In The Workplace
July 11, 2012
Ideally, the workplace should be free of violent threats or actions and staff should feel safe while at work. Workplace violence has been defined by the National Institute for Occupational Health and Safety (NIOSH) as an act of aggression directed towards persons at work or on duty and ranges from offensive or threatening language to homicide. Workplace violence has gained recognition as a distinct category of violent crime that requires specific responses from employees, law enforcement and the community.
Medical institutions are particularly vulnerable to violence because of the 24-hour accessibility to the public, the possible lack of adequately trained, armed or visible security and an overall stressful environment.
The National Crime Victimization Survey (1993-1999) found that the average annual rate for non fatal violent crime was 21.9% per 1000 workers for nurses compared with only 12.6% per 1000 workers for all occupations.
The environment of medical institutions and the inherent condition of the patient’s being cared for can fuel the emotional tension between staff, patients and visitors.
In the health care industry, it is difficult to get accurate incidence statistics because violence is often underreported. There are multiple reasons why an employee would fail to report a threatening or injurious action, directly affecting his or her personal safety and well being. Because medical services are perceived to be a public entitlement, nurses are often empathetic to the frustration and vulnerability of the patients and visitors and violence is frequently considered to be “just part of the job”.
ENA and other health care professional organizations and unions are advocating for federal standards and regulations that require health care institutions to practice effective violence prevention and response. The Occupational Safety and Health Administration has published the Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers which includes policy recommendations and practical corrective measures to help prevent and mitigate the effects of workplace violence. The guidelines are voluntary. Joint Commission has always recognized the importance of providing a safe environment for the patient. A recent Sentinel Event Alert was issued by the Joint Commission identifying the rising rate of health care institutions and offering a list of thirteen suggested actions that organizations can take to prevent violent crimes in their healthcare facilities. With this in mind health care workers and their professional organizations believe that safe practices should not be voluntary guidelines or recommendations.
In 2009, ENA published a study entitled “Violence Against Nurses Working in US Emergency Departments”. In an effort to better understand the strategies necessary to effectively address this problem and facilitate a safer workplace, their study focused on investigating nurses’ experiences and perceptions of violence from patients and visitors in emergency departments in the US. A total of 3,465 emergency nurses who were ENA members participated in this cross-sectional study. The 69-question survey was conducted online for one month in the spring of 2007.
More than half of the nurses surveyed for Violence Against Nurses Working in U.S. Emergency Departments, cited one or more of the following as precipitating factors when they experienced abuse: patients or visitors under the influence of alcohol or illicit drugs; psychiatric patients being treated in the emergency department; crowding; prolonged wait times; and shortage of emergency department nurses. Research indicates that such situations can cause frustration and feelings of vulnerability, which may...