Addressing Workplace Violence in Nursing

By | 2022-06-08T15:22:15-04:00 June 8th, 2022|0 Comments

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

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.

Within the healthcare industry, nurses experience the most workplace violence, given that they provide 24-hour care to patients. Workplace violence can include physical violence (assaults, spitting, or kicking) or psychological violence (including verbal abuse, acts of intimidation, and bullying) and affect a nurses’ ability to perform their job.

Violence within the workplace can take many forms, from egregious acts that appear on the news, such as the recent shooting at a medical facility in Tulsa, Oklahoma, to daily verbal transgressions. More often than not, workplace violence for nurses 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.

Nurses should never have to put their health and safety in jeopardy. 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 healthcare can be either verbal or physical. Most violent incidents within the workplace involve 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 nurses accept them as a normal part of the job.

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

How To Prevent Workplace Violence in Nursing

While there’s no one solution for preventing workplace violence, nurses and healthcare leaders 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.

Provide Education

Preventing abuse in the workplace begins with workplace violence education. Comprehensive training and training help nurses identify and report violent acts and develop programs to keep their teams safe. Workplace violence in nursing can have both physical and emotional consequences ranging from physical injuries to trauma, and even permanent disability or death. Education is a key component to arming nurses with information they need to protect themselves and their coworkers.


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

Preventing Violence in the Healthcare Setting

(1.0 contact hours)

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

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Felicia Sadler, MJ, BSN, RN, CPHQ, LSSBB
Felicia Sadler, MJ, BSN, RN, CPHQ, LSSBB, has been a Registered Nurse for over 30 years and is a Certified Professional in Healthcare Quality, a Lean Six Sigma Black Belt in Healthcare, and has served as an examiner for the Tennessee Center for Performance Excellence. She holds a Master of Jurisprudence in Health Law from Loyola Chicago School of Law and a Bachelor of Science in Nursing from South University. Felicia has served as chairperson for ASHRM's Education Strategy Committee, and ASHRM’s Education Development Task Force and assists health care organizations with strategic solutions to impact clinical outcomes and optimize organizational performance.

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