Violence and abuse against nurses have grown into serious problems in healthcare settings across the country, from hospitals and long-term care facilities to rehab centers and clinics. In addition to physical and mental abuse, it’s also been reported that sexual harassment is a major challenge in the workplace for both male and female nurses.
A press release from the American Nurses Association (ANA) on February 1, 2018 explains that it first launched the #EndNurseAbuse Initiative in 2017 with the intent of addressing workplace abuse against nurses. The ANA also supports the #TimesUpNow movement, which promotes enforcing consequences for harassment, sexual assault, abuse, and inequality in the workplace.
Just how serious is this problem of violence against nurses? In the past few months, two nurses in Illinois were taken hostage, one was beaten and raped, and a nurse in Massachusetts was stabbed by a patient. Making headlines also was the Utah nurse who was wrongly arrested after being shoved by a police officer; a nurse in Arkansas was pushed down a flight of stairs. Just a couple of weeks ago, abuse incidents were reported in three different states – and those are just the ones that get picked up by the media.
ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN explains, “Nurse safety is a critical component to ensure quality and safe care. Time’s up for employers who don’t take swift and meaningful action to make the workplace safe for nurses. Together, nurses, employers and the public must take steps to change our culture. Abuse is not part of anyone’s job and has no place in healthcare settings.”
Why the Increase in Violence?
Between 2005 and 2014, the number of violent acts toward nurses and medical caretakers rose at an alarming rate, increasing by 110% in private sector hospitals. A study in the Journal of Emergency Nursing found that 76% of nurses at a private hospital system in Virginia said they had experienced abuse in verbal or physical form from patients in 2014.
According to ANA’s Health Risk Appraisal in 2015, one in four nurses had been assaulted by patients or their family members while trying to do their jobs. Similarly, 25% of nurses reportedly experienced violence in their workplaces in 2016. Even though the healthcare sector makes up only 9% of the overall workforce in the United States, it sees as many violent injuries as all other industries combined.
One of the contributing factors of this increase in assaults aimed toward nurses is the fact that these professionals must often deal with patients who are feeling vulnerable, scared, and emotionally volatile. In addition, cognitive deficits can also lead patients to act out toward their caretakers.
“A lack of funding may also be to blame,” says Alexia Campbell of The Atlantic. “After the Great Recession, many health care providers cut staff levels, which meant fewer nurses and security guards are available to help when patients got out of control,” Campbell said. States also dramatically cut funding for preventive mental health services in some cases.
The Search for Solutions
Currently, there are no federal regulations in place that are designed to guide hospitals to protect their health care workers from workplace violence. However, pressure is growing for regulators to take action and protect our nurses.
The U.S. Department of Labor is considering setting nationwide workplace safety standards for hospitals and medical care facilities to try to curb violence against staff members.
At the state level, several states have taken the initiative and now require healthcare facilities to teach de-escalation techniques to their staff members.
Trickling down from the state level, more and more hospitals are taking their own steps to reduce violence against their medical personnel. For example, in Massachusetts, Providence Behavioral Hospital hosts self-defense classes every week that are designed specifically for nurses. In addition, Mercy Medical Center, also in Massachusetts, conducts training exercises that simulate domestic violence, behavioral health violence, and other situations.
The #EndNurseAbuse Initiative and the ANA
Requiring training and implementing regulations aren’t the only answer, however. There are still far too many nurses who say they are discouraged from speaking out about violent incidents; a disturbing number of nurses also say they are treated dismissively by supervisors when they do. According to the Journal of Emergency Nursing study, only about 29 percent of nurses who have experienced a physical attack reported the incident.
In 2015, the ANA adopted a policy of “zero tolerance” for violence that takes place in healthcare facility settings, and called for nurses, along with their employers, to work together. The goal is to not only reduce abusive, violent incidents, but also to ultimately prevent as many as possible from happening at in the first place.
