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Human Resources (HR) personnel in any industry often face budgetary challenges in securing programs that will effectively mitigate and, hopefully, prevent adverse incidents in the workplace, particularly workplace violence. For HR professionals in the healthcare space, responding to and protecting staff demands even more urgent action, as recent research on violence against nurses and emergency staff has demonstrated.

Though workplace violence is an ongoing issue across the nation, healthcare facilities and their staff experience this violence at alarming rates compared to others. Researchers at the University of California at San Diego recently found that nurses have higher rates of suicide than the remainder of the population, the latest and one of the most tragic consequences of this violence.

The university’s findings support HR professionals in their fight to fund and supply essential resources, like workplace violence prevention programs, to not only better employee performance and save patients’ lives but also those of staff.

The Extended Impact of Workplace Violence in Healthcare Facilities

Several factors contribute to this higher rate of suicide, including long hours and inherently stressful environments. While it is true that the suicide rate in the U.S. has risen nationally over the last decade, the level of violence in healthcare facilities cannot be discounted as a contributing factor in the heightened risk of suicide among nurses. Although there aren’t any research studies that directly link workplace violence to suicide rates, previous studies have shown that high-stress occupations and occupations that involve exposure to violent or traumatic events can lead to increased suicide risk.

The American Nurses Association (ANA) found that 1 in 4 nurses experience assault on the job on any given day. According to the U.S. Government Accountability Office (GAO), from 2002 to 2013, healthcare professionals required days off to recuperate from a workplace violence incident at a rate five to 12 times greater than those from other industries.

While government entitles like the Occupational Safety and Health Administration (OSHA) have statutory authority over unsafe working conditions – OSHA introduced several guidelines for preventing workplace violence in the healthcare field in 2016 – a federal law does not exist that specifically prohibits assault on nurses and other healthcare staff. Consistent, pervasive exposure to violence in the workplace or the risk of it not only degrades morale but can also have a detrimental effect on an individual’s mental wellbeing.

What a Workplace Violence Prevention Program Can Do

The primary goal of a workplace violence prevention program is to promote safety and, ultimately, save lives by precluding a violent incident. But an often-overlooked outcome of putting an effective program in place is the cultural shift it can induce within the organization. This is especially important for nurses and healthcare staff who sometimes normalize violence as part of their working environment.

At the center of this culture shift is the need for a consistent approach to incident reporting procedures. However, the ANA notes that nurses face many barriers to reporting, ranging from a culture that considers violence part of the job to a lack of managerial support. In its 2019 Issue Brief on the subject, the ANA found these to be key reporting barriers for nurses in particular:

  • A healthcare culture that considers workplace violence part of the job.
  • A perception that violent incidents are routine.
  • A lack of agreement on definitions of violence; e.g., does it include verbal harassment?
  • Fear of being accused of inadequate performance or of being blamed for the incident, and fear of retaliation by the offender and/or employer.
  • Lack of awareness of the reporting system.
  • A belief that reporting will not change the current systems or decrease the potential for future incidents of violence.
  • A belief that the incident was not serious enough to report.
  • A practice of not reporting unintentional violence; e.g., incidents involving Alzheimer’s patients.
  • Lack of manager and employer support.
  • Lack of training related to reporting and managing workplace violence.
  • A fear of reporting supervisory workplace violence.

HR professionals play a crucial role in addressing these issues, along with a properly established workplace violence prevention program with an emphasis on developing lines of communication, defining workplace violence and encouraging nurses to report without repercussions. Ongoing workplace violence prevention training for managers and employees is also critical.

This type of program could also serve as an impetus for related changes to overall security. In a 2018 American College of Emergency Physicians (ACEP) survey, one half of emergency physicians said hospitals can do more by adding security, cameras, metal detectors and more visitor screening to protect staff.

Making Your Case in a Budget-restricted Environment

It may be difficult to consider a comprehensive workplace violence prevention program when coping with restricted budgets, which are unfortunately extremely common in hospitals and other healthcare facilities. However, the rise in nurse suicides should serve as a catalyst for leadership to understand that without changes, employees and services will suffer. In the same ACEP survey, 7 out of 10 emergency physicians said violence is increasing – the time to act is now.

If you would like more information on ending nurse abuse or to contribute to the cause, visit the ANA’s #EndNurseAbuse page here.

Matthew Doherty is the senior vice president and practice leader of Threat + Violence Risk Management at Hillard Heintze, a Jensen Hughes Company, and a retired U.S. Secret Service Special Agent, formerly in charge of the National Threat Assessment Center. He is a widely recognized expert across the U.S. in assessing and preventing targeted violence, and, for over 30 years, has developed plans to monitor an individual and to intervene, as appropriate, to prevent an attack by coordinating intervention strategies with social systems such as family, work, community, criminal justice, mental health and social services. To learn more about preventing workplace violence in healthcare facilities, contact Matthew and his team for additional resources.