Verbal abuse. Physical assaults. Violence against healthcare workers, nurses in particular, is not a new problem. Physical and verbal violence both are often endured by nurses in psychiatric facilities, and emergency rooms nationwide. Yet the issue is rarely reported on by the media, and unfortunately under reported by the nurses and other clinicians as well.
One study's findings indicated that of nurses who self-reported a violent event at work, 88% of them didn't document the incident, and if the violent event didn't result in missing work it was less likely to be reported.
According to the Occupational Safety and Health Administration (OSHA), since 2011, workplace violence to healthcare workers has risen more than 60%, and healthcare workers are five times more likely to be a victim of workplace violence than workers in general.
What's New About Violence Towards Nurses?
“Many members of the general public, they're like, 'Are you kidding me? People assault nurses?' They don't understand that it's a problem'” — Cindy Zolnierek, head of the Texas Nurses Association
While this problem is decades old, the attention it is recently gaining isn't. Why now you ask? Well, after over a year now of a global pandemic that has high jacked much of the media's attention, the stories of healthcare professionals, and nurses are coming through the fore. Those stories have covered working without adequate supplies of PPE, working multiple double shifts due to staffing shortages, the sacrifices they make to protect their families due to their frequent exposure to COVID, some even working while having the virus, and finally, the physical and verbal violence. Healthcare workers are becoming seen and valued in a new way, and with the attention, the good and the bad have been laid out like laundry for public inspection.
What's Happening in Texas
In 2016, the Department of State Health Services of Texas conducted a study of 7,759 registered nurses and licensed vocational nurses (RNs and LVNs) across 2,762 different medical institutions in the state. Their findings were unfortunate, but as a nurse probably unsurprising:
"Most nurses had experienced some kind of violent act in the workplace in the past 12 months. Verbal abuse was the most common type of workplace violence experienced by nurses. Patients were the most commonly reported group to commit violent acts against nurses."
Almost half of the nurses surveyed reported physical violence and 82% verbal abuse. The survey may be from 2016, but it is serving as research and support for a bill that would require:
- Healthcare employers create committees dedicated to workplace violence prevention plans.
- Offer medical treatment or other services to healthcare staff following a violent incident.
- Protect nurses who report abuse from being penalized
The bill has been introduced by state representative Donna Howard of Austin, who herself was a nurse that has experienced workplace violence.
Higher Risk Among Visiting Nurses
A notable trend in the U.S. even before the pandemic was a rise in job opportunities with home health agencies. With the baby boomers aging, and costs of long term care facilities high, many prefer to stay in their homes, and hire home health aides and or nurses to help. While these jobs seem attractive due to their flexibility, they also leave the clinician incredibly vulnerable.
While not all healthcare institutions across the nation have violence prevention plans, there are a few natural protections in place that visiting nurses simply don't have. For healthcare workers in a facility they have the general feeling of security because it is a public place, with at the least some security, the general social expectation of appropriate social conduct, and other staff or security persons to intervene or report to after any such incident occurs.
Visiting nurses enter homes they may or may not have been in previously, not knowing if there are other people in the house than just their patient and inside closed doors of a home of a stranger, they are vulnerable.
Pandemic Pressure and Staffing Shortages Continue
While the seemingly never-ending stress and the pressure cooker that is COVID-19 continues to take its toll, staffing shortages double the pressure and the risk of burnout to nurses is great. Suffering events of workplace violence may be considered by some nurses to just be "part of the job" but they also can cause lasting emotional and mental trauma in addition to any physical injuries.
Does Your Workplace Have Guidelines for Workplace Violence Prevention?
Do you know what the protocol is in your work setting for if you are subjected to physical or verbal abuse on the job? Does your healthcare employer have any published guidelines or trainings on workplace violence prevention?
For now, there are no laws on the federal level aimed to address specifically the workplace violence in the nursing industry. Moreover, there is no requirement set forth by OSHA for facilities to have a violence prevention plan. The state of California was the first to make this a requirement, doing so back in 1993. Nine states currently require that facilities have workplace violence programs in place, while 35 have laws in place that have stronger penalties for the assault of a nurse, the same as a first responder.
If you're facility doesn't have a committee or prevention plan in place, maybe it's up to you to get things started. If that feels too daunting, perhaps reach out to your local nurses union. The OSHA created some guidelines to help hospitals and health care agencies who want to make workplace safety for their staff a priority. You can view the entire guide by going to the OSHA website.
Don't let the "part of the job" attitude prevent you from reporting incidents if or when they occur. Several parts of workplace violence prevention plans include in depth analyses of the workplace itself and the previously reported events. We know that these circumstances are under reported, and missing information can impact results.
