Nurses and other health care workers are in danger every day at work. In fact, they are almost three times more likely than other workers to experience violence on the job, according to “Violence: Occupational Hazard in Hospitals,” a study published by the National Institute for Occupational Safety and Health (NIOSH) in 2002.
While the American Nurses Association and many other organizations have raised awareness and sought solutions by creating task forces and passing resolutions with recommendations, the numbers haven’t budged much, said Dan Hartley, an epidemiologist and NIOSH workplace violence prevention coordinator.
Although more hospitals have implemented violence-prevention programs and some states have passed laws to make such programs mandatory or required stiffer penalties for assaulting health care workers, the risk remains about the same.
“I think the problem is getting worse,” said Tom Barnes, director of corporate security for Columbus Regional Healthcare System. “There are many factors at play. For one thing, most people are already upset, sick or hurting when they come to a hospital. The health care system is overtaxed and a lot of people have been adversely affected by the economy.”
Budget cuts, crowded emergency rooms and staff shortages all contribute to creating a more-volatile work environment.
“We have a ‘Zero Tolerance for Workplace Violence’ [program] in place and we’re proactive. We do everything we can to keep incidences down,” Barnes said.
His staff works with local law enforcement agencies to plan and practice for emergencies. Security officers patrol the parking lots and shuttle guests to the door for added safety. He allocates more resources to high-risk areas or activities.
“We do a lot of staff training to give people the skills to recognize pre-incident indicators and teach them what to do in different situations,” he said. “With good communication, workers can often keep a verbal situation from escalating to physical violence.”
Although it’s an employer’s job to create a safe workplace, “security is everybody’s responsibility,” Barnes said. “We tell people to look out for each other and to report everything. No matter how veiled, we tell them, ‘Never undervalue a threat or write it off. Help us to help you.’ ”
NIOSH addresses the problem through research and best-practice recommendations. Recent studies have focused on assaults on nursing assistants by patients in nursing homes and risks to pharmacists who have been robbed at gunpoint by criminals wanting OxyContin and Vicodin. Thanks to data collected by NIOSH, more pharmacies are changing their approach to storing and dispensing these drugs.
“Last year, we did a pilot study with a VHA hospital in Bedford, Mass. Every week their psychiatric unit held a community meeting with staff, patients and families to discuss issues, including workplace violence prevention,” Hartley said. “It was a low-cost and promising intervention suggested by a staffer. We saw a 30 percent reduction in incidences and [we] are rolling it out in nine other hospitals next year.”
NIOSH is developing an online best-practices course to train health care workers in violence prevention. It will count toward continuing education requirements for many professionals and will be available next year through the American Nurses Association and NIOSH websites.
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