A hospital or other healthcare facility can be a stressful place for patients – they are in pain, afraid, confused, frustrated – but it can also take a toll on those who work there, too. We don’t realize it, but workplace violence in healthcare facilities tends to be higher than in many others.
Workplace violence involves not just a physical assault, but also verbal abuse – threats, harassment, hostility – often prevalent in healthcare. In fact, many in the healthcare industry consider this harassment and verbal abuse to be more of an occupational hazard.
In hospitals, nursing homes and other healthcare facilities, workplace violence comes from not just co-workers, but also the patients and their family members and may include things such as:
- Verbal threats or physical attacks
- Distraught family members becoming abusive
- Gang violence in an emergency room
- Domestic disputes
- Coworker bullying
The Statistics Tell the Story
According to OSHA, from 2002 to 2013, incidents of serious workplace violence (those requiring days off for the injured worker to recuperate) were four times more common in healthcare than in private industry on average.
In fact, in 2013, the broad “healthcare and social assistance” sector had 7.8 cases of serious workplace violence per 10,000 full-time employees whereas other large sectors such as construction, manufacturing and retail all had fewer than 2 cases per 10,000 full time employees.
Often, violence in the healthcare industry goes unreported because:
- Caregivers feel a professional and ethical duty to do no harm to patients, putting their own safety and health at risk to help a patient
- Many recognize that injuries caused by patients are unintentional and accept them as routine or unavoidable
Prevalence of Workplace Violence in Healthcare
Many factors contribute to the risks healthcare workers face with regards to workplace violence.
- Working directly with people who have a history of violence or who may be delirious or under the influence of drugs
- Lifting, moving and transporting patients
- Working alone
- Poor environmental design that may block vision or escape routes
- Poor lighting in hallways or exterior areas
- Presence of firearms
- Working in neighborhoods with high crime rates
- Understaffing in general and especially during meal times and visiting hours
- High worker turnover
- Inadequate security staff
- Long wait times and overcrowded waiting rooms
- Unrestricted public access
Preventing Workplace Violence at Healthcare Facilities
Education is where prevention starts. Staff need to be trained on which situations carry an elevated risk of patient violence, what may be a trigger situation. Understanding the “why” can help determine what approach to take with a patient, such as offering a more detailed explanation or moving slowly and calmly.
Other factors that can help reduce violent tendencies include:
- Providing comfortable waiting rooms
- Adopting measures to decrease waiting time
- Providing sensitive, timely information to people who are waiting
- Establishing a system for identifying patients with a history of violence
- Discouraging staff from wearing necklaces to prevent strangulation
- Discouraging staff from carrying items that may be used as weapons (such as keys or pens)
- Ensuring that nurses and physicians are not alone when providing care that involves close contact with the patient
- Looking over the facility regularly to remove items that could be used as weapons, such as maintenance tools.
Be sure to address responses to an active shooter situation. You may not realize it, but the run, hide, fight approach doesn’t necessarily work in the healthcare field. I’ve had this brought to my attention in my OSHA Training classes. Staff in healthcare facilities can’t just leave their patients should an active shooter event take place.
As with any other organization, safety training to address workplace violence situations must be tailored to the risks faced at that workplace, addressing all types of situations, and must be ongoing.
Resources for You
- Workplace Violence: Are Supervisors and Managers Prepared?
- Tips for Developing a Workplace Violence Prevention Program
- Preventing Violence in the Workplace
- Domestic Violence Impacts the Workplace, Too
- Workplace Violence