By: American Nurses Association

Workplace violence within the nursing profession is a startling and somber reality that we are actively  seeking to improve. But why exactly, is it so prevalent? In my opinion, it is the emotionally charged nature of our work, combined with the wide variety of interactions with others that cultivates and  allows for the opportunities for violence. There are five general categories of workplace violence as recognized by researchers and the CDC, and as a nurse, it is easy to see how we come across each type on a regular basis.

1. Criminal intent. In criminal intent workplace violence incidents, the perpetrator usually has no relationship with the establishment and the primary intent is theft. Violence is rarely the intent but will frequently occur when the perpetrator perceives a potential interference with their theft. Within the healthcare system, the pharmacy and the emergency department are the most likely targets for criminal intent due to the presence of drugs and cash.

2. Customer/client. In the customer or client type of workplace violence, the perpetrator is the customer or client of the victim. Violence often occurs in the course of the normal duties of the worker. This is, by far, the most common type of physical violence that nurses face. In fact, nurses are four times more likely to be the victim of client violence than the average private sector employee (source: everbridge.com). The high likelihood for violence in which the patient is the perpetrator is, in part, due to the high stress environment that healthcare is for patients. Things like restrictions of food, water, or pain meds are often triggers for violence. However, although annoyed, patients are unlikely to abuse without a potentiating factor such as psychosis, dementia, drug or alcohol abuse, mental health issues, or other factors that affect decision-making capability. In addition, in many facilities, there is a culture that expects violence as part of the job and deters reporting or pressing charges. Taken together, these make nursing a profession with a high risk for violence perpetrated by the very people we are trying to help.

3. Worker on worker. In this kind of violence, the perpetrator is a current or former employee or coworker. Violence may occur up (directed at a supervisor), across (directed at a peer), or down (directed at a supervisee) the chain of command. Interpersonal and organizational conflict is most often implicated in this type of violence. Within the healthcare system, worker to worker violence is commonly intensified in times of high workload and short staffing, and in units that have a culture of mistrust or “eating their young”. Violence from our coworkers can be the most devastating, because these are the people that should be in our corner, should be helping, should be having our backs. Violence from our patients can usually be somewhat understood and excused, but violence from our team is a deep betrayal of trust.

4. Personal relationship. Domestic violence may enter the workplace when a spouse or partner follows an employee to work. The perpetrator is not usually an employee or former employee but takes advantage of knowing exactly where their spouse is likely to be during work hours.
5. Ideological. Ideological workplace violence is directed at an organization, a particular group of people within the organization, and/or its property for ideological, religious or political reasons. Active shooter incidents (when not perpetrated by a patient or their family) are most often in this category.

As you can see in these different types and scenarios, workplace violence within the nursing profession is a real and significant problem. If you would like to be part of the solution, you can take action now. Take the Pledge: Text PLEDGE to 52886 to take our #EndNurseAbuse pledge. Learn more about the End Nurse Abuse campaign today!

Categories: Nursing Initiative