Research on violence cases in the workplace - prevention and intervention Eda Merisalu, Dr.Med.Sci Estonian University of Life Sciences A+A ILO International Occupational Safety and Health Conference, 17-19.10.2017, Düsseldorf
When I was bullied about two years ago it was my foreman, who caused me all the upset and pain. Why? To this day I ll never know. He would me feel small and make me cry and be very unkind and cruel to me. I get small bit of comfort that I was not the only one who was doing it to Dr. Mona O Moore Irish National Survey on Bullying, Trinity College, Dublin, 2000
Violence Violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation. (WHO, 2014) Work place Colleagues Clients World report on violence and health (2014)
Statistics UK (2009-2010) - 53% of employees had been victims of workplace (WP) bullying and 78% had witnessed such behavior. ~ 318 000 workers had experienced at least one incident of WP violence in the past year. 2010 - British Crime Survey recorded 677 000 incidents of violence at work (310 000 assaults and 367 000 threats). New Zealand (2011) Massey University survey of 96 organizations found >50% had experienced WP violence (2466 cases). - 20% of cases reported involved physical injury - 175 cases led to hospitalization - 572 lost working days because of WP violence. Taiwan (2007-2008) IOSH survey revealed that, - 13% suffered from heavy pressure in their work, - 24% had emotional problems - anxiety, depression, irritability, - 757 committed suicide, an average of two per day, making suicide the 4th largest cause of death among workers.
Statistics The U.S. Department of Labor survey of employers with >1000 workers revealed that more than 50% reported at least one incident of workplace violence in the past 12-months. The Allied Barton Security Services survey Violence in the American Workplace revealed that 52% of Americans have heard about, or had experienced a violent event at their workplace. OSHA states that nearly 2 million American workers are victims of workplace violence each year, though many cases are not reported. Finally, it s believed that workplace violence is related to low employee morale or low safety culture.
Occupational groups more at risk of WP violence Health Care Workers or those to dispense pharmaceuticals police, security, or correctional officers social services employees, incl. crisis intervention & counselling services teachers or education providers municipal housing inspectors public works employees retail employees sellers of alcohol (sale, or consumption on the premises) taxi drivers or transit drivers
Types of WP violence? Harassment any behaviour that demeans, embarrasses, annoys, humiliates, alarms or verbally abuses a person and that is known or would be expected to be unwelcome. This includes words, gestures, intimidation, bullying, or other inappropriate activities. Threatening shaking fists, destroying property, throwing objects. Verbal threats any expression of an intent to inflict harm. Verbal abuse swearing, insults or condescending language. Physical attacks hitting, shoving, pushing or kicking. Rumours, swearing, pranks, arguments, property damage, vandalism, sabotage, pushing, theft, physical assaults, psychological trauma, angerrelated incidents, rape, arson and murder - examples of workplace violence.
What is bullying at workplace? Bullying - as acts or verbal comments that could 'mentally' hurt or isolate a person in the workplace, as well negative physical contact. Bullying usually involves repeated incidents that is intended to intimidate, offend, degrade or humiliate a particular person or group of people. There is a "fine line" between strong management and bullying. 70,8% respondents believed that poor management style with yealousy, envy of the victim, an effort to force a resignation and the desire to get even being other strong reasons given. 34,2% of victims specified other reasons as staff shortages, new equipment with inadequate training and high-pressure industry. 27% respondents reported that bullying started after a change of manager; 20% and less - after change of job. Irish National Survey on Bullying, 2000
What is bullying behaviour? Making jokes 'obviously offensive' by spoken word or via e-mail. Intruding on a person's privacy by pestering, spying or stalking. Assigning unreasonable duties or workload which are unfavourable to one person (in a way that creates unnecessary pressure). Underwork - creating a feeling of uselessness. Yelling or using profanity. Criticising a person persistently. Belittling a person's opinions. Unwarranted (or undeserved) punishment. Blocking applications for training, leave or promotion. Tampering with a person's personal belongings or work equipment.
Outcomes of WP violence Psychological symptoms Shock, panic, anger, depression, nervousness, anxiety, PTSD Feelings of frustration or helplessness Increased sense of vulnerability Loss of memory, inability to concentrate. Psychosomatic and physical symptoms Inability to sleep Chronic fatigue Headaches, migraine Loss of appetite Stomach pains Cardio-vascular problems (angina, MIC, atherosclerosis) Behavioural symptoms Loss of confidence, avoidance of social contact Family tension and stress Low morale and productivity
Chapell-di Martino Model Risk factors of generating - defusing WP violence. By Poyner-Warne, 1988.
Risk factors of work violence among nurses 70 60 50 40 30 20 10 0 Conflicts by subordinates Psychological violence Patients' unsatisfaction Cut of contract Negative solutions Bad microclimate % Frequency Disturbacy Uncomfortable working milieu Role conflict Nool, I. 2000. Relationships between personality factors, work stress and burnout among elder nurses in Estonia. Bach. Tartu.
Relationships between WP violence factors and health (r=0.30, p<0.05) Varik, M. 1999. Work stress and health among head nurses in Estonia. Bach. Tartu.
