Violence in the Healthcare Workplace

(Part One of a Two-part Series)

Read Part Two of the Series on Prevention and Reporting Workplace Violence

Healthcare workers account for approximately 50% of all victims of workplace violence according to the Occupational Safety and Health Administration (OSHA) who consider workplace violence to be “a recognized hazard in the health care industry.” Unfortunately, incidents of serious workplace violence are four times more common in health care than in private industry. 

So, what constitutes workplace violence?

Any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite.

But the alarming truths of the occurrence in the health care industry is of most recent concern.

Bullying and disrespect of others in the health care setting are far more frequent than most believe and impact more than we think. These actions can occur between staff, clients and between staff and clients. This intent by one or more individuals to have a negative intent on a person, can threaten the workplace environment and even decrease the quality of care being provided.

Types of Workplace Violence

There are many types of violence in the workplace, and they are categorized using a I to IV scale, from criminal intent to personal/interprofessional relationships.

According to occupational researchers at The Injury Prevention Research Center (2001) classified it into four basic types:

1. Criminal intent
2. Client-on-worker
3. Worker-on-worker
4. Personal relationship

Most health care workplace violence incidents happen as a type II, which involves a patient who has a relationship with the health care organization and becomes aggressive or violent when receiving services from a health care provider. Many incidents of workplace violence are verbal in nature, other natures involve assault, battery, domestic violence, stalking, and sexual harassment.

Research suggests that worker-on-worker (Type III) violence may result from power imbalances and is found to be associated with poor retention and low work satisfaction of nursing staff.

Causes of Workplace Violence

The causes of workplace violence are vague, but risk factors include:

1. Emotional Trauma. Extreme levels of stress for patients, families of the patient and the staff providing care. When patients are at their emotional limits and faced with severe illness and impairment, they are more apt to lash out in their emotional instability. Employees of the health care system are faced with daily moral and emotional dilemmas which amplify a staff members’ burnout rate causing them to be more susceptible to increased violence by the individual or response from the lack of preventative mental health assurance.
2. Criminal Intent. Someone outside or within the organization who commits violence against a coworker, or someone with a relationship to a caregiver or team member. Where mental health issues play a stronger role in this type of violence, the psychiatric industry is hit hardest. In fact, among psychiatric aids the rate of violence is 69 times the national rate of violence in the workplace.

Prevention of Workplace Violence in Nursing

One thing we know for certain, silence is not prevention. While many in health care will consider abuse inherent to the job, remaining quiet about it exacerbates the issue and overall health care worker stress.

Health system staffing shortages, especially during the height of the pandemic, set ablaze tensions of patients who take out their aggression on health care staff and especially nurses. But often nurses don’t report the incidents.

There are laws that protect nurses and union advocates working to help address shortages. If you have questions about your rights as an APRN or health care worker, please contact us.

Next In The Series

In our next blogs in this series, we’ll cover Prevention Efforts and Laws that Protect Nurses.

Want to dig deeper? Visit these helpful articles on Workplace Violence in Healthcare to learn more.

1. Violence Rocks Hospitals
2. Workplace Violence Epidemic in Healthcare  
3. Prevention of Workplace Violence