The ANA has developed a pledge for everyone – not just health care professionals – to stand with nurses. The pledge asks people to support zero tolerance policies for abuse against nurses, report abuse whenever it’s safely possible, and to share the pledge with family and friends, asking them to sign as well. The ANA also asks that all nurses share their stories on workplace abuse. So far, everything seems to be starting on the right track, with just over 10,000 nurses and people from the public pledging.
In addition, the ANA has plans to convene a panel consisting of experts to address the barriers nurses often face when it comes to reporting these abuses. There are currently more than 3.6 million registered nurses and with that, #EndNurseAbuse is making strides to create safer work environments for our nurses, who make up the largest group of health care professionals we have.
Share your thoughts in the comments section below.
The abuse started at the top generations ago, this is the fall out.
I have said this many times, if the overall treatment of nurses does not improve, the entire healthcare system is going to collapse. Nurses will quit there jobs or be forced to go on disability. I know that taking care of myself is my primary responsibility I will not be injured so some boss can save money for the company and get a bonus. I will not
I had been subjected to frequent and harsh treatment from doctors, residents, coworkers and patients. I had been grabbed forcefully by my patient and thrown out of her icu room- whereby she dressed and ran from the room; security came after code grey and just followed her around. Many patients grabbed me yanked on my arms grabbed my stethoscope around my neck, I’ve had pts visitors punch the papertowel unit off the wall and throw furniture at me. Been kicked grabbed, threatened my life, but the worst treatment was from my employee health dept whose dismissive and poor treatment of my “injuries “ experienced on the job failed me greatly! I am permanently injured as result due to their neglectful attention to my complaints. I also had been subjected to abuse of power from physicians and to their misuse and abuse of power towards pts all of this dismissed by HR and led to PTSD of all of these events. There’s more; we all know if you make statements and formally complain you are labeled and “they” meaning management will be watching you- waiting for a reason and will have you on their radar. Abuse comes from the top and filters down through supervisors – coworkers- patients-visitors/families. We need support we need a voice we need legal help to protect us!!!!! 28 years in critical care now permanently injured, PTSD and damaged beyond belief. I regret my choice of profession even though I helped thousands of people. It seems it’s not worth it.
Families need to be respectful of our profession, how do they expect us to take care of there loved one when they are hyper vigilant. I would suggest asking them to step out so you can focus on your patient. I work with dual diagnosis clients who are the worst of the worst and integrating them into society is a huge challenge. The mental health system has totally failed our country. So I feel for all of you who end up dealing with these patients because there are no beds where they should be. I was there once too. And as for the Doctors, they need to step up and take responsibility for our safety as well. They admit them and they need to stop putting so much responsibility on us to clean up the messes. A good doctor knows how valuable the nurses are. And they will take action and accountability to make sure staff and their patient is safe.
I was punched in the face by my patient and it resulted in a dislocated jaw, TMJ, malocclusion, and other issues with my speech and mastication. The daughter didn’t want the patient medicated. He had been combative a whole week prior to my incident. I feel as though my employer allowed the daughter to go AMA (against medical advice)Crazy thing is while I was in the ER he was medicated with Geodon IM and Ativan. I feel they waited until he actually hurt somebody before they pushed the issue of calming agents. I now have PTSD have been off work for a year and Workmans comp drags their feet. I have spent 1,000 on my teeth and this is unacceptable. Nurses and healthcare providers should be protected from combative patients. I signed up for blood, guts, brains, urine, and even poop. However, I did not sign up to be assaulted. I will have facial and teeth issues for the rest of my life because of this angry patient. Really their is no excuse because he was not drugged up and the employer is at fault because they failed to try and fix the situation before it got out of hand. I’m in shock that this happened to me and I want nurses and healthcare workers to be protected in any event or threat..!!!
I’m going to quote here from this article and then comment.
“One of the contributing factors of this increase in assaults aimed toward nurses is the fact that these professionals must often deal with patients who are feeling vulnerable, scared, and emotionally volatile. In addition, cognitive deficits can also lead patients to act out toward their caretakers.”
This does very little to explain the uptick in violence.
Patients have only “recently” been feeling vulnerable, scared and emotionally volitle?? Really? And we have never before had patients with cognitive defects?? Really?? Is this all new?
