An image of a diverse group of hospital clinicians. Workplace violence in healthcare is a challenge faced by teams in hospitals across the country.

Five Tips for Addressing Workplace Violence in Healthcare

 

Workplace violence significantly impacts healthcare more than other industries, as highlighted by the Bureau of Labor Statistics: incidents are four times more common in hospital settings. Although healthcare workers account for less than a fifth of all workplace injuries, they endure over half of all assaults. And the threat is escalating.

A Center for Disease Control and Prevention (CDC) report indicates a doubling in reported abuse and violence among healthcare workers from 2018 to 2022. By 2023, over 80% of nurses experienced some form of workplace violence, according to a National Nurses United (NNU) report

These alarming numbers underline the impact that workplace violence (WPV) has on healthcare workers and organizations. Workplace violence occupies the nexus of healthcare organizations’ core challenges, including recruitment and retention, burnout, patient outcomes, and sustainable business practices.

Healthcare organizations must continue taking action to protect healthcare workers and staff. Here, we’ll explore five key strategies to enhance organizational safety, understand the breadth of workplace violence, and implement effective prevention tactics, working toward a safer environment for our healthcare professionals.

1. Create a Safe Physical Environment

Healthcare organizations can safeguard their frontline clinicians by enhancing physical security measures. Remarkably, up to 20% of patients in emergency departments carry weapons, posing increased risks to both healthcare providers and other patients.

Implementing deterrence measures such as metal detectors, securing furniture, and auditing potential hazards in waiting and triage areas significantly improves safety. While these steps do not eliminate the threat of workplace violence, they are crucial in mitigating risks and minimizing the likelihood of severe injuries.

2. Foster a Culture of Safety and Civility

Patient-to-nurse abuse is a significant concern, yet it represents just one facet of the challenges nurses face. Verbal abuse, bullying, and psychological assaults also emanate from fellow nurses, physicians, and hospital staff. A workplace culture that permits such incivility can cultivate a toxic work environment, drive valuable staff away, and compromise the quality of care delivered.

Leadership plays a pivotal role in fostering a civil environment. The attitudes and actions of an organization’s leadership set the tone for addressing issues like workplace violence. When nurse leaders model professionalism and maintain a zero-tolerance stance toward incivility and violence, it sets a standard that encourages all clinicians to emulate these values.

Find five additional strategies for promoting civility in the workplace in our recent article, including insights from leaders at UnityPoint Health and UNC Rex Healthcare.

3. Advance from Awareness to Empowerment

Nurse leaders must cultivate a culture that unequivocally rejects workplace violence. Beyond establishing this foundational stance, effective leaders empower their teams to actively promote civility and safety, both among themselves and in patient interactions.

Training staff to de-escalate potentially violent or abusive situations is crucial. Integrating this training into regular meetings or through dedicated sessions reinforces its importance. Additionally, introducing clinicians to conflict resolution tools, strategies, and resources during these sessions — and as a key component of onboarding new clinicians — establishes clear expectations and preparedness for managing workplace violence.

Patient care thrives when clinicians are focused and equipped. However, without the necessary tools to address or de-escalate conflicts, or if distracted by internal disputes, clinicians can’t deliver the high standard of care the patient community expects and deserves.

4. Make Workplace Violence Easy to Report

Healthcare organizations across the country acknowledge workplace violence is a critical challenge, and while many have adopted preventive measures, the problem persists at scale. Underreporting incidents is a significant factor that allows WPV to thrive. The American Nurses Association highlights that only a small percentage of violent or abusive incidents are reported. Even when incidents are reported, it doesn’t guarantee action: only a third of healthcare organizations have a clear process for reporting such incidents.

