The Bureau of Labor Statistics has reported that 60% of workplace assaults occur in healthcare, and instances of verbal abuse and physical violence against healthcare workers have continued to rise in recent years.[1] While our first blog post on this topic covered the types of abuse nurses and other healthcare professionals face daily, the reasons they face them, and why they occur, we will now turn to the consequences of this rising trend as well as methods of prevention. In understanding the costs, we can better understand why finding solutions are crucial not only to the wellbeing of healthcare workers, but to hospitals and patients as well.
What are the consequences of workplace violence in healthcare?
On-the-job conflict lowers nurses’ morale and job satisfaction, and the repeated stress can cause healthcare workers to leave a profession that is already experiencing serious staffing shortages. A healthcare worker’s physical wellbeing can obviously be threatened by violent acts perpetrated by patients or other customers, resulting in physical illness in additional to physical injury, disability, and chronic pain. [2] Additionally, employees who endure violence or verbal abuse may suffer from psychological problems, such as loss of sleep, nightmares, flashbacks, depression, PTSD, anxiety, irritability, apathy, and self-blame.[3]
Workplace violence also comes at a high monetary cost; if an employee requires medical treatment or misses work because of an injury they suffered at the workplace, worker’s compensation insurance or the organization the individual works for will be responsible for reimbursement.[4] Moreover, since injuries and stress are common factors that drive caregivers to leave the profession, hospitals that lose staff due to abuse will be faced with replacing them, and the estimated cost of replacing a single nurse – including recruiting, orientation, and training – ranges from $27,000 to $103,000.[5] Both staff and employers suffer when workplace violence is prevalent.
What can be done?
- Challenge and change perceptions: There is a widespread perception that violence and verbal abuse are “part of the job” when it comes to nursing. While the stressful environment of departments like the ED and patients who lack the cognitive abilities to control themselves will always warrant the potential for harm to caregivers, the norm that violence is expected and therefore unworthy of mention leads to unnecessary pain, unproductiveness, and unhappiness. One medical center found that half of verbal and physical assaults by patients against nurses were never reported in writing; due to a lack of a reporting policy, lack of faith in the reporting system, or fear of retaliation, these nurses felt they had to shy away from positive change.[6] Precautions to prevent violence need to be put in place as seriously as precautions to prevent contracting infectious diseases; abuse needs to be treated with absolute seriousness, not as something to be tolerated and dismissed as inevitable, and with the intention of changing the culture.[7]
- Enact more laws: Currently, there are no federal laws mandating that hospitals attempt to protect nurses from workplace violence.[8] Some states, however, have passed measures that require hospitals to develop violence-prevention programs, including teaching de-escalation techniques, and increasing penalties for people convicted of assaulting healthcare professionals.[9] However, nationwide workplace-safety standards for hospitals need to be put in place to minimize incidents across the country.
- Hospitals need to step up: One Massachusetts hospital offers self-defense classes for staff, while another hosts training exercises that simulate potentially violent hospital scenarios, ranging from gang violence to mental-health patient outbursts.[10] Such precautionary measures are all too rare in U.S. hospitals, however, so to prepare more nurses for violent encounters, personal-safety standards need to be increased in hospitals and clinics. Increasing safety and health training, worksite analysis and hazard identification, and protocol for recordkeeping and program evaluation need to be instated, and managers need to demonstrate commitment to eliminating the stigma of reporting abuse and support bringing these problems to light.[11]
- Consult Additional Resources: OSHA has a series of resources available for healthcare workers to consult that explain specific workplace violence they may encounter, strategies of prevention, and descriptions of how preventing workplace violence can easily go hand-in-hand with strategies a health care organization might already be using to improve other aspects of their institution.[12]
Violence and verbal abuse against healthcare workers affects everyone coming in the doors of the hospital; being cared for by workers who feel stressed, unsafe, and unhappy means both patients and staff alike will suffer. In order to address this ugly reality, it first needs to be acknowledged for what it really is – a serious, often preventable problem – and then treated accordingly.
[1]Gates, Donna M, Gordon L. Gillepsie, and Paul Succop, “Violence Against Nurses and its Impact on Stress and Productivity,” Medscape, 2011, http://www.medscape.com/viewarticle/746092
[2] Ibid
[3] Ibid
[4] “Worker Safety in Hospitals; Caring for our Caregivers,” OSHA.gov, http://www.rwjf.org/en/library/articles-and-news/2015/07/nurses-face-epidemic-levels-of-violence-at-work.html
[5] Ibid
[6] Ibid
[7] “Nurses Face Epidemic Levels of Violence at Work,” Robert Wood Johnson Foundation, July 16, 2015, http://www.rwjf.org/en/library/articles-and-news/2015/07/nurses-face-epidemic-levels-of-violence-at-work.html
[8] Fernandez Campbell, Alexia, “Why Violence Against Nurses Has Spiked in the Last Decade,” The Atlantic, Dec. 1, 2016, https://www.theatlantic.com/business/archive/2016/12/violence-against-nurses/509309/
[9] Ibid
[10] Ibid
[11] “Worker Safety in Hospitals”
[12] Ibid