Baton Rouge nurse, Lynne Truxillo, died last week after an altercation with a patient. Her death is being investigated as a homicide. Moments like these often inspire nurses to share their stories of violence–the strangulation, sexual assault, or threats made against their life–and the corresponding fallout. Such as being told by supervisors that it would be unwise to report the assault, or that it is just part of the job and that perhaps they are in the wrong line of work if they cannot handle it. Some nurses describe being unaware there is even a way to report attacks or are fearful they will lose their jobs if they attempt seek help. Assault, battery, threats, verbal and sexual harassment, and homicide perpetrated by patients, patients’ family members, or hospital staff should not be “part of the job” for nurses.
Nurses are on the front lines of health care, and violence against health care workers is on the rise, according to the Joint Commission. The Occupational Safety and Health Administration (OSHA), reported that reasons for increases in violence include: understaffing, lack of training and policies, lack of law enforcement presence, overcrowded waiting rooms, and the perception that violence is tolerated. The American Nurses Association (ANA) identified workplace violence as under-reported due to: a high tolerance for workplace violence, lack of awareness about reporting, disagreement on the definition of violence, fear of retaliation, perception that violence is routine, belief that nothing will change, and lack of managerial support, among other issues.
OSHA does not require employers to provide training on workplace violence prevention. According to the ANA, Ohio authorizes hospitals to post zero tolerance policies against violence targeting health care workers and Hawaii passed legislation to promote safe work environments and reduce workplace bullying. Many states have amended existing statutes to include nurses in assaults against first responders. These laws illustrate good will towards nurses and other health care workers, but challenges remain.
In 2019, the ANA introduced an issue brief about the importance of reporting incidence of workplace violence. Identifying the days missed from work due to injuries and the negative impact workplace violence and bullying have on patient care and retention of staff, ANA called for change. Their suggestions included:
- culture change in health care facilities to encourage protecting employees from violence,
- standard violence reporting processes in medical facilities,
- state and federal legislation to prevent and track workplace violence at medical facilities,
- education and prevention training, and
- support and counseling for nurses who experience workplace violence, including expressing sympathy and support.
This effort should include developing—with registered nurse input—unified workplace violence prevention programs and state-wide, anonymous incident reporting systems, as well as signage indicating a zero tolerance policy for workplace violence. The current process of allowing hospitals to manage workplace violence without any national standards or oversight is not creating a safer space for health care workers. Nurses are the best placed professionals to assist with guiding, shaping, and advising on matters that impact their profession. Radical Nurses has started an open Facebook group called RN Violence Tracker. This site provides an open forum for nurses and other health care workers to discuss incidents of workplace violence, and share resources and best practices. Please share the hashtags below on social media and reach out to us with your stories. Working at the state and federal levels, we can create change.
#NotOneMore #EndViolenceAgainstNurses #ShiningtheLightOnViolenceAgainstNurses
– Vanessa Shields-Haas is a sexual assault nurse examiner and nurse practitioner student. She lives in New Orleans, Louisiana. All opinions are her own.
American Nurses Association. (n.d.). Workplace violence. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/state/workplace-violence2/
Occupational Safety and Health Administration. (2015). Workplace violence in healthcare. Retrieved from https://www.osha.gov/Publications/OSHA3826.pdf
The Joint Commission. (17 April 2018). Physical and verbal violence against health care workers. Sentinel Event Alert. Issue 59. Retrieved from https://www.jointcommission.org/assets/1/18/SEA_59_Workplace_violence_4_13_18_FINAL.pdf
Washington State Legislature. Violent acts–Records. Retrieved from https://app.leg.wa.gov/RCW/default.aspx?cite=49.19.040
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