Underreporting hurts healthcare organizations’ ability to prevent violence. Why aren’t staff reporting these incidents? A few common factors deter reporting:

  • A belief that abuse is part of the job
  • Varying perceptions of what constitutes abuse
  • Fear of retaliation, especially in cases of clinician-on-clinician violence

For healthcare leaders to combat workplace violence effectively, they need a comprehensive understanding of the issues—knowing what happens, where it occurs, and who is involved is crucial. Visibility is key; you can’t address what you can’t see. Leaders must prioritize creating an effortless and accessible reporting process.

Clinicians overwhelmed with their work won’t report incidents they deem ‘minor.’ They’re unlikely to take steps to report violence or abuse if it involves cumbersome processes, if they believe it will lead to no concrete action, or if they fear it could negatively impact their careers.

To encourage reporting, the process must be quick, easy to access, transparent, and safeguarded to protect those who come forward.

Tips for Implementing Better Incident Reporting Systems

  • Clarify Post-Incident Procedures: A major source of frustration for healthcare workers regarding workplace violence is the perceived lack of follow-through after incidents. According to the NNU report, over half of healthcare organizations do not investigate incidents of workplace violence, and only a fifth make changes to enhance safety post-incident.

    It is critical for healthcare organizations to clearly articulate their WPV incident reporting process to build trust, retain staff, and improve patient care. This should include specifics on who reviews and responds to reports, how and when the victim will be communicated with, and what definitive measures will be implemented to prevent similar incidents in the future.

  • Define Workplace Violence and Abuse: Contrary to some common beliefs among clinicians, workplace violence and abuse are not ‘part of the job’ and should never be treated as such. WPV and abuse have a direct negative impact on patient outcomes, clinician retention, and the sustainability of healthcare organizations.

    Nursing and hospital leadership must provide clear, unambiguous definitions of what constitutes workplace violence and abuse to eliminate confusion and improve reporting accuracy.

  • Establish and Reinforce Expectations: The onboarding of new staff presents a pivotal opportunity to influence perceptions of workplace violence and abuse within your organization. Establishing a zero-tolerance policy from the outset — and consistently reinforcing this stance — sends a strong message to all personnel, regardless of tenure.

    Remember, adopting a zero-tolerance policy toward WPV requires demonstrable action following reported incidents. Without visible enforcement, the desired cultural shift within the organization will likely fall short of expectations.

 

5. Get Buy-in From Executive Leadership

Whether your organization is increasing staffing to enable a buddy system for escalated incidents or implementing security measures like metal detectors and cameras, addressing workplace violence in healthcare demands a substantial investment.

Before requesting investment in staff, equipment, or infrastructure, CNOs and other clinical leaders should do their homework to paint a picture of workplace violence’s holistic impact on the organization. Consider illustrating the cost of maintaining the status quo:

While presenting hard data is crucial for securing investments, connecting this data with personal stories can create a compelling case for investment. Encourage CNOs and executives to listen to the experiences of staff who’ve faced workplace violence, detailing how these incidents have reshaped their professional lives. Combining quantitative data and emotional testimony can powerfully advocate for more significant steps toward a safer workplace.

The Bottom Line: Workplace Violence in Healthcare Demands Attention and Prevention

Workplace violence is both a symptom and cause of the issues facing healthcare organizations today. No two healthcare organizations have the same patients, staff, or challenges. Reducing and eliminating workplace violence and abuse will require time, thought, and buy-in from the top down.

Workplace violence is both a symptom and a catalyst of the challenges healthcare organizations face today. Each organization has its unique patients, staff, and hurdles. Addressing and ultimately eliminating workplace violence and abuse demands thoughtful engagement and commitment from all leadership levels.

The journey to address workplace violence is complex. However, it is undoubtedly more manageable than continuing on a path where clinicians and healthcare staff endure routine assaults, disparagement, and threats while performing critical roles. The key to finding effective solutions lies in having the right leadership.

With over three decades of experience in healthcare leadership recruitment, Kirby Bates Associates is uniquely equipped to understand your specific challenges and pinpoint leaders with the skills to address them effectively.

To explore how we can support your organization’s needs, contact our team today.