By Daniel M . Edgar , BSN , RN , CEN , PHRN
Introduction
Frequently , nurses report assault , battery , verbal threats , and disrespect from patients . These cause nurses to feel devalued by their patients , their organization , and the judicial system . Medical occupations have the third-highest rate of workplace violence compared to any other profession ( Speroni , Fitch , Dawson , Dugan , & Atherton , 2014 ). Daily violence against nurses happens too frequently in the United States . According to Hester , Harrelson , and Mongo ( 2016 ), a 2014 study reported that 76 % of healthcare workers experience some form of violence each year . Another report showed that 25 % of emergency department ( ED ) nurses experience episodes of violence more than 20 times over a threeyear period . Studies have shown that close to 100 % of nurses have experienced verbal assault from patients or their family members ( Baby , Glue , & Carlyle , 2014 ; Kaur & Kaur , 2015 ).
This article will discuss the underreporting of patient violence on nurses and will analyze potential barriers from organizations , patients , and nurse colleagues . Strategies to overcome these barriers will be described , as well as an evidence-based plan for intervention . Finally , the article will identify healthcare professionals who can be enlisted to drive organizational change . Steps will be discussed to transform the prevailing attitude that violence against nurses is expected and / or accepted .
Changing Mindsets
Consider this familiar scenario : At 2:00 am , police are summoned to the local ED for a distraught teenage woman who intentionally bit the arm of a nurse . The summoned police are reluctant to take the report . Nurses ridicule their nurse colleague for involving the police . Patients are appalled that a nurse would attempt to take legal action against a patient . The patient ’ s family files a complaint against the nurse as retaliation for pressing charges . Hospital administrators and risk managers , wanting to limit potential liability , look for mistakes by the nurse that may have provoked an attack . Judges and the prosecutor dismiss the case . Finally , the nurse victim of the assault doubts her decision , questioning her compassion for patients . The nurse feels depressed , has flashbacks of the incident , suffers from insomnia , and calls in sick to work the next week . A few weeks later , she quits the nursing profession .
The “ just a part of the job ” mindset encountered in similar scenarios jeopardizes a nurses basic rights and quest for justice when addressing workplace violence . If this incident happened in another employment setting , the assault victim would certainly report a safety incident and may choose to press charges .
However , nurses are expected to accept violence as a normal part of the job they “ have signed up for .” With this prevailing attitude , “ the time for just waiting to see if workplace violence in hos- pitals will get better is long past ” ( Duncan , 2014 , Boost Security ).
Resistance to Change
The Occupational Safety and Health Administration ( OSHA ) defines workplace violence as any “ act or threat of physical violence , harassment , intimidation , or other threatening disruptive behavior ” ( Hester et al ., 2016 , p . 204 ). Workplace violence is a leading cause of job-related deaths , costing the country $ 4.2 billion per year ( Speroni , Fitch , Dawson , Dugan , & Atherton , 2014 ).
Nurses should not go to work with an expectation that they will be harmed . Mindsets and attitudes of nurses , administrators , risk managers , police , judges , and the public must change . According to Lisa Wolf , a research director with the Emergency Nurses Association ( ENA ), “ There is a top-to-bottom cultural assumption that violence is part of the job … It goes from the bedside up to the judicial system ” ( Jacobson , 2014 , para . 4 ). Several barriers must be analyzed and addressed surrounding this topic .
Lack of Education Nurses , administrators , and the public should receive education on the organization ’ s no-tolerance policy on violence . According to AnnMarie Papa , former ENA president , “ We [ must ] continue to let people know that this is an issue . Public awareness is important because it ’ s the public who is committing the violence ” ( Auty , 2011 , para . 9 ). Management , from the C-suite to the front-line
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