Relationships between WP violence factors and burnout (r=0.20, p<0.05) Varik, M. 1999. Work stress and health among head nurses in Estonia. Bach. Tartu.
Violence against nurses by patients and their relatives in Emergency Departments of hospitals 60 50 40 % 30 20 10 Patients' violence toward ED nurses 0 Verbal violence Physical violence Sexual harassment Male Female Tyrkson, 2017
Types of violence against nurses by patients and their relatives in the Emergency Departments Tyrkson, 2017
Examples of decisions of recognition or rejection PTSD diagnosis as a consequences of WP violence Example 1. Health Care Work A home help had for some years worked with a female patient who was paralysed on one side. Her spouse behaved very aggressively and threateningly in the home help s presence, hit and kicked at objects and knocked a first into the wall, right above the head of the home help. The medical specialist s certificate stated the diagnosis of posttraumatic stress disorder (PTSD). The claim has qualified for recognition on the basis of the list. In her work, the home help experienced instances of a very aggressive behaviour on the part of a client s husband. She had developed symptoms of PTSD in relevant time correlation with the exposure. The claim was recognised and diagnosis was compensated as WRD. Kieffer, C. 2012. What recognition of work-related mental disorders? A study report on 10 EU countries. Examples from the National Board of Industrial Injuries.
Not recognised claim of prison officer Example 2. Work as a prison officer A 50-year-old prison officer had worked for 20 years for the prisons. In this employment he was exposed to daily conflicts with the inmates, was threatened with broken glass and knives, and was kicked in the face in connection with an arrest. Well over 4 years leaving the job he had symptoms of a mental disease with nightmares and emotional complaints. The medical specialist established symptoms of a moderate traumatic stress condition. The claim was not qualify for recognition on the basis of list, and there were no grounds for submission of the claim to the Committee. The prison officer had psychologically vert stressful experiences from his work, but only developed mental symptoms after 4 years after cessation of work. There was no good time correlation between the exposure and the development of disease? Kieffer, 2012
Not-recognised clame after complaints and exposure to psychiatric patients violence Example 3. Psychiatric healthcare assistant A healthcare assistant had been employed in a psychiatric nursing home since 1978 on regular night duty. I later years he had been alone on night duty. Two incidents had been reported and recorded as accidents at work. In March 1992 a threatening and scolding patient kicked him. After this incident he had violent anxiety attacks and became weepy and afraid of the dark. In June 1992 he resumed work. In 1994 there were violent incidents with colleagues. He felt unwell again and started drinking. The claim was not recognised as OD. The event in 1992 was recognised as accident. In 1991 he developed symptoms of PTSD. He had relapse in 1994 in connection with violence with colleagues, which was complicated by alcohol consumption. There is no documentation of any relevant mental trauma in connection with the relapse. It should be assessed, however, whether the relapse might be attributable to the accidents. Also, the previous cases therefore should be reassessed. Kieffer, 2012
Statistics of recognised cases of mental damage Kieffer, 2012
How can bullying affect the workplace? Increased absenteeism Increased turnover Increased stress Increased costs for employee assistance programs and recruitment Increased risk for accidents or violence incidents Decreased productivity and motivation Decreased morale Reduced corporate image and customer confidence Poor customer service
Jäämägi Adapted by Loeppke, et al. 2009. Health and Productivity as a Business Strategy: A Multi-Employer Study. JOEM, 51(4):411 428.
How to prevent WP violence? Outline the process by which preventive measures will be developed. Encourage reporting of all incidents of violence. Outline the confidential process by which employees can report incidents/to whom. Assure no reprisals will be made against reporting employees. Outline the procedures for investigating and resolving complaints. Describe how information about potential risks of violence will be communicated to employees. Make a commitment to provide support services to victims of violence. Offer a confidential Employee Assistance Program to seek help. Clear out the violence prevention training needs. State applicable regulatory requirements.
A workplace violence prevention program Identify risk factors Develop a prevention policy Conduct a hazard assessment Develop a comprehensive prevention program Develop procedures for reporting and investigating incidents Develop a critical incident management plan Develop victim support services Follow-up on and learn from incidents Develop a training program Identify relevant legislation
Charter Dignity at work Purpose To quarantee human dignity at work To create trustable relations at work that employees feel valued and perceive their appreciated role at work. Mission To create positive working milieu To protect human rights To achieve human dignity behavior To be informed about implementation of the declaration Signature of declaration Irish National Survey on Bullying in the Workplace, 2000
Regulations of WP violence In 2007, the European social partners BUSINESSEUROPE, UEAPME, CEEP and ETUC signed an autonomous framework agreement on violence and harassment at work. It requires that signatory parties cooperate on the improvement of working conditions. Penal Code 152. Violation of equality (1) Unlawful restriction of the rights of a person on the basis of his or her nationality, race, color, sex, language, origin, religion, sexual orientation, political opinion, financial or social status is punishable by a fine of up to 300 fine units or by detention. 153. Discrimination based on genetic risks (1) Unlawful restriction of the rights of a person or granting of unlawful preferences to a person on the basis of his or her genetic risks is punishable by a fine of up to 300 fine units or by detention. 153 1. Sexual harassment is punishable by a fine of up to 300 fine units or by detention.
Thank you for attention!