Violence towards health care professionals is a problem that has recently come to light in reports. Patients and their families frequently engage in violent behavior toward healthcare workers, including doctors, nurses, and other staff members. Physical assault, verbal abuse, obscene threats, and sexual harassment are all examples of this violence.
Initiatives like the Social Service Workers Act (Ontario, Canada) is just one of the many regulatory bodies that were created to ensure the protection of social workers, including those in the health sector. Providing social workers with a secure and healthy work environment is one of the main goals of this act.
In addition to giving employees the right to refuse labor they believe may threaten their health or safety, the legislation mandates that companies take all necessary measures to safeguard employees against harassment and aggressive advances at work.
In the United States, there is no federal iteration of the act; nevertheless, state-level rules and regulations regulate the practice of social work and allied professions.
The licensing board or regulatory body that supervises the practice of social work and upholds professional standards is unique to each state. These boards often have the power to establish educational and training requirements, issue licenses, look into complaints, and sanction practitioners who break ethical or professional norms.
Another initiative was created in the US. The National Association of Social Workers (NASW), a professional association, is another organization that represents and promotes social workers on a national basis.
On a more international scale, a specialized UN organization called the International Labour Organization (ILO), was established to enforce international labor standards and advocates for respectable working conditions.
To prevent and resolve issues with unfortunate working conditions, the ILO has created a variety of global labor norms and guidelines, including the Violence and Harassment Convention in 2019.
In recent years, however, steps in legislation have not guaranteed the absolute protection and occupational hazards that come with patient care and other related services.
Hospital safety directors claim that staff violence increased as the COVID-19 pandemic worsened in 2020. In a study conducted this spring by National Nurses United, the largest organization of registered nurses in the country, 48% of the more than 2,000 nurses who responded said that workplace violence had increased; this is more than double the percentage from a year earlier.
The root causes of violence within healthcare settings are complicated and multidimensional, and they include things like stress experienced by patients and their families, mental health problems, substance addiction, and occupational strains.
In order to solve this problem, steps must be taken to educate the public, create safety measures, train healthcare employees, and offer assistance and resources to victims of violence. Combating workplace violence is still a top goal as the field of medicine develops.
What is Workplace Violence?
Workplace violence is any act of bodily harm, threats, coercion, harassment, or other hostile behavior that takes place at work or nearby. Aggression committed by coworkers, clients, patients, customers, or other people with whom an employee might come into contact while doing their job tasks falls under this category.
Workplace violence can take many different forms, from physical assault to homicide. It can also take the shape of verbal threats and demoralizing actions.
Here are some examples:
Verbal intimidation or threats
This might take the shape of hostile words or body language, danger to one’s life or physical injury, or other verbal abuse.
Physical contact with the intent to injure the victim
This includes hitting, kicking, shoving, and other forms of assault as well.
Sexual harassment
This form of workplace can take the form of unwanted advances, touches, or remarks that breed hostility at work.
Bullying
This form of is defined as repeated humiliation, criticism, or other psychological assault.
Armed robbery, burglary, and theft
This includes theft of corporate property and personal property of co workers, patients and other clinical staff.
Homicide
This is the most severe type of aggression that can cause an employee’s death.
Physical violence at work, especially in health care, can have major repercussions for both employees and employers, including physical harm, mental distress, lower productivity, increased absenteeism, and legal liability.
As a result, it is crucial that healthcare institutions take action to ensure violence prevention and to protect health care workers. Some of these measure include carrying out risk analyses, training employees on how to identify and respond to aggressive conduct, and providing support and resources to those who have been affected by this.
Is the Violence Getting Worse?
In recent years, heightened aggression in the healthcare industry has expanded as an issue.
About 75% of nurses have suffered violent incidents (physically and verbally abused) on the job, and nearly 20% of emergency department nurses have experienced physical violence at work, according to a study published in the Journal of Emergency Nursing. In a separate research, the American Nurses Association discovered that one in four nurses had experienced violence at their place of work in the previous year.
In addition to nurses, other health workers are also at risk, according to these figures. Healthcare workers are five times more likely to face nonfatal workplace injuries than workers in other industries, according to a research by the Occupational Safety and Health Administration (OSHA). Nearly 70% of all nonfatal workplace injuries in 2016 involved health care and social service professionals.
Violence in hospital settings can have a serious negative impact. Violence can leave healthcare workers with physical wounds, mental anguish, and diminished job satisfaction. Moreover, it can result in lower patient satisfaction and care quality, as well as higher health care expenses because of an increase in absenteeism and staff turnover.
There have been ongoing efforts to prevent violence at work, and organizations like OSHA and the Joint Commission have offered suggestions and guidelines for healthcare facilities to put violence prevention programs in place.
To safeguard the safety and well being of health care professionals as well as to address the underlying causes of violence in health care settings, more work must be done.
Who commits most of the violence in the healthcare setting?
