Protecting Nurses from Workplace Violence

March 16, 2010
Health care organizations must establish a zero tolerance policy for violence against nurses to protect employees and the quality of patient care, according to Jean Henry, an assistant professor of health science at the University of Arkansas.

Henry and colleague Gregory O. Ginn of the University of Nevada outlined the issues and actions administrators can take to provide a safe and functioning health care facility in “Prevention of Workplace Violence,” a chapter in Leadership and Nursing Care Management.

“There has to be an organizational culture established that has a zero tolerance policy for violence,” Henry said. “When it comes to protecting health care workers, administrators must make it clear that they won’t tolerate any violence – verbal or physical – against workers.”

Such a commitment sets the tone for developing policies and procedures to ensure a safe workplace. Henry and Ginn emphasize the importance of implementing a risk-management system throughout health care facilities to protect people and property from violence and prevent problems.

The Front Line

“A lot of what you see now in patient violence comes from frustration with the health care system in general. The system is not doing a good job in providing adequate care,” Henry said. “Nurses are on the front line, so patients vent at the nurse.”

General frustration with the system is compounded by problems with maintaining sufficient staffing levels. In the chapter, Henry uses an example of an inexperienced emergency room nurse who misreads a situation with an angry individual in the waiting room.

“Even with maturity and experience, emergency room nurses are often swamped and stressed and can miss what is going on in the waiting room,” Henry said.

She suggested ways to handle emergency rooms to lessen the potential for patient violence. Staffing an emergency room with a patient advocate, who may be a trained volunteer, can help ensure that patients don’t feel “invisible and forgotten.” Procedures requiring that regular and frequent contact with patients be noted on a chart can facilitate follow-up and reduce patient frustration.

Henry noted that nurses themselves are the most common perpetrators of some forms of violence, such as “horizontal violence” directed against other nurses. This usually takes the form of psychological harassment, such as bullying. These actions “often seem to be precipitated by staffing shortages and increasing workloads.”

Once again, institutions must establish a culture that does not tolerate violence, including bullying and harassment, which in some workplaces “may be so endemic that it is taken for granted and dismissed as inconsequential.” Permitting bullying and harassment to go on has significant negative consequences, including demoralization and loss of confidence as well as negative attitudes and impaired work performance.

The goal, Henry said, is an organizational culture that can be characterized as “caring, trusting and collaborative.”

In addition to assessing the risks and making changes in policies, procedures and physical environment to protect against violence, health care administrators need to develop procedures for responding to incidents of violence that both support the victim and lead to improvements in the workplace.

“Nurses have to know that the organization will protect them and that if something happens, they will not be treated as though they did something wrong,” Henry said. “When people are victims of violence, we don’t want to further victimize them during the investigation.”

Broader Impact

Finally, the researchers noted that workplace violence has a broader impact than what was done to any one victim.

“It damages trust, community and the sense of security that every employee has a right to feel while at work,” they wrote.

Health care administrators and the educational institutions that prepare nurses both have a responsibility in the face of increasing violence, Henry and Ginn wrote. Employers need to show a commitment to providing a safe workplace in all clinical areas and other high-risk settings. Educators and employers both need to prepare nurses to deal with potentially violent situations.

About the Author

Laura Walter

Laura Walter was formerly senior editor of EHS Today. She is a subject matter expert in EHS compliance and government issues and has covered a variety of topics relating to occupational safety and health. Her writing has earned awards from the American Society of Business Publication Editors (ASBPE), the Trade Association Business Publications International (TABPI) and APEX Awards for Publication Excellence. Her debut novel, Body of Stars (Dutton) was published in 2021.

Sponsored Recommendations

10 Facts About the State of Workplace Safety in the U.S.

July 12, 2024
Workplace safety in the U.S. has improved over the past 50 years, but progress has recently stalled. This report from the AFL-CIO highlights key challenges.

Free Webinar: ISO 45001 – A Commitment to Occupational Health, Safety & Personal Wellness

May 30, 2024
Secure a safer and more productive workplace using proven Management Systems ISO 45001 and ISO 45003.

ISO 45003 – Psychological Health and Safety at Work

May 30, 2024
ISO 45003 offers a comprehensive framework to expand your existing occupational health and safety program, helping you mitigate psychosocial risks and promote overall employee...

Case Study: Improve TRIR from 4+ to 1 with EHS Solution and Safety Training

May 29, 2024
Safety training and EHS solutions improve TRIR for Complete Mechanical Services, leading to increased business. Moving incidents, training, and other EHS procedures into the digital...

Voice your opinion!

To join the conversation, and become an exclusive member of EHS Today, create an account today!