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Addressing Workplace Violence in Nursing

Many people are surprised to learn how often workplace violence in nursing occurs. Several factors increase a nurse’s risk of encountering workplace violence, including dealing directly with patients who have a history of violence or who may be delirious or under the influence of drugs.

According to a U.S. Department of Labor report, the rate of serious incidents of workplace violence was, on average, higher than four times higher in health care than in private industry between 2002 and 2013. Even more alarming, the report found that health care accounts for almost as many violent injuries as all other industries combined.

In the healthcare sector, nurses are the most victims of workplace violence, given that they provide round-the-clock care to patients. violence at work may include physical abuse (assaulting, spitting or kicking) or emotional abuse (including verbal abuse, bullying and harassment) and affect a nurse’s ability to do their job.

Violence in the workplace can take many forms, ranging from blatant acts that appear on the news, such as recent shot in a medical facility in Tulsa, Oklahoma, to daily verbal transgressions. More often than not, workplace violence for nurses manifests in verbal abuse and threats that go unreported. This type of violence is repeatedly overlooked and considered “part of the job,” resulting in the perpetuation of an unsafe and toxic work environment.

Nurses should never have to put their health and safety at risk. Through conscious interventions and strategic communication, healthcare leaders can work to protect their employees and allow them to focus on what matters most: serving their patients.

What is workplace violence in nursing?

Violence in nursing and health care can be verbal or physical. Most violent workplace incidents involve hostile encounters with patients.

When patients are afraid or unsure of their condition, they can transmit this anxiety to the very people trying to help them. Verbal threats directed at a practitioner are particularly prevalent in healthcare settings, but some patients take this abuse even further, physically attacking them when a nurse attempts to check their vital signs or a security guard asks a family member. Hostile encounters with patients often go unreported because nurses accept them as part of their job.

Although the degree of violence in the workplace may vary in nature, they all have serious implications for nurses and their organizations. Workplace violence has been linked to psychological distress, low employee engagement, high turnover, reduced quality of care, and financial responsibility. Nurses understand that identifying ways to prevent workplace violence in hospitals and other health care settings is a top priority.

How to Prevent Workplace Violence in Nursing

While there is no one-size-fits-all solution to preventing workplace violence, nurses and healthcare leaders can take several steps to directly address and reduce the most common forms:

Develop a zero tolerance policy

Organizations should develop zero-tolerance policies that clearly outline a code of conduct in the workplace as well as the consequences for those who violate that code. Creating this type of formal document sends the message that lateral violence is not tolerated within the organization.

Create open lines of communication

Organizations with open lines of communication enable their employees to recognize and report acts of violence before they escalate. With open lines of communication between peers and managers, an organization can foster an environment where employees are comfortable sharing their experiences.

To raise awareness

Many healthcare workers take violence in stride, assuming it comes with the territory. Raising awareness of workplace violence – what it looks like, who it affects and why it is dangerous – helps increase incident reporting and keep employees safe.

Streamline the reporting process

Many healthcare facilities either do not have a workplace violence reporting process in place or have one that is extremely complex. Both scenarios deter victims from speaking out and allow perpetrators to continue their abuses. Healthcare administrators are encouraged to develop a simple reporting process that allows employees to alert leaders to abuse. The more information leaders have, the better equipped they are to track, respond to, and combat workplace abuse.

Identify patterns

Incidents of workplace violence should be continuously recorded and analyzed, allowing healthcare administrators to identify patterns of abuse – in which departments it occurs most, repeat offenders, etc. – and adjust their approaches if necessary.

provide education

Preventing workplace abuse begins with education about workplace violence. Comprehensive education and training helps nurses identify and report acts of violence and develop programs to keep their teams safe. Workplace violence in nursing can have both physical and emotional consequences ranging from physical injury to trauma, and even permanent disability or death. Education is key to equipping nurses with the information they need to protect themselves and their colleagues.


Consider this course to learn more about addressing workplace violence in nursing:

Prevention of violence in the healthcare environment

(1.0 contact hours)

Violence in healthcare settings reflects the chaos of a wider work environment. The National Institute for Occupational Safety and Health defines workplace violence as “acts of violence (including physical assault and threats of assault) directed against persons at work or on duty.” Experts not only agree on the extent of violence in healthcare settings, but also agree on its best treatment: education and prevention. Nurses build their awareness and expertise to deal with violence in their workplace by learning to identify risk factors and warning signs, and applying interventions that can protect themselves and their patients from harm .

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