
- Importance of not intruding on personal space
Nursing organizations are also addressing the prevalence of violence. National Nurses United presented a petition in July 2016 that calls for a federal workplace violence prevention standard to protect healthcare workers. The American Nurses Association (ANA) established a zero tolerance for violence as stated in its position statement Incivility, Bullying, and Workplace Violence. Furthermore, the ANA requests that nurses and employers collaborate to create a culture of respect and use evidence-based strategies to curb indecent behavior and violence.
Currently, there are no federal regulations for defending nurses from workplace violence in hospitals. However, some individual states require hospitals to implement violence-prevention programs and have introduced stricter penalties for anyone convicted of assaulting healthcare workers.
Nurses must not accept that violence is part of their job. Instead, they need to prepare for the likelihood of violent outbreaks and only consider working for employers who value their safety.
Learn more about Northeastern State University's online RN to BSN program.
Sources:NURSE.com: Workplace Violence: Nurses Should Not Be Afraid to Go to Work
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