These statements do NOTHING to explain this huge increase in violence to nurses. NOTHING. It’s words. Just words and until someone comes up with a better understanding of and solutions to combat violence against nurses…(besides turning nurses into ninja warriors or psychiatrists) then its only words. You can’t believe that just because it was looked at, discussed and some words were thrown around that there is any solution. We all feel really comforted that you have now dumped in the lap of nurses an added responsibility. Violent patients.
I too am suffering a permanent disability and because all the workmans comp doctors blew off my complaints it has taken 7 years and the ability to seek medical opinions outside w/c to get a final diagnosis of nerve damage( facial/ Crainal nerve/ ) So no…bringing it up, putting the onus on the nurse and dusting off your hands doesn’t solve anything.
Here’s your culprit
“A lack of funding may also be to blame,” says Alexia Campbell of The Atlantic. “After the Great Recession, many health care providers cut staff levels, which meant fewer nurses and security guards are available to help when patients got out of control,”
The hospital I was assaulted at and rendered unconscious, had NO security. NONE.
If they can’t do business properly, can’t staff properly and provide safety then GET OUT
Do you think McDonald’s can cut corners in food safety because they lack the finances to run a proper business???
Yes, you can guess I am angry and every nurse who’s ever been put in last place and every nurse who’s yet to be assaulted, or murdered should be angry.
Many years ago I was assaulted by an over dose patient. I received a concussion and a ruptured ear drum. This incident was not addressed by management. No one should be used as a punching bag.
I work in an NICU and have dealt with verbal abuse and threats. Sometimes there is not a way to defuse the situation. Parents are worried and ( even in this age), without knowledge of what prematurity actually means. Expectations are not met . Sometimes before explaining what 28 weeks GA means, a parent is already angry . I understand this and let parents vent within reason. Most parents when at baby’s bedside will keep their voice down in consideration of their baby. Sometimes other family members are a help, sometimes they just egg things along. Most parents will calm if nurse is calm also. The worst thing is non support of other staff , doctors, and even charge nurses. I deal with the situation the best I can and hindsight criticism does not help. Each and every incidence has to be handled individually. Offering to have doctors talk to parents does not always help especially when some of our doctors tell me “I have already talked to them”. There was an incident that could not be defused by the baby’s nurse and our police officers were called. The worst thing I heard was the nurse should have done this or that and then the police would not have been needed to be called. This Mom had issues from before birth and with her rough life already.
No abuse is acceptable or excusable nurses matter. There just stop had to be staff available to deal with such patients Joint commission should shut them down.
Nurses and teachers are the most undervalued professionals in the United States!
I have been the object of physical abuse at work, many times in the last several years. The two most discouraging times were never acknowledged or addressed by my employer. (By the way both occurred while in a management role, not the emergency department). I had stepped in as a nurse manager to assist staff withal mental health patient, who was escalating. We called a code grey, which brought security help ans administration (partly because it was the hired code grey to that room that shift! While we took care of the situation and encouraged staff to continue on with their other duties. The patient was placed in four point leather restraints and only the primary nurse and I were left to instruct the patient on behavior parameters, this was on med/surge unit. (Earlier that shift we had insisted on a psych evaluation of the patient and staff education regarding how to best address the patient. The staff nurse turned to edit the room, iwasrounding the bed from the far side to exit also, I was about 4 feet from the bed, when the patient bent. Her knee and horse kicked me in the small of my back. It sent me flying into the wall and I dropped to the floor. The staff nurse ran and called another code grey. I was assisted up and to my office. Administration came to my office. I stated thatchers was. Not a safe situation for staff and we needed their assistance to address this staff safety issue. The answer I recieved floored me, “other options had been checked and no mental health facility would accept the patient because the were too violent, so we would judtneed to do the best we could. Security could not be spared to help manage the patient. I had missed the safety and compliance meeting during the code greys on my unit which was unacceptable and not to happen again. Staff just needed to do the best they could”. After administration left, I got my keys, closed my door and went home. The incident was never mentioned again.