Violence in Healthcare
According to North American Safety and Health, certain occupational groups are at higher risk for workplace violence. Rated high in this area are healthcare employees.
The dominant profession of women in hospitals is nursing.
According to "Canadian Nurses Association Position Statement on Violence", "Nurses are at particularly high risk of verbal and emotional abuse, physical violence and sexual harassment in the course of their work."
Although there is abuse of:
Many studies show that nurses face a high rate of workplace violence. Some examples include:
Alberta study (2000)…more than 9000 nurses in Alberta and British Columbia surveyed. 46% had experienced 1 or more forms of violence in their last 5 shifts. Patients were responsible for 96% of assaults and workers in ER and Psychiatry suffered the most. The study concludes that most causes of workplace violence involving health care workers are because of long waiting times in the ER and staffing levels in long term care.
University Health Network (UHN) in Toronto (2002) conducted a study of nurses at their 3 sites to assess their response to abusive behaviour from patients. The numbers in this study are similar to the Alberta study. An interesting aside to this study was that less than half of the respondents were aware of UHN's abuse policy or of the CNA's guidelines on abuse. Most of the respondents wanted to see a clearer UHN policy, a more direct process of actions following abuse and education programs for nurses to become more comfortable with disclosing experiences of abuse. A poster campaign is being launched to educate nurses about abuse and violence in the workplace. This study also concluded that nurses are 16 times more likely to experience abuse than other health care professionals.
An in-depth research study by Angela Henderson, associate professor, School of Nursing UBC Vancouver entitled: "Nurses and workplace violence. Nurses experiences of Verbal and Physical abuse at work" This study was done in Canada and the UK with 49 nurses from 4 clinical areas; maternity, community health, emergency and community mental health. The nurses were interviewed both in focus groups and individually about factors influencing their care of abused women. In the course of the original study, the degree of verbal abuse and physical violence that nurses routinely encounter in their work became apparent. It also became apparent that abuse against nurses is an important issue that has a significant impact on nurses' abilities to offer effective care. Nurses experience significant threats frequently in the context of their work at the hands of patients and their relatives. Verbal abuse is an almost daily occurrence. Supports from other health care professionals or from administrators in addressing the issue, while improving somewhat is still inadequate. The threat of violence is an increasingly recognized concern in the work life of nurses.
Disturbingly, a US based expert reports that when hospitals are forced to investigate causes of workplace violence against nurses; too often the nurses themselves are held responsible for the incident in a "blame the victim" response.
Various authors have noted that incidences of violence against nurses are under-reported. There is a general lack of adequate training, administrative support and political will. To some degree, nurses view violence as an integral part of their work and think that strategies to prevent it and lessen its impact when it does occur should be an automatic part of their training. The findings in this paper pertain only to violence and abuse from patients and their relatives. Although the study was not restricted to women, all but one of the participants was female.
All the nurses in the study reported having felt personally threatened at work and several had been physically assaulted. Three of them had been off work for a period of time as a result of injuries. One emergency nurse had been admitted on a stretcher to her own ER as a result of an attack by a man who was angry at being kept waiting on a Friday night to have his sore throat examined.
When administrators tolerate verbal or physical abuse against nurses, they not only send the message that violence is ok, they also send a message to the public (and to other nurses) that nurses are not valued. Although there has been some response, there is much to be done. Administrators in health care settings must make it clear to both their staff and the public that there is a zero tolerance environment and that violence will not be condoned. These policies, however, are only as effective as their implementation. To date, this is still inconsistent and often ineffective.
Nurses, doctors, and administrators must change the way they think, feel and do things in other words – Social Change must take place before abuse is obliterated!
A JWIC led Task Force on Violence in Health Care is working to establish protocols and devise systems to better identify, educate and respond to the effects of domestic abuse among health care workers throughout the British Columbia health care system.
