TONL Monthly
August 2018

Violence in Healthcare: Keeping Nurses Safe by Addressing Cracks in the Foundation

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By Jamie L. Brennan, M.S.N., R.N., C.M.S.R.N., NE-BC

Have you ever felt afraid to go to work? Afraid for your staff to enter a patients’ room? Fearful that you or a colleague may be assaulted?

Unfortunately, in nursing today, staff members face these fears regularly, and it has become increasingly accepted as “part of the job.” According to the New England Journal of Medicine, a large study was conducted among healthcare professionals and the results stated that 46 percent of nurses reported some type of workplace violence during their five most recent shifts; of these nurses, one-third were physically assaulted.

In public service professions, dealing with the masses comes with many unknown factors. As a nurse walking into a patient assignment or a leader rounding on the floor for the day, you are presented with a world of possibilities. Your job is to be caring and compassionate to those who need you most, putting everyone before yourself. As a nurse leader, your daily schedule and routine are ever-changing based on the needs of the department. As violence against nurses continues to rise, anxiety and fear in the nursing profession rises as well. As leaders, we are faced with increasing challenges, such as rising staff turnover as well as decreased staff morale and satisfaction. Fear leads to the desire for change.

What is workplace violence?

There are many definitions depending on the circumstance; however, in the end, violence is violence. According to the National Institute for Occupational Safety and Health, workplace violence is violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty. Violence is also dependent on the effect it has on the victim. To one nurse, trauma may result from a verbal altercation and to others only physical assault would cause them to feel as though they were a victim of violence. At the end of the day, raising awareness regarding violence in healthcare is essential to the implementation of effective workplace violence prevention programs.

Addressing the “cracks”

As leaders, we are limited to caring for our staff and providing them with the tools they need to deal with stressors in the workplace. In addition, it is important as leaders to equip nurses with the steps they need to take to address point-of-care safety concerns and threats toward them immediately. Too often nurses brush off hostility or physical abuse as “part of the job” and “they didn’t mean it.” Although this may be true in some instances, violence in the healthcare setting is unacceptable, and this message should be ingrained in the culture of healthcare. The following “cracks” and opportunities to our current system are:

  • Implement a structured reporting system if one is not already in place.
  • Implement a security detail within your organization including security and cameras.
  • Address the behavior directly with the patient and/or family.
  • Know your legislation and share it with your staff.
  • Implement a decompression room/safe place for employees to recover after a traumatic event.

Moving forward

The tools that are available may vary from facility to facility, but the primary focus should be on preventing and reporting violence every time. To address this growing epidemic, we must have access to more accurate data to present on a larger scale. Nurses must also be aware that being a victim of violence in the workplace is never OK and that it should never be accepted as part of the job. Empowering nurses with this knowledge and giving them the ability to put their safety first will impact the direction of healthcare for future generations of nurses everywhere.

References

  1. Gillespie, Gordon Lee, et al. “Workplace Violence in Healthcare Settings.” Work, Vol. 51, No. 1, Sept. 2015, pp. 3–4., doi:10.3233/wor-152017
  2. James, A. (2006). “Violence and Aggression in the Emergency Department.” Emergency Medicine Journal, 23(6), 431-434. doi:10.1136/emj.2005.028621
  3. Schablon, A., Wendeler, D., Kozak, A., Nienhaus, A., and Steinke, S. (2018). “Prevalence and Consequences of Aggression and Violence towards Nursing and Care Staff in Germany—A Survey.” International Journal of Environmental Research and Public Health, 15(6), 1274 doi:10.3390/ijerph15061274
  4. Toolbox for Developing your Workplace Violence Prevention Program. (2015). doi:10.1016/c2013-0-14170-0
 

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