Physical Violence Against Nurses

Out of all of the people who are employed in healthcare facilities, nursing staff members are the most common targets of beatings and other violent physical assaults due to their close proximity to patients and visitors who sometimes become violent. The purpose of this article is to shed light on the topic of physical violence against nurses. Nurses Announcements Archive Article

Physical Violence Against Nurses

Physical violence is an explosive epidemic, especially in hospitals and other healthcare settings. Workplace violence can be any act of physical violence, threats of physical violence, harassment, intimidation, or other threatening, disruptive behavior that occurs at the work site (USDA, 1998).

Workers in the healthcare sector have increasingly become victims of violence at their jobs in recent years. Healthcare workers accounted for 45 percent of all reported non-fatal assaults resulting in lost work, according to a 2005 report by the U.S. Bureau of Labor Statistics (Prost, 2010).

These violent perpetrators are typically patients or emotionally disturbed family members. Nurses are often on the receiving end of physical assaults, because they are typically the first and most frequent medical personnel by the bedside of ill and sometimes angry or frustrated patients (Lothian, 2007).

The lion's share of the physical assaults against nursing staff has taken place in emergency departments and psychiatric units across the United States, but workplace violence also occurs with regularity in other healthcare settings. Patients have punched, kicked, groped, grabbed, and spit at their nurses. Others have thrown fecal matter and blood at nursing staff. Some reported being strangled, sexually assaulted or stuck with contaminated needles (Lothian, 2007).

Unfortunately, management and administration at numerous hospitals and healthcare facilities have tolerated physical violence from patients and visitors for many years. Nurses had been encouraged to deescalate these volatile situations and deal with assaults on their own. Nurses were sometimes discouraged from taking action and told that unruly and sometimes violent patients were part of the job (Lothian, 2007).

However, the tide is changing, albeit slowly. Some organizations are even urging nurses to have anyone who physically attacks them on the job prosecuted to the fullest extent of the law. For instance, the Massachusetts Nursing Association now encourages nurses to press charges if they have been victimized.

How do we even begin to tackle the problem of physical violence against nursing staff in the workplace? Well, the entities and people who employ nurses need to get involved with a more hands-on approach. The best protection employers can offer is to establish a zero-tolerance policy toward workplace violence against or by their employees (OSHA, 2002). In other words, employers must stop making excuses for the fully oriented patients who inflict violence upon staff. Human resources personnel should also inform all employees of their rights to press charges.

How can healthcare workers protect themselves against workplace violence? Taking some personal initiative is recommended because nobody knows when nursing staff will be victimized next. Learn how to recognize, avoid, or diffuse potentially violent situations by attending personal safety training programs (OSHA, 2002). In addition, the presence of uniformed officers often deters or prevents physical violence against nurses.

Physical violence in healthcare is a serious problem that will not go away overnight. However, management needs to do their part by supporting nurses with zero-tolerance policies, and society needs to do its part by having more realistic expectations of healthcare facilities. After all, the hospital is not the fast-food restaurant where people can have it their way.

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TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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The best approach is to make it a felony to assault a health care worker.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Also, I've mentioned this in another recent discussion, but I'll mention it again because it pertains closely to the issue of workplace violence.

The guy who gropes the female cashier at the convenience store will not be served. The traveler who kicks the pilot on a major airline will be forcefully stopped by the air marshall and arrested. The patron who punches the server at the steakhouse will be arrested. The person who slaps a cop will be arrested and charged with assault on a police officer. The customer who spits into the bank manager's face might have the FBI called on them.

Other industries have zero-tolerance policies toward violent assaults. It is time for healthcare to jump onto this bandwagon and stop tolerating violence from our so-called 'customers.' The nurse is a human being, not a punching bag.

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

needless to say, i'm a strong advocate on this subject which i have no tolerance for this kind of behavior in our facility. in addition, i was elated when violence against nurses bill in ny (a3103-a / s4018-a) when into effect, wish i still await for it to reach all states in the near future. moreover, violence in the workplace for nurses is very under reported most nurses never report the incident in fear of losing their jobs or retaliation of some sort. consequently, nurses will feel empowered and secured by implementing this law in all states. in conclusion, this law enforces the following physical abuse like, being spit on, bitten, hit or pushed. thank you for sharing this article......aloha~

I was once slapped very hard by a patient who had been increasingly acting out over the course of two days, and there were multiple notes saying the docs had been notified. He had been on psych meds that had been d'c'd about 2 months prior to this hospitalization for surgery. There was no psych consult requested until after the assault, and I was actively discouraged from pressing charges.

What made me really angry was the docs' nonchalant attitude about something that THEY might have prevented.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I was once slapped very hard by a patient who had been increasingly acting out over the course of two days, and there were multiple notes saying the docs had been notified. He had been on psych meds that had been d'c'd about 2 months prior to this hospitalization for surgery. There was no psych consult requested until after the assault, and I was actively discouraged from pressing charges.

What made me really angry was the docs' nonchalant attitude about something that THEY might have prevented.

