Workplace Violence: Nurse Safety Issue Analysis Rachel Fox & Abby Densmore
Nurse Safety: Workplace Violence, Health & Safety Introduction
Objectives Define workplace violence and identify three examples of such behaviors. Identify 5 potential causes of workplace violence. Discuss the impact workplace violence may have on bedside nursing care. Discuss recommendations/interventions for protecting nurses against violence.
Workplace Violence Defined: Any physical assault, emotional or verbal abuse or threatening, harassing or coercive behavior in the work setting that causes physical or emotional harm. Emergency Nurses Association. (2010). Step One: Understanding the Issue. Retrieved from https://www.ena.org/practiceresearch/practice/violencetoolkit/documents/toolkitpg4.htm
Assessment of Healthcare Environment Policies Significant underreporting of occurrences Implement mandatory reporting on identified behaviors Zero tolerance policy Only two states currently have felony charge for assaulting an RN. Need for legislation Research Influential factors of violence: Alcohol/drug abuse Drug-seeking behaviors Dementia/cognitive impairment Long ER wait times Staffing issues/shortages Inadequate security
Assessment of Healthcare Environment Financial Burden of treating RN injuries as a result of violence $4.2 billion annually Lack of finances as a source of nursing shortages/staffing concerns Political Legislators review Gun laws Privacy Laws Wrongful termination Resources Nursing shortages have been shown to increase risk of violence Difficulty in RN recruiting due to threat of violence Intangible costs of violence Resource Websites http://www.victimsofcrime.org http://www.cdc.gov/niosh/docs/2002-101/
Assessment of Healthcare Environment Nursing Practice Job satisfaction Job performance Employee turnover Patient Satisfaction Decreased apathy towards patient Safety Highest Rate of Assault among other professions 60% of all reported assaults occur in healthcare setting Physical Violence Verbal abuse Ethical Autonomy Nonmaleficence Toward RN Sexual assault At-Risk Groups: Emergency nurses Psychiatric nurses Night shift nurses Violence from patient s & visitors
Need for state Legislature Zero Tolerance Policy Underreporting Lack of Policy Society culture of acceptance Nurses expectation of violence Acceptance Decreased violence towards Registered Nurses Understaffing Need for Security Training for Nurses Staffing Issues Lack of Resources Root Cause Analysis
Inferences & Implications Society s culture of acceptance for violence/aggression Nursing s Perception: Part of the Job Acceptance of violence High nursing turnover leads to poor patient satisfaction Staffing issues/shortages Decreased nursing care quality/ability
Consequences Decreased Quality of patient care Higher anxiety levels Burnout leading to turnover Financial burden Decreased time for other patients
Recommendations Adopt a proactive plan (not reactive). Training Recognition of high risk behaviors Communication techniques Diffusing volatile situations Protective methods Implementation of mandatory reporting of violence Zero Tolerance policy Management, RN, patients, visitors, all equally accountable Ongoing evaluation of violence trends
Conclusion RN s and other healthcare providers are among the most at-risk profession for experiencing workplace violence. A certain level of acceptance by the RN lead to underreporting of violent acts. Healthcare facilities and RN s need Congress support through enacting laws which enforce stricter punishment and penalty for committing an act of violence against healthcare workers. Currently only 2 states have a felony charge for this crime Hospitals can decrease the risk of violence against their nurses through: Training Adequate staffing Increased security Decreased patient wait times
References Blando, J. et al. (2013). Impact of hospital security programs and workplace aggression on nurse perceptions of safety. Journal of Nursing Management. (21). 491-498. Emergency Nurses Association. (2010). Step One: Understanding the Issue. Retrieved from https://www.ena.org/practice-research/practice/violencetoolkit/ Documents/toolkitpg4.htm Gates, D., Gillespie, G., & Succop, P. (2011). Violence against nurses and its impact on stress and productivity. Retrieved from http://www.nursingworld.org/ MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1- Jan-2013/Stressful-Incidents-of-Physical-Violence-against-Emergency-Nurses.html Jackson, D et al. (2002). Who would want to be a nurse? Violence in the workplace-a factor in recruitment and retention. Journal of Nursing Management. (10). 13-20. Speroni, K. el al. (2014). Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors. Journal of Emergency Nursing. 40(3). 218-228 U.S Department of Justice. (2001). Workplace violence: Issues in response. Retrieved from https://www.fbi.gov/stats-services/publications/workplace-violence