ANA: 'Zero Tolerance' for Workplace Violence, Bullying

Home Health Columnist / Guide · Sep 12, 2015

Found at Huffington Post:

Workplace Violence a Growing Problem for Health Care Workers

Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN

9/4/2015

As the nation observes Labor Day, economic issues such as income equality, paid leave and the minimum wage may be making headlines, but workplace safety -- particularly in health care settings -- is another issue that must be addressed.
Violence Against Health Care Workers
Acts of violence against health care workers are being committed with increasing frequency in hospitals and health care facilities. This week alone, a hospital patient was arrested after assaulting 14 nurses and staff members at a hospital in Charleston, S.C., and in central Florida, a patient attacked nurses who were trying to transfer him from an ambulance stretcher when he arrived at a local hospital.
While not all violent incidents result in devastating consequences, many cause injury; damage workers' teamwork, morale and sense of safety; and result in high turnover at a time when the health care industry can least afford it.
Consider these incidents in just a three-month period from November 2014 through January 2015:
â€¢ A 68-year-old male patient attacked four nurses with a metal bar at a Minnesota hospital; one nurse suffered a collapsed lung, another a broken wrist and two others cuts and bruises.
â€¢ In Boston, a cardiologist was murdered after a man, the son of one of the cardiologist's patients, located the physician and shot him.
â€¢ A 58-year-old man who entered an Oklahoma City hospital emergency room complaining of chest pains pulled out a knife and attacked three nurses and a security guard, causing stab and bite wounds.
â€¢ A 20-year-old male receiving a medical evaluation at a health clinic across from a hospital in Los Angeles allegedly shot and wounded a nurse in the thigh.
Health care professionals have a duty to provide care that keeps people safe, alleviates suffering and restores health. But when health care workers fear the threat of personal harm from attack and injury, their focus on the patient is undermined -- and so is the U.S. health care system. ...

Zero Tolerance Policy
To address this growing problem, ANA convened an expert panel on Incivility, Bullying and Workplace Violence. The panel analyzed research findings and has proposed detailed guidance for nurses and employers to follow to prevent and reduce workplace violence, bullying and incivility. Recommendations for employers include, among many others, establishing a zero tolerance policy for all types of violence, fostering a non-punitive environment that encourages reporting incidents and developing a comprehensive violence prevention program. Ultimately, implementing better safety and professional standards will be the key to curbing workplace violence, bullying and incivility.
Nurses and other health care workers, like law enforcement officers, are guardians of our communities, and their welfare demands protection. A first step is acknowledging and reporting the problems. Training needs to be a priority, and should be specialized to the type of setting and include a variety of methods, such as hands on practice, simulation and mock drills. More aggressive prevention efforts are needed to diminish the violence that disrupts our healing and caring environments.
Additionally we call on our citizens who are our patients and their family members, to help ensure health care facilities are indeed places for care, support, healing, and wellness. Everyone can help by respecting these places as safe havens, and being watchful so that caregivers are not subject to harm. We cannot afford to have one more health care worker killed or maimed.
Violence is not part of the job.

KatieMI, BSN, MSN, RN · Sep 12, 2015

That's all words and nothing else. When a patient (and family, if involved) will be banned from a hospital because their violent behavior and the teary lawsuit they initiate get dropped right away in the very first time, or when an RN loses license because of inappropriate behavior toward other RN in the first time, then we start speaking business.

And even the all above does not cover things like inpatient psych and geri psych, where violence toward personnel just seems to be written into job description in invisible ink.

Overland1, RN · Sep 13, 2015

Much of the problem is perpetuated when a person is arrested for a violent crime in a hospital (per the law) and is released by the judge upon arraignment. This is something that goes beyond the "AMA" and "position statements". It is not just an issue, it is a problem in the greater community, as many judges find excuses to release violent offenders almost immediately. Those offenders then continue doing what they did before, as well as pass the word that such misbehavior is OK (the word on the street is a powerful thing).

We can file all the charges we want, but if the courts do not support us, we are in trouble. As on old guy, I still recall when a hospital was a sort of sacred place (even if there were no nuns ) and bad behavior was not tolerated... heck, bad behavior almost never happened in hospitals. Now, hospital staff needs to learn and practice situational awareness at all times.

Keep your head on a swivel, and watch your six!

lindarn · Sep 14, 2015

I will believe it when I see it. Actions speak louder than words. I have stated many times, that the ANA is about as useful as tits on a bull.

As I stated in a recent thread, why is it that nurses are the only recipient of patient violence? Patients never seem to direct their anger at other health care professionals, only nurses.

The dietician is never targeted if the patient does not get what they want on their tray. No trays of food launched at the dietary staff. No one throws a used syringe at the lab tech, after the lab tech draws morning labs. The list goes on.

Nurses remain the unhappy patient punching bag, and we put up with it, or administration will find a reason to fire us.

What can I say?

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN (ret)

Somewhere in the PACNW

Jensmom7, BSN, RN · Sep 14, 2015

Actually stopping patients and families from abusing the Nursing staff is sure to lower those precious Press-Gainey scores. So, that ain't gonna happen any time soon.

Rob72, ASN, RN · Sep 15, 2015

"Violence is not part of the job."

I strongly disagree. It is an inherent part of the job. The problem is that nurses are not taught how to recognize, verbalize, or document inappropriate verbal or physical behavior.

Attempting to create a "violence-free" zone ensures that someone, at some point, will use violence. Why? Because all the "nice" people wag their fingers and tongues and there is no immediate, overwhelming, response. The idea that violent behavior is corralled or modified by verbiage is a failed concept, as demonstrated by the efforts in Corrections Science, from ~1960-1980. Unfortunately, the idealists, with their student loans to pay off, and their ideals to sustain, have moved into Public Education and Healthcare.

Press-Gainey is a huge problem, as their overall model is based on sensation and reality-denial.

If a patient is presented with the (real) choice of restraining their impulse, or receiving care at County (jail), or being tazed, they generally choose to conform to the stated standard. Truly violent people, with limited impulse-control understand that a minor assault charge is nothing to fear and they are likely to get what they want by threats and modest expressions of force.

Hoosier_RN, MSN · Sep 17, 2015

I will believe it when I see it. Actions speak louder than words. I have stated many times, that the ANA is about as useful as tits on a bull.
As I stated in a recent thread, why is it that nurses are the only recipient of patient violence? Patients never seem to direct their anger at other health care professionals, only nurses.
The dietician is never targeted if the patient does not get what they want on their tray. No trays of food launched at the dietary staff. No one throws a used syringe at the lab tech, after the lab tech draws morning labs. The list goes on.
Nurses remain the unhappy