Violence and Danger in the Healthcare Workplace

Violence and Danger in the Healthcare Workplace

It’s no secret that nurses and other healthcare professionals face the daily danger of infection, back injuries, falls, needlesticks, and other on-the-job hazards. During the height of the COVID-19 pandemic, healthcare workers put themselves at grave risk to care for critically ill patients, and some paid with their lives.

Beyond the hazards we recognize within American healthcare, did you know that social services and healthcare workers experience the highest injuries from workplace violence (WPV) in any industry?

Working in healthcare is dangerous on many levels, but suffering violence at the hands of others is certainly not something any of us willingly signed up for when we chose to enter the field.

Disturbing Numbers

According to the Bureau of Labor Statistics  (BLS), the WPV 2018 numbers were clear as day:

“In 2018, the private ownership all-worker incidence rate for nonfatal occupational injuries and illnesses involving days away from work resulting from intentional injury by other persons in the private healthcare and social assistance industry was 10.4 per 10,000 full-time workers, compared to the all-worker incidence rate of 2.1. The health care and social service industries experience the highest rates of injuries caused by workplace violence and are five times as likely to suffer a workplace violence injury than workers overall.”

The BLS adds that “healthcare workers accounted for 73 percent of all nonfatal workplace injuries and illnesses due to violence in 2018. The industry’s number of total workplace violence has grown since 2011.”

In July of 2023, a Denver-area hospital security guard was killed by a visitor in July of 2023. In October of 2022, a man attending the birth of his child at a Dallas hospital shot and killed two facility staff members. A man killed his surgeon and three others in Tulsa in June of 2022 because he blamed his surgeon for his continued pain following back surgery. The U.S. Department of Justice Civil Rights Division has documented significant violence against those legally providing reproductive health services.

When it comes to healthcare workers’ dangers, the disturbing stories and statistics are real. If an average of 300 American physicians die by suicide each year, with nurses also at increased risk, we can conclude that the dangers of working in healthcare are unique and far beyond the general public’s imagination.

We Didn’t Sign Up for This

Imagine your first day in nursing school. You’re excited, trying to calm your nerves, and already fretting about surviving the program. As your education begins, you learn about pathophysiology, the nursing process, patient care, and leadership, and you also start your clinical rotations.

During your coursework, there may hopefully be a discussion about burnout prevention and self-care. However, it’s unlikely that your instructors will talk about nurse suicide, let alone the statistics regarding healthcare workplace violence. Nursing education does not include self-defense classes and active shooter scenarios, but perhaps it may in the future.

We all want to be safe and do the jobs we signed up for, namely taking care of patients or otherwise supporting the system that does so. However, the knowledge that WPV against healthcare workers is more significant than those employed in law enforcement is serious food for thought.

Solutions Must be Found

The Occupational Safety and Health Administration (OSHA), states the following:

“In most workplaces where risk factors can be identified, the risk of assault can be prevented or minimized if employers take appropriate precautions. One of the best protections healthcare employers can offer their workers is to establish a zero-tolerance policy toward workplace violence. The policy should cover all workers, patients, clients, visitors, contractors, and anyone else who may come in contact with workers of the facility.”

“By assessing their worksites, employers in the healthcare industry can identify methods for reducing the likelihood of incidents occurring. OSHA believes a well-written and implemented Workplace Violence Prevention Program, engineering controls, administrative controls, and training can reduce workplace violence. It is critical to ensure that all workers know the policy and understand that all claims of workplace violence will be investigated and remedied promptly.”

OSHA’s dedicated Workplace Violence Safety and Health Topics web page and Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers are necessary resources healthcare workplaces should avail themselves of. The National Institute for Occupational Safety and Health (NIOSH) also provides various resources, including workplace violence prevention education specifically for nurses

Recognizing the dangers, taking them seriously, and being proactive are critical. Healthcare professionals should be fully trained in identifying risk factors for violence and incident response.

Just as American students and their teachers are tragically in need of training for active shooter scenarios, healthcare workplaces sadly need the same. With some calling for arming school teachers, we may not be far from similar calls to arm healthcare workers.

While some states may have laws making assault or battery against healthcare workers a felony, we recognize that the threat of punishment does not necessarily deter those inclined to such behavior.

On a more philosophical, sociological, and anthropological level, the larger societal factors regarding why these violent acts occur in the first place are worthy of discussion. What about our culture makes these types of crimes so common? What is it about our shared humanity that drives us to violence? And how can we lower the risk of overall violence in our communities?

The reality of workplace violence remains a daily threat however we choose to address these grave issues. As a society and separate industries, we must address the scourge of violence enveloping our country and do our best to create a safer, saner, more civil society and workplace environment. How we get there remains a topic desperately open for discussion.