Ashley began her shift at 7:00 am on a Medical Surgical unit at a community hospital in the suburbs of a city in the Midwest. In report, one of her patients was described as “a 66 year-old male admitted for treatment of pneumonia who was agitated during the night.” After report, Ashley walked into the patient’s room to introduce herself and do an assessment. The patient was standing near the doorway and hit her in the face as she waked into the room.

Tom is an Operating Room nurse. After a 6-hour surgical procedure that had a poor patient outcome, Tom was outside the operating room when the surgeon approached him and standing directly in front of Tom and inches away from his face, yelled, “What the he** is wrong with you? Are you an idiot? I want to punch you in the face!”

Both are examples of workplace violence. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty.” In hospitals, nursing homes, and other healthcare settings, possible sources of violence include patients, visitors, intruders, and even coworkers. Whether the violence inflicted on healthcare employees is verbal or physical, every single day employees in the healthcare field are assaulted in the United States.

What is Workplace Violence?

When addressing workplace violence, people typically think of physical assaults or threats that result or can result in serious physical harm. However, workplace violence includes verbal violence—threats, verbal abuse, hostility, harassment, and the like—which can cause significant psychological trauma and stress, even if no physical injury takes place. Verbal assaults can also escalate to physical violence. It is important for healthcare professionals to report incidences of verbal or physical abuse so that it can be tracked and addressed. Many healthcare professionals tolerate this behavior as part of the job, but it should not be tolerated nor accepted as the norm.

What can be done?

Although healthcare professionals can follow guidelines to increase their safety, such as keeping oneself between the patient and the door and utilizing de-escalating techniques, there is still a risk. Healthcare organizations need to implement a written program for workplace violence prevention. This should be incorporated into an organization’s overall safety and health program, offering an effective approach to reduce or eliminate the risk of violence in the workplace.

The building blocks for developing an effective workplace violence prevention program include:

A violence prevention program focuses on developing processes and procedures appropriate for the workplace in question.

OSHA (Occupational Safety and Health Administration) has specific guidelines for implementing a violence prevention program. All healthcare professionals can and should be leaders in this initiative.