As the nation observes Labor Day, economic issues such as income equality, paid leave and the minimum wage may be making headlines, but workplace safety -- particularly in health care settings -- is another issue that must be addressed.
Violence Against Health Care Workers
Acts of violence against health care workers are being committed with increasing frequency in hospitals and health care facilities. This week alone, a hospital patient was arrested after assaulting 14 nurses and staff members at a hospital in Charleston, S.C., and in central Florida, a patient attacked nurses who were trying to transfer him from an ambulance stretcher when he arrived at a local hospital.
While not all violent incidents result in devastating consequences, many cause injury; damage workers' teamwork, morale and sense of safety; and result in high turnover at a time when the health care industry can least afford it.
Consider these incidents in just a three-month period from November 2014 through January 2015:
• A 68-year-old male patient attacked four nurses with a metal bar at a Minnesota hospital; one nurse suffered a collapsed lung, another a broken wrist and two others cuts and bruises.
• In Boston, a cardiologist was murdered after a man, the son of one of the cardiologist's patients, located the physician and shot him.
• A 58-year-old man who entered an Oklahoma City hospital emergency room complaining of chest pains pulled out a knife and attacked three nurses and a security guard, causing stab and bite wounds.
• A 20-year-old male receiving a medical evaluation at a health clinic across from a hospital in Los Angeles allegedly shot and wounded a nurse in the thigh.
Health care professionals have a duty to provide care that keeps people safe, alleviates suffering and restores health. But when health care workers fear the threat of personal harm from attack and injury, their focus on the patient is undermined -- and so is the U.S. health care system.
Not "Part of the Job"
Our hospitals and other health care facilities must be bastions of safety where patients and workers feel protected, yet acts of violence are occurring with increasing frequency. A proactive stance to develop effective workplace violence prevention programs is critical to ensure the safety of patients, nurses and other health care workers. We must completely dispel the prevailing notion that being physically or verbally assaulted is just "part of the job."
Less visible is the daily drumbeat of violence that goes unreported but makes health care workers fearful and contributes to distrust, dissatisfaction and decreased performance in the workplace -- workers being struck, bitten, kicked, spat upon and verbally threatened and harassed by patients, family members or visitors.
While all clinicians are vulnerable, nurses are assaulted most often. A report in April by the Occupational Health Safety Network (OHSN) concluded that nurses and nurse assistants are the most likely to be injured due to workplace violence.
In addition, three of four nurses reported experiencing violence on the job -- verbal or physical -- within the past year, and three of 10 reported physical abuse by patients, according to a 2014 survey published in the Journal of Emergency Nursing. A high proportion of the incidents involved patients under the influence of alcohol or drugs.
In an American Nurses Association (ANA) survey of registered nurses, one-third identified "on the job assault" as one of their top three workplace safety concerns, and 21 percent reported they were at a "significant level of risk" for violence at work.
Zero Tolerance Policy
To address this growing problem, ANA convened an expert panel on Incivility, Bullying and Workplace Violence. The panel analyzed research findings and has proposed detailed guidance for nurses and employers to follow to prevent and reduce workplace violence, bullying and incivility. Recommendations for employers include, among many others, establishing a zero tolerance policy for all types of violence, fostering a non-punitive environment that encourages reporting incidents and developing a comprehensive violence prevention program. Ultimately, implementing better safety and professional standards will be the key to curbing workplace violence, bullying and incivility.
Nurses and other health care workers, like law enforcement officers, are guardians of our communities, and their welfare demands protection. A first step is acknowledging and reporting the problems. Training needs to be a priority, and should be specialized to the type of setting and include a variety of methods, such as hands on practice, simulation and mock drills. More aggressive prevention efforts are needed to diminish the violence that disrupts our healing and caring environments.
Additionally we call on our citizens who are our patients and their family members, to help ensure health care facilities are indeed places for care, support, healing, and wellness. Everyone can help by respecting these places as safe havens, and being watchful so that caregivers are not subject to harm. We cannot afford to have one more health care worker killed or maimed.
Violence is not part of the job.