Workplace violence: A Serious Problem in Healthcare

There’s no industry that’s immune to workplace violence, whether it’s construction, manufacturing, retail, or media. However, healthcare professionals face a greater risk of injury, trauma, emotional distress, and even death as they go about their everyday work responsibilities – giving injections, taking X-rays, drawing blood, and prepping patients for surgery.

In 2017, longtime ER nurse Elise Wilson was brutally stabbed in the neck and arms by a patient in the Massachusetts hospital where she worked. A year later, she is still in pain and unable to return to the nursing job she loved. In November this year, a shooter killed three people including a physician, a pharmacy resident, and a police officer at Mercy Hospital & Medical Center on Chicago’s South Side. In March, a gunman entered a veterans’ home in Northern California and killed three staffers. Other incidents of violence against healthcare workers like hitting, punching, shoving, and biting don’t make the evening news.

The Numbers are Telling

Violence against healthcare workers occurs in all types of settings, from busy emergency rooms to surgery centers, from walk-in clinics to nursing homes. Too often, it is perceived to be just part of the job and has a long-standing history in the industry.

According to American Nurse Today, 67% of all nonfatal injuries caused by workplace violence occur in healthcare, even though the industry represents only 11.5% of the U.S. workforce. From 2002 to 2013, incidents of serious workplace violence – those requiring time off from work to recuperate – were four times more common in healthcare than in other private industries, according to the Occupational Safety and Health Administration (OSHA). About 25% of psychiatric nurses experience disabling injuries from patient assaults.

Bullying by Coworkers

One of the most common instances of workplace violence, which does not typically make the headlines, is bullying by coworkers. Nurses of all ages and experience levels report being bullied by their colleagues. Often referred to as lateral or horizontal violence, bullying behavior can be overt or insidious. It may include eye-rolling, insulting comments, exclusion, humiliation, withholding information, scapegoating, intimidation, and backstabbing. Bullying often results in diminished professional status and personal standing, isolation, and overwork. The targets of bullying may not receive credit for their accomplishments at work.

The Toll of Workplace Violence

Workplace violence in any form comes at a high cost to the individual and institution. It has lasting effects on our healthcare system and deeply impacts clinicians on a personal and professional level. Workplace violence can have a wide range of impacts, including effects on self-esteem, relationships with co-workers, patient care, professional growth, recruitment, and retention. The psychological trauma often makes individuals fearful of returning to work. They may experience feelings of guilt and powerlessness. There’s also the economic impact of workplace violence including having to take time off from work, legal fees, and out-of-pocket medical expenses.

Everyone has the right to a safe work environment, one that is free from violence of any kind, verbal or physical, and with the assurance to be treated with dignity and respect. As healthcare professionals, we must be advocates for not only our patients but also for ourselves. A safe work environment is built upon a foundation of trust and respect for all. No case should go unreported and zero tolerance should be implemented to ensure that we can protect ourselves as well as deliver safe patient care. It is important to us all to stop the violence - if you see something, say something.

Workplace Violence Prevention Resources

• OSHA’s Five Components of an Effective Workplace Prevention Program
• The Joint Commission’s Workplace Violence Prevention Resources for Healthcare
• Healthcare Facilities and Workplace Violence Prevention.

Our next blog will explore the ways in which healthcare organizations can create a safe workplace for their employees and patients.

About Barbara West
As a Clinical Program Director, Barbara leads the clinical management oversight for AMN clients in Maryland, Washington, D.C., and Pennsylvania. She is also a member of the AMN Strike Support team, leads the Per Diem Clinical Directors, and serves on the AMN Education Committee. Barbara previously served at Johns Hopkins Hospital, where she worked in the CVSICU, the Transplant Division, and as an administrator in Human Resources and Nurse Recruitment. Barbara is a member of the American Nurses Association and Maryland Nurses Association where she is a member of the Legislative Committee.

^{References
Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment. Locke, L., Bromley, G., & Derspiel, K. A. F. (2018). Patient violence: It’s not all in a day’s work: Strategies for reducing patient violence and creating a safe workplace. American Nurse Today, 13(5), 10. Riggio, R. E. (2011). Why workplace Bullies Thrive: The Bystander Effect: What can be done to stop workplace bullying? Psychology Today, posted Jan 26, 2011. Parker, K. M., Harrington, A., Smith, C. M., Sellers, K. F., & Millenbach, L. (2016). Creating a Nurse-Led Culture to Minimize Horizontal Violence in the Acute Care Setting. Journal for Nurses in Professional Development, 32(2), 56. The Joint Commission. CDC - The National Institute for Occupational Safety and Health (NIOSH). Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. Occupational Safety and Health Administration. Healthcare Facilities and Workplace Violence Prevention. Texas Department of Insurance Division of Workers’ Compensation Workplace Safety.}