“It’s Just Part of the Job;” The Dangerous Perceptions and Realities of Workplace Abuse for Nurses

 

If you overhear someone saying they were aggressively told on the job, “Why don’t you bring your p—y over here and sit on my face,” you might make certain presumptions about that woman’s occupation. However, if you then learned this woman was a nurse, and was told this by a patient whose family later laughed off the story, you would likely be left with a completely different feeling. The nurse who told this story is unfortunately not unique; in 2014, a study in the Journal of Emergency Nursing found that 75% of nurses said they had experienced physical or verbal abuse on the job.[1]

Beyond the crass, hurtful, and frightening language patients might use against them, from 2002 to 2013, healthcare workers reported four times more incidents of serious workplace violence than those in any private industry job.[2] Additionally, due to the persistent perception that assault is just “part of the job,” the actual number of incidents is much higher and grossly underreported. [3] In order to understand the specific threats posed to healthcare workers on the clock, what causes them, and why they are occurring, here is the first of a two-part series that will focus on the daily dangers suffered by many healthcare workers today:

 

What kinds of abuses are nurses facing?

Abuse is divided into two categories: verbal and physical. Verbal abuse consists of communication via behavior, tone, or words that intend to humiliate, degrade, or disrespect an individual.[4] This leaves the victim feeling hurt, frightened, and/or professionally or personally attacked or devalued, resulting in decreased happiness and productivity.[5] In one 2014 study, over 50% of registered nurses and nursing students reported being verbally abused in a 12-month period.[6] Violent assaults include when medical staff members are spit on, slapped, kicked, beaten, shoved, or scratched, and about 30% of 700 registered nurses surveyed in Virginia reported being physically assaulted by patients within the past 12 months.[7]

 

Who are the abusers?

Eighty percent of serious violent incidents reported in healthcare settings in 2013 were caused by interactions with patients.[8] Patients with dementia or Alzheimer’s and patients on drugs are the most likely to hurt nurses, but encounters with patients who have a history of violence and those who are delirious or experiencing withdrawal are also more likely to act out.[9] In general, high-volume urban emergency departments, inpatient and acute psychiatric facilities, and geriatric long-term care settings have the highest risk of on-the-job violence.[10] Additionally, 12% of violent interactions healthcare workers face come from other clients and customers, such as a distraught family member who may be abusive or even become an active shooter.[11]

 

Why does this happen?

There are a number of environmental factors that can influence the likelihood of violence and verbal abuse against nurses. Some of these factors include understaffed departments, inadequate security, overcrowding, poor environmental design that may block vision or escape routes, working in neighborhoods with high crime rates, unrestricted public access, and a lack of policies and staff training for recognizing and managing hostile behavior from patients, clients, and visitors.[12]

In the past decade, there has been a 110% spike in the rate of violent incidents reported against healthcare workers, and the explanation has a lot to do with money.[13] During the recession of 2008, hospitals started slashing budgets, and states cut billions of dollars in funding for preventative mental-health services.[14] The increase in psychiatric patients seeking treatment in hospital emergency rooms has been on the rise ever since; fewer staff numbers and greater numbers of unpredictable patients leads to a greater chance of medical professionals having to handle violent outbursts and abusive language.[15]

 

What are the long-term effects of this abuse? How can it be minimized? The second part of this series will focus on these questions and look to provide solutions and protection methods for the caregivers affected by this malady.

 

[1] Johnson, Steve, “Nurses often victims of abuse, assault,” Times Free Press, Jan. 16, 2017, http://www.timesfreepress.com/news/local/

[2] “Workplace Violence in Healthcare; Understanding the Challenges,” Occupational Safety and Health Administration, https://www.osha.gov/Publications/OSHA3826.pdf

[3] Gates, Donna M, Gordon L. Gillepsie, and Paul Succop, “Violence Against Nurses and its Impact on Stress and Productivity,” Medscape, 2011, http://www.medscape.com/viewarticle/746092

[4] Judkins-Cohn, Tanya, “Verbal Abuse: The Words that Divide Impact on Nurses and Their Perceived Solutions,” Southern Nursing Research Society, December 2010, http://www.resourcenter.net/images/snrs/files/sojnr_articles2/Vol10Num04Art15.html

[5] Ibid

[6] “Workplace Violence in Healthcare”

[7] Fernandez Campbell, Alexia, “Why Violence Against Nurses Has Spiked in the Last Decade,” The Atlantic, Dec. 1, 2016, https://www.theatlantic.com/business/archive/2016/12/violence-against-nurses/509309/

[8] “Workplace Violence in Healthcare”

[9] Fernandez Campbell, “Why Violence Against Nurses Has Spiked”

[10] “Clinical FYI: Healthcare Workers Have Highest Rate of Workplace Violence,” American Medical Resource Institute, n.d., https://www.aclsonline.us/articles/healthcare-workers-have-highest-rate-of-workplace-violence/;

[11] “Workplace Violence in Healthcare”

[12] “Clinical FYI;” “Workplace Violence in Healthcare”

[13] Fernandez Campbell, “Why Violence Against Nurses Has Spiked”

[14] Ibid

[15] Ibid

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