In situations of violence in health care and social spaces, the perpetrators can originate from a variety of places. Instances of verbal and physical abuse directed at healthcare workers are reported often, with aggressive patients and their family members frequently listed as the main perpetrators.
Hostile actions, however, can also be exhibited by fellow healthcare workers and staff.
In New York City’s Bronx-Lebanon Medical Center in 2017, there was an instance of violence in a medical environment.
Before committing suicide, the former employee who had entered the hospital with a rifle started shooting, killing one doctor and injuring six others. The gunman allegedly had a history of workplace aggression, including sending threatening emails and intimidating coworkers.
Another example occurred in 2020 at a hospital in New York City. After being told by a nurse that she would need to wait for test results, the patient yanked her hair and punched the nurse in the face.
These unfortunate occurrences serve as a reminder of the necessity for healthcare facilities to have rules and procedures in place to ensure workplace safety as well as to offer assistance and services to individuals affected by such incidents.
Studies have revealed that women and younger health care workers are more at risk to become victims of physical attacks in healthcare settings, in terms of specific demographics.
The nature of their employment and the patients they treat may also put health care workers in emergency medicine and psychiatric units at a higher risk of attacks from patients or other workers.
Any person, regardless of age, gender, or occupation, however, might become a victim of aggressive behavior.
Efforts to Reduce Acts Of Violence
The prevention of risk of assault in hospital settings necessitates a comprehensive strategy that combines proactive tactics with emergency reaction procedures.
Many steps are used in today’s prevention techniques to assist health care companies in establishing safer working conditions and efficiently handling violent situations.
- Workplace Violence Prevention Programs
Numerous healthcare units have put in place strategies that prevent workplace violence to encourage worker security and stop violent situations.
These initiatives could involve educating staff members about potential threats and how to handle them, establishing clear policies and procedures for handling violent occurrences, and providing access to support and counseling services for workers who have been victims of attacks.
- Environmental Design
Another factor in reducing harmful behavior is the way medical facilities are built. Reduce the probability of violent situations by implementing environmental design strategies like better illumination, panic alerts, and restricted access to specific locations.
- De-Escalation Techniques
De-escalation strategies can be taught to healthcare professionals to assist them manage potentially violent situations. The goal of de-escalation tactics is to diffuse possible confrontations by adopting ways for calm, non-confrontational communication with patients and their families.
- Reporting and Response Procedures
To effectively handle violence, reporting and response measures must be effective. For reporting violent crimes and for acting swiftly and effectively in the event of threats, healthcare organizations should have clear policies in place.
- Collaboration and Communication
Cooperation and communication between healthcare organizations, law enforcement, and other stakeholders is key to effectively create a safe environment for our medical professionals. Cooperation can assist healthcare institutions in creating prevention methods that work as well as effective responses to violent situations.
- Advocacy and Policy
Last but not least, lobbying and policy initiatives can assist in addressing the underlying causes of violence in the health sector, such as mental health conditions and substance misuse.
Raising awareness and promoting policy changes that assist preventative and response initiatives are both possible through advocacy.
Resources:
CNN. (2017, June 30). Gunman kills doctor, wounds six others at Bronx hospital before taking his own life. Retrieved from https://www.cnn.com/2017/06/30/us/bronx-lebanon-hospital-shooting/index.html
Occupational Safety and Health Administration. (2015). Guidelines for preventing workplace violence for healthcare and social service workers. Retrieved from https://www.osha.gov/Publications/osha3148.pdf
Emergency Nurses Association. (2018). Workplace violence prevention in emergency departments. Retrieved from https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/workplace-violence-prevention-in-the-emergency-department-position-statement.pdf?sfvrsn=8f45d54e_4
Boyle, P. and Writer, S.S. (2022) Threats against health care workers are rising. here’s how hospitals are protecting their staffs, AAMC. Available at: https://www.aamc.org/news-insights/threats-against-health-care-workers-are-rising-heres-how-hospitals-are-protecting-their-staffs (Accessed: April 7, 2023).
Workplace violence in healthcare, 2018 (no date) U.S. Bureau of Labor Statistics. Available at: https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm (Accessed: April 7, 2023).
Types of domestic violence (2019) ACESDV. Available at: https://www.acesdv.org/domestic-violence-graphics/types-of-abuse/ (Accessed: April 7, 2023).
National nurse survey reveals significant increases in unsafe staffing, workplace violence, and moral distress (2022) NationalNurses United. Available at: https://www.nationalnursesunited.org/press/survey-reveals-increases-in-unsafe-staffing-workplace-violence-moral-distress (Accessed: April 7, 2023).
Ontario Ministry of Children, Community and Social Services. (n.d.). The Social Service Workers Act. Retrieved from https://www.mcss.gov.on.ca/en/mcss/programs/socialwork/act.aspx
National Association of Social Workers. (n.d.). Code of Ethics. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
ABC News. (2020, December 23). Patient attacks nurse in New York City hospital. Retrieved from https://abcnews.go.com/Health/patient-attacks-nurse-york-city-hospital/story?id=74932859
