Addressing Workplace Violence and Abuse Against Nurses

Workplace violence against nurses is an under-reported issue that has a devastating impact on the healthcare industry. Studies show that workplace violence in healthcare dramatically impacts the overall quality of care and care outcomes. Further, the American Nurses Association (ANA) states that nurse abuse contributes to adverse psychological conditions and a significant reduction in nurses’ job satisfaction and organizational commitment.

What is Nurse Abuse?

According to the American Nurses Association, nurse abuse is defined as “Any act or threat of physical violence, harassment, intimidation or other threatening, disruptive behavior from patients, patient’s family members, external individuals, and hospital personnel. It includes physical, sexual, and psychological assaults.”

Data on Nurse Abuse

Considering the praise and celebration our nurses and healthcare workers have received throughout the COVID-19 pandemic, hearing about workplace violence in healthcare might surprise you, but the numbers tell a frightening story. As an under-reported problem, the extent of workplace violence can only be estimated.

Inside the Numbers

• One in four nurses is assaulted.
• Only 20-60% of these workplace violence incidents are reported.
• As much as 13% of missed workdays are due to workplace violence.
• During the pandemic alone, 44% of nurses reported experiencing physical violence and 68% reported verbal abuse.
• Nurses are two to four times more likely to experience post-traumatic stress disorder, anxiety, depression, and burnout than nurses with no exposure.
• Overall, the likelihood of healthcare workers being exposed to violence is higher than police or corrections officers.

Promoting Nurse Safety

The ANA and other nursing organizations are joining forces to promote #EndNurseAbuse, a national campaign to raise awareness across the healthcare industry and the general public. The stated goal is to establish a zero-tolerance workplace culture where abuse is not tolerated in any form.

Another key to creating a safer environment for nurses is understanding that it will take everyone, from those within the healthcare industry to the patients and consumers of healthcare, to make a real difference. Below are four actions that can begin to affect change today.

What We Can Do Now

1. Recognize Abuse: It is essential to recognize that nurse abuse can be verbal, physical, psychological, sexual, and racial. Abuse should never be acceptable in any form or environment. Subtle forms of abuse, like a derogatory comment, can be as harmful as an overt action, like striking a caregiver. Being aware of all the forms abuse can take is an important first step.
2. Report Abuse: Workplace violence cannot be tolerated and should be reported as soon as it is safe to do so. The ANA promotes the acronym STOP WPV as a tool to help when reporting an incident.
   
   Situation: Describe what happened.
   Type: Was the abuse or threat verbal, a physical assault, or were any weapons used?
   Observers: Make a list of any witnesses to the incident.
   People: Make a list of everyone involved in the incident.
   
   Where and When did the incident occur?
   Preceding Factors: Describe the events leading up to the incident.
   Verify: Note any injuries sustained, physical or emotional.
   
3. Get Involved: Learn more about your facility’s policies and join, or create, a committee to build upon what is in place. Ensure that your organization has a “zero tolerance” policy that includes:
   • Widespread education and awareness that identifies the risks and reduces workplace vulnerabilities.
   • Encourages victims to come forward and provides a safe mechanism for reporting.
   • An effective response to violence and incidents immediately after the occurrence.
   • Continual improvement of the policy through strategies that target reducing the long-term impacts of abuse.
4. Speak to Legislators: It is vital to promote the #EndNurseAbuse campaign through your elected officials at the local, state, and federal levels. On April 16, 2021, the U.S. Congress passed R. 1195-Workplace Violence Prevention for Health Care and Social Service Workers Act. The bill requires that the Department of Labor address workplace violence in health care by issuing standards for employers to take that protect workers and other personnel from workplace violence. Since then, the bill has been received in the Senate and referred to committee.

To keep the momentum going on this issue, we must make our voices heard and push the Senate to take further action. To contact members of the Health, Education, Labor & Pensions Committee, visit their senate page. The development of enforceable standards, such as those outlined in H.R. 1195, is critical to ensure that employers take nurse abuse seriously and implement workplace violence prevention plans that protect healthcare workers from violent incidents of all types.

Resources for Nurses

It is necessary for all of us to play a role in supporting our healthcare workers and eliminating workplace violence and abuse. From senior leadership to human resources, every employee should be working together to take this issue seriously through advocacy, reporting, and prevention.

Together, we must all support the nursing community and stand up against nurse abuse. Here are some resources for education, prevention, and reporting of workplace violence.

Guides and Briefs

• ANA’s Issues Brief: Reporting Incidents of Violence
• OSHA’s Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers

Courses and Continuing Education

• CDC’s Workplace Violence Prevention course
• Violence Against Nurses: It’s NOT Part of the Job! webinar
• Workplace Violence in the Emergency Department continuing education course