18 Aug 2022
Violence against clinicians has long been a pressing concern for the healthcare industry – with violence in healthcare about four times more prevalent than in any other industry.1 According to the Occupational Safety and Health Administration (OSHA):
Healthcare organizations are naturally prone to many common risk factors for workplace violence, including:5
We tend to focus on the ER, but we fail to recognize that, with those ER patients, we’re taking away their control [when we move them to] the inpatient setting. Those same vulnerabilities and stressors exist, but now we’ve [removed even more control over] their own environment. Healthcare is a stressed, strained environment right now for patients and for caregivers. I think it just makes everything a little more vulnerable and a little more at risk.
VP of Customer Experience, Whitney Lloyd, RN, BSN, MBA„
Covid-19 brought with it social distancing, new safety protocols and heightened stress for patients and clinicians alike. While these practices were important to help prevent the spread of disease, they also introduced new stressors into an already strained environment. It is not surprising, then, that global surveys found an increased perception of violence against healthcare workers around the world.6
For patients, the lack of visitors and family members at the bedside removed an important source of comfort. Masks, face shields and limited staff in patient rooms also presented challenges to building trusting connections between patients and care teams.
And as Schmitz points out, the added stress for healthcare workers only compounded the issue — and continues to do so today:
“For [hospital workers], there is no break from the stress. People have the same stress they’re coming in to see you for, but home is also stressful. They come in with greater tensions than they would have prior.”
Although studies have shown it to be effective in healthcare, workplace violence training is underrepresented in many nursing school curricula.7 The CDC, NIOSH and OSHA all recommend and/or offer workplace violence prevention programs to support employee and patient safety, improve quality of care and enhance employee relations.8,9
Schmitz and Lloyd agree that all vulnerable employees should be trained on personal safety and de-escalation procedures.
“Anxiety levels are high right now for patients and caregivers. You can feel that,” comments Lloyd. “And sometimes it’s hard to recognize when something is going to pop off to a level where you’re in danger. We tend to ride a fine line … and it’s very easy to miss subtle signs that things are escalating.”
“De-escalation is a skill set in and of itself,” points out Schmitz. “And it’s not just in the emergency department. If you’re in an inpatient unit for three days, it might be on day three that you’re really frustrated. So healthcare workers across the board need to know how to manage that conversation to prevent escalation, but also to reassure patients and give them that true sense of security that you’re doing everything you can to take care of them.”
Rather than counting on a single program or intervention to address violence against nurses and other healthcare workers, both Lloyd and Schmitz recommend a layered approach. Training staff on safety, clearly communicating behavioral expectations to patients and visitors, and fostering a culture where employees are encouraged to voice their concerns are all important.
The right technology investments can also help create safer environments:
Hear more from Whitney Lloyd, Baxter and Jennifer Schmitz, Cheif Nursing Officer at SMHC as they discuss how technology can change the way we address violence in the healthcare workplace.