The latest sentinel event alert from the Joint Commission said healthcare workers and organizations need to do better on reporting—and preventing—workplace violence, including verbal abuse that physicians and nurses too often too often dismiss as “part of the job.”
The commission’s own data has recorded 68 incidents of homicide, rape or assault of hospital workers over the past eight years. The actual number of violent incidents, however, is likely far higher as workplace violence is often underreported and occurs most often in healthcare and social service settings. The Occupational Safety and Health Administration (OSHA) has estimated nearly 75 percent of the 25,000 workplace assaults reported every year happen in those environments, with healthcare workers “four times more likely to be victimized than any other industry.”
Those statistics don’t include the kind of verbal abuse hospital employees experience every day.
"I’ve been bitten, kicked, punched, pushed, pinched, shoved, scratched and spat upon,” said Lisa Tenney, RN, of the Maryland Emergency Nurses Association. “I have been bullied and called very ugly names. I’ve had my life, the life of my unborn child, and of my other family members threatened, requiring security escort to my car.”
Even the violent incidents can be underreported, the commission said, as workers may believe patients aren’t “responsible for their actions due to conditions affecting their mental state,” because dementia, delirium or intoxication are some of the most common characteristics in these incidents. Accepting that any kind of abuse is “part of the job” in healthcare is a mindset that the commission argued has to change in both workers and leadership.
For leaders, it starts with defining workplace violence and giving employees “simple, trusted and secure” ways to report all instances of abuse, including those which don’t escalate to physical violence. The commission recommended removing all barriers to reporting incidents, like making sure there’s no retribution or disapproval towards workers making these reports and capturing the abuse data from several sources.
Better tracking will be key, the commission emphasized, for figuring out what is contributing to violence in your hospital. Physical changes may be needed—like better lighting in certain areas, regular security patrols in areas like parking lots or better exit routes—on top of changes from the administrative end, like trying to reduce crowding and wait times, two factors that increase the risk for violence.
“Other administrative or work practice solutions may include developing workplace violence response teams and policies; reviewing entry and identification procedures; and changing work procedures to keep team members, including those providing transportation, secure and not isolated by having the means to call for help,” the commission said.
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.