Reducing Workplace Violence in Nursing and Healthcare

Workplace violence is an all-too-common problem in healthcare, and the recent shooting in a Tulsa, Oklahoma, hospital complex serves as the latest tragic example. According to a report from the U.S. Department of Labor, the rate of serious workplace violence incidents was, on average, more than four times higher in healthcare than in private industry between 2002 and 2013. Even more alarming, the report found that healthcare accounts for nearly as many violent injuries as all other industries combined.

Violence within the workplace can take many forms, from egregious acts that appear on the news to daily verbal transgressions. More often than not, workplace violence for nurses and doctors manifests as verbal abuse and threats that go unreported. This type of violence is repeatedly overlooked and taken in stride as “part of the job,” leading to the perpetuation of an unsafe and toxic work environment.

Healthcare employees should never have to put their health and safety in jeopardy. Through conscious interventions and strategic communication, healthcare organizations can work to protect their employees and allow them to focus on what matters most: serving their patients.

What Is Workplace Violence in Healthcare?

Violence in nursing and healthcare can be either verbal or physical. Most violent incidents within the workplace fall into one of three categories:

Hostile Encounters With Patients

When patients are scared or uncertain about the status of their health, they may take this angst out on the very people trying to help them. Verbal threats addressed to a practitioner are particularly prevalent within the healthcare setting, but some patients take this abuse one step further, lashing out physically when a nurse attempts to check their vitals or a security guard questions a member of their family. Hostile encounters with patients frequently go unreported as practitioners accept them as a normal part of the job.

Lateral Violence

Also known as horizontal violence or bullying, lateral violence is defined as non-physical, aggressive, harmful, and/or hostile behavior between coworkers. Lateral violence is particularly prevalent among nurses, many of whom view it as a right of passage. In fact, nursing workplace violence statistics estimate that somewhere between 46% and 100% of nurses have experienced lateral violence at some point during their careers. While lateral violence doesn’t put healthcare workers in immediate physical danger, it still creates a toxic work environment that negatively impacts employee productivity and morale.

Domestic Violence

It is not uncommon for violence that occurs outside of the workplace to creep into healthcare settings. Domestic violence is one of the most common, but least-discussed, forms of workplace violence. This type of abuse typically manifests when a partner threatens his or her significant other’s job performance and security through abusive, controlling acts.

For example, the perpetrator may repeatedly show up to their partner’s place of work unannounced, demanding that they make time for them. Abuse within the home also takes a psychological toll on the victim, often inhibiting their ability to perform their job to the fullest extent possible.

While these three forms of workplace violence differ in nature, they all have serious implications for healthcare professionals and the institutions for which they work. Workplace violence has been linked to psychological distress, low employee engagement rates, high turnover, reduced quality of care, and financial liability. For administrators seeking to protect their staff and patients, identifying ways to prevent workplace violence in hospitals and other healthcare settings is a top priority.

How to Prevent Workplace Violence in Healthcare

While there’s no one solution for preventing workplace violence, healthcare organizations can take several steps to directly address and reduce the more common forms:

Develop a Zero-Tolerance Policy

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

Create Open Lines of Communication

Organizations with open lines of communication empower their employees to recognize and report violent acts 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.

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 impacts, and why it’s dangerous — helps increase incident reporting and keep employees safe.

Streamline the Reporting Process

Many healthcare institutions have either no workplace violence reporting process in place or an extremely complex one. Both scenarios deter victims from speaking up and allow perpetrators to continue their abuse. Healthcare administrators are encouraged to develop a straightforward reporting process that empowers employees to alert leaders when violence occurs. The more information leaders have, the better equipped they are to track, respond, and combat abuse in the workplace.

Identify Patterns

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

Prevent Workplace Violence in Healthcare

Preventing abuse in the workplace begins with workplace violence education. Comprehensive training programs help administrators and frontline employees identify and report violent acts and develop programs to keep their teams safe.

Editor’s Note: This post was originally published in August 2020 and has been updated.