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What Nurses Need to Know About Workplace Violence

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Nurses must stay alert to the possibility of violence in the workplace. A Bachelor of Science in Nursing (BSN) degree program prepares nurses for this growing concern by teaching them critical thinking and problem-solving skills. These skills can reduce the occurrence of dangerous altercations. Healthcare facilities also need to have strategies in place to guard nurses from harm.

What Is Workplace Violence?

Workplace violence is any act that is harmful to employees. The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as “violent acts (including physical assaults and threats of assault) directed toward persons at work or on duty.”

Why Should Nurses Be Concerned About Workplace Violence?

The U.S. Bureau of Labor Statistics reported in its June 2017 Monthly Labor Review that the common cause of healthcare injuries in 2015 was violence and that the assaults occurred mainly in state-run psychiatric and substance abuse hospitals. The number of cases recorded was 4,590. Over half of the injuries were subclassified as “intentional injuries by other person.”

According to the American Nurses Association (ANA), 25 percent of nurses were physically attacked by a patient or a patient’s family member, and 9 percent were concerned about their safety at work.

The U.S. Government Accountability Office (GAO) study “Workplace Safety and Health: Additional Efforts Needed to Help Protect Health Care Workers from Workplace Violenceconcluded that “workers in health care facilities experience substantially higher estimated rates of nonfatal injury due to workplace violence compared to workers overall.” The GAO reviewed three federal datasets and found that the estimated number of nonfatal workplace violence cases ranged from 22,250 to 80,710 in 2011.

What Types of Workplace Violence Happen in Healthcare Facilities?

Nurses can be the target of many forms of violence. The violence may consist of verbal or physical aggression, and also may be carried out with weapons. Examples of threatening behavior are:

  1. Biting.
  2. Hitting.
  3. Kicking.
  4. Punching.
  5. Pushing.
  6. Scratching.
  7. Shoving.
  8. Throwing objects.

How Can Nurses Deal with Workplace Violence?

The Occupational Safety and Health Administration (OSHA) lists risk factors that can trigger violence. The risks may vary depending on the healthcare setting. Here are a few of the hazards that nurses should be aware of and bring to the attention of their nurse leaders and employers:

  • Inadequate lighting in rooms, hallways and parking lots.
  • Lack of emergency communication.
  • The physical strain of lifting, moving and transporting patients.
  • Long wait times.
  • An absence of training or policies regarding workplace violence.
  • Poor design features that make a building easy for someone to lurk in or escape from.
  • Public access.
  • Patients with a history of violent behavior.
  • Understaffing.
  • Solitary working conditions.

What Can Healthcare Facilities Do to Reduce the Chances of Violence?

Healthcare facilities should enact and enforce a zero-tolerance policy as well as post signs to notify employees, patients and visitors about their stance against violence. To keep nurses safe, employers should prepare nurses with protocol and training so they learn how to prevent, contain or end violent episodes. To this end, employers should:

  • Develop comprehensive policies and procedures, and strictly adhere to them.
  • Identify risks.
  • Prepare staff to recognize warning signs for potential violence.
  • Encourage nurses to report any incidents of violence or perceived threats.
  • Ensure investigation of incidents.
  • Provide emotional support for nurses involved in violent events.
  • Document any acts of violence.

What Can Nurse Leaders Do to Protect Their Nursing Staff?

Nurse leaders must always maintain a safe environment for their staff, patients, family members and guests. The American Organization of Nurse Executives (AONE) along with the Emergency Nurse Association (ENA) developed guiding principles to aid nurse leaders in combating workplace violence. The principles outline the need for recognizing, addressing and collaborating with other healthcare professionals at all levels to reduce and stop violence from occurring. The principles also state that everyone in a healthcare organization is responsible for upholding behavioral standards.

Nurses need to insist that their employers safeguard them. Violence to any degree is unacceptable, even if it is just a pinch, slap or yelling. Healthcare facilities and nurse leaders need to take measures that create a secure place for nurses where they are free from worry about their well-being. The communication, coping and decision-making skills that nurses learn in a BSN program can help them avoid conflict and de-escalate violent situations.

Learn more about The University of Alabama in Huntsville’s online RN to BSN program.


HuffPost: Violence Against Nurses Is a Serious Problem, But Hospitals Are Basically Policing Themselves

AONE Guiding Principles: Mitigating Violence in the Workplace

U.S. Bureau of Labor Statistics: Hospital Workers: An Assessment of Occupational Injuries and Illnesses

American Nurses Association: Executive Summary

H&HN: Violence in the Hospital: Preventing Assaults Using a Clinical Approach

CDC: The National Institute for Occupational Safety and Health (NIOSH) – Healthcare Workers

RNL: Being Safe: Dealing With Injuries, Violence in the Workplace

ECRI Institute: Violence in Healthcare Facilities

CDC: NIOSH: Violence Occupational Hazards in Hospitals

OSHA: Workplace Violence in Healthcare

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