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Workplace Violence Against Health Care Workers

12/17/2020

By K. Suresh Gautham, MD, DM, MS, FAAP 

One Friday night in the emergency department, a patient attacked and choked her nurse, Maria Gaytan, by grabbing her stethoscope and tightening it around her neck.1  

While this is an extreme and rare case, less extreme incidents of violence against health care workers (workplace violence or WPV) are quite common.  

One systematic review found that more than half of health care workers reported experiencing workplace violence, with significant variation across settings.2 Such violence is a global problem occurring in: 

  • hospitals 
  • emergency departments 
  • outpatient clinics
  • other health care settings  

When young learners join their professional schools to eventually become physicians, nurses, respiratory therapists and other types of health professionals, they expect to serve patients and their families. They do not expect to be victims of violence. As one article put it, workplace violence is not “part of the job.” 3 Such violence always results in psychological trauma – and sometimes physical trauma – to the health care worker. This trauma may have long-lasting health effects, including post-traumatic stress disorder and physical disability.  

All health care institutions should have effective: 

  • programs to prevent verbal and physical violence against their staff and employees 
  • programs to provide psychological support to affected health care workers in the aftermath of an incident
  • ongoing monitoring and support, with referral to mental health professionals when required 

A 2018 Sentinel Event Alert from The Joint Commission lists detailed and specific actions that organizations can take to tackle workplace violence.  

In the upcoming March 2021 issue of The Joint Commission Journal on Quality and Safety, Busch and colleagues describe an increasing frequency of incidents of workplace violence in two institutions, detected from data from peer-support programs, and provide two detailed case studies. This article serves as an important reminder for health professionals and institutions that the problem of workplace violence is increasing and requires more attention and resources. The two vivid stories included in the article describe how nurses were attacked when caring for patients, emphasizing the suddenness with which violent events occur and their distressing impact on health professionals.  

For more information on workplace violence, visit The Joint Commission’s Workplace Violence Prevention Resources, developed in partnership with the National Institute of Occupational Safety and Health (NIOSH) and other leading organizations.  

K. Suresh Gautham, MD, DM, MS, FAAP, is deputy editor for
The Joint Commission Journal on Quality and Patient Safety, senior editor of the Neonatal Review Group of the Cochrane Collaboration and professor of pediatrics at Baylor College of Medicine, Houston.  

 

References: 

  1. Skerrett P. Choked, punched, bitten: Nurses recount attacks by patients. Stat News, November 20, 2015. https://www.statnews.com/2015/11/20/nurses-patient-violence/ 
  2. Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019;76(12):927-37. 
  3. Wax JR, Pinette MG, Cartin A. Workplace violence in health care – it’s not “part of the job”. Obset Gynecol Surv. 2016;71:427-34.