Ending Violence Against Healthcare Workers Starts with Leadership

The statistics are sobering: according to recent estimates US Bureau of Labor Statistics. Workplace violence in the healthcare sector has been on the rise every year since 2011, with rates of violence against nurses and personal care workers double that of other healthcare workers.

In Pennsylvania, nurses are at a much higher risk of workplace injury from physical abuse than almost any other profession. And the rate of workplace violence against all healthcare workers has more than doubled from 2010 to 2020, according to the Pennsylvania Association of Hospitals and Health Systems.

On the subject: Medical facilities should be a place for healing, not violence

At our own Allegheny Health Network, located in Western Pennsylvania, 89% of emergency room physicians reported being threatened by patients or visitors during the previous year, and nearly half of our nurses have experienced physical abuse during their careers by someone in the under their care.

There are several hospitals that have not reported a major escalation in violence against caregivers in the era of COVID-19. In fact, a March poll by ECRI — an independent group that tracks health safety and quality trends — identified “verbal and physical abuse against healthcare workers” as the industry’s No. 2 issue for 2023, second only to the child mental health crisis.

This information may come as a shock to those who do not work in the hospital. However, those who do so know only too well the reality of it: Biting, punching, kicking and verbal abuse have become commonplace for healthcare professionals.

This is unacceptable and must end.

Zero tolerance for violence

Violence against medical staff has reached epidemic levels. The joint commission last year implemented new violence prevention standards for all hospitals accredited by the commission. The updated protocols include new recommendations for reporting and data collection, post-incident analysis, de-escalation training, and building a safety culture.

The last point may be the most important. As health care leaders, we must understand that patients and their families often come to our facilities at their most difficult moment, the most difficult day of their lives. Emotions and anger often run high, especially in emergency rooms and intensive care units.

But this sensitivity must have limits, especially when there is violence or even the threat of violence. To our nurses, doctors and other frontline personnel, we have a responsibility to cover up in these situations and do whatever is necessary to keep them safe.

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While there is no panacea that can curb violence in healthcare settings, it all starts with a zero tolerance policy for violent or offensive behavior. In healthcare, this way of thinking requires a significant cultural shift.

For too long, violence has been expected in our emergency rooms—and even tolerated to some extent. Experienced caregivers tell younger ones that random attacks are inevitable, and as a result, it can be seen as a natural part of the work day. When this attitude prevails, “minor” incidents may go unnoticed and not brought to the attention of management.

Fortunately, this is starting to change. At AHN and hospitals across the country, violence against caregivers is promptly addressed and reported, and patients and visitors are informed – through signage, counseling and other means – that such behavior is unacceptable and that attacks will be prosecuted.

It starts from the top

Violence against caregivers cannot be seen as just an emergency room or safety issue – it is an issue that everyone should address and should be a priority for the entire organization, from the very top.

Preparing for, responding to, and mitigating violence requires a comprehensive strategy that includes input and support from hospital management, security, human resources, patient safety specialists, facility managers, behavioral health professionals, and others.

Of course, the best way to deal with violence in hospitals is to stop it before it starts.

This means investing in training caregivers and other staff to de-escalate conflicts, as well as putting in place tools and protocols to enable staff and security to intervene quickly when patients or family members become violent and before the situation becomes volatile. .

And while violence is never an appropriate response to long waiting times, we must be aware of our own role in creating stressful situations—not just in the emergency room, but also in common areas where anger can flare up. Mitigating this stress means sending medical staff to waiting areas to update patients more frequently, investing in patient flow coordinators who can help triage more efficiently, and taking proactive steps to reduce emergency room traffic by diverting care elsewhere when it is clinically needed. appropriate.

Violence, of course, can also be rooted in stressors outside of the hospital, such as housing instability, food insecurity, substance abuse, or mental health issues, which is another reason for health systems and other organizations to prioritize strategies focused on social factors. that affect well-being.

Caring for guardians

We understand that even with the best efforts and programs, caregivers will always face some level of risk. That’s why it’s so important to provide our team members with all the support they need. When incidents happen, we provide therapy to help our employees recover from their trauma. We conduct surveys, collect data, flag repeat offenders, and initiate criminal cases when necessary.

Our actions must be immediate and targeted. Nothing discourages team members more than feeling the lack of response or the consequences of violent action against them.

To be the best we can be for our patients, healthcare providers must create the safest possible work environment for those who choose these medical professions and who help us deliver on our promise to create safer, healthier communities every day.

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