I was grabbed, pulled, and clawed by a 29-year-old female diagnosed with borderline personality disorder, anorexia nervosa, and other issues. She was screaming multiple vulgarities at me during her attack. Several years later, I still have the scars on my right hand where she broke my skin open by digging in with her long fingernails.

I have also had my breast area stroked by alert and oriented males, and have demanded that they stop it.

Three years ago I was punched by a pt, completely displacing my cheekbone to a position approximately two inches lower and just in front of my right ear. Two years ago, I was punched in the testicles by a "developmentally challenged" pt. While I rolled on the floor vomiting, the GI doc I had shielded from the punch, ran out of the room shouting "I'm getting some Haldol...STAT". Last year, a bodybuilder, in the middle of what was later characterized by a Psych-Doc as a "Roid-Rage" punched me so hard, that I was propelled across the room hitting the opposite wall, fracturing my skull, two ribs, and severely bruising my liver.

Each time, Ive been called at home the next day by a hospital Risk Manager to "See how I'm doing"...and each time they find a way to steer the conversation onto "We believe that no one would benefit from a formal legal process in this matter. The hospital's reputation is that of a "safe-haven" in the community. The hospital would like you to think about what's best for everyone involved (aka: the implied job threat). We would like you to take the next week off with pay, and of course treatment for your injuries will be fully covered by the hospital, with no out-of-pocket expense to you."

The next time a pt goes off on me, I'm calling EVERYONE! The police, newspapers, TV, the Elbonian Mafia, the girl scouts...EVERYONE!

I've got a frickin' titanium plate holding my cheekbone in place...I'M NOT TAKING ANOTHER BEATDOWN FOR THE HOSPITAL!

Three years ago I was punched by a pt, completely displacing my cheekbone to a position approximately two inches lower and just in front of my right ear. Two years ago, I was punched in the testicles by a "developmentally challenged" pt. While I rolled on the floor vomiting, the GI doc I had shielded from the punch, ran out of the room shouting "I'm getting some Haldol...STAT". Last year, a bodybuilder, in the middle of what was later characterized by a Psych-Doc as a "Roid-Rage" punched me so hard, that I was propelled across the room hitting the opposite wall, fracturing my skull, two ribs, and severely bruising my liver.

Each time, Ive been called at home the next day by a hospital Risk Manager to "See how I'm doing"...and each time they find a way to steer the conversation onto "We believe that no one would benefit from a formal legal process in this matter. The hospital's reputation is that of a "safe-haven" in the community. The hospital would like you to think about what's best for everyone involved (aka: the implied job threat). We would like you to take the next week off with pay, and of course treatment for your injuries will be fully covered by the hospital, with no out-of-pocket expense to you."

The next time a pt goes off on me, I'm calling EVERYONE! The police, newspapers, TV, the Elbonian Mafia, the girl scouts...EVERYONE!

I've got a frickin' titanium plate holding my cheekbone in place...I'M NOT TAKING ANOTHER BEATDOWN FOR THE HOSPITAL!

Holy Moses.:bowingpur

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

the next time a pt goes off on me, i'm calling everyone! the police, newspapers, tv, the elbonian mafia, the girl scouts...everyone!

needless to say, you made my day i lol at one of our meetings as i read your post on my cell :cool:

Specializes in ICU.

I have been assaulted three times in my career. The first time required a tetorifice shot and antibiotics. I lost a huge wad of hair during the second one. This last one is what I really don't understand. I was assaulted, then I was put on suspension without pay, because I "must have done something to cause it." They didn't even talk to the patient, just assumed that I must have let it "escalate to that point." I had tried to get help with the situation, but was ignored, then all the blame was put on me, because I must have made the patient mad. I didn't even hit the patient back or anything. All I did was yell for help! This was a HUGE guy, and I had been verbally assaulted by him the entire shift, then towards the end of my shift, he hit me! But, alas, apparently it was all MY fault, as I got all the blame! (The first two were by confused patients, but this last one was by an entirely alert and oriented patient.) It is all about those darn patient satisfaction scores. I was told he might say bad things about us in the community, so they needed to keep him happy. Never mind little ole me.

I have been fortunate so far to have dodged a lot of physical assault on to me and have jumped out of the way. But there was an incident with a little old lady who hit, kicked, tore shirts of the CNA's. At that time I had called the DON and she allowed me to call and take her on a psych hold. But then I had a DON hang up on me when I reported that the patient was stricking staff and throw something across the room in attemp to hit me with it. Before she hung up on me she said how much damage can a little old lady do. I have heard of discouragement in pressing charges when assaulted. I once believed that if a patient assaulted me and they were not of sound mind that there was nothing I could do about that. That it was basically their right and I didn't have any recourse. That was told to me by a DON also. Found out later anyone can press charges but the great white doors of the institution is not going to save/help you.

I am not a nurse yet and don't start nursing school until August. I am a CNA and have been assaulted, scratched, groped, spit on you name it while working in a LTC even been cussed out by family members for reasons that I don't know. Each time administration just asked if I was fine and that was pretty much it. It seems like assaults against staff aren't taken seriously. I've now been working as a CNA in a psych facility for a yr now and fortunately I haven't been assaulted. I just hope that facilities do more for health care workers when they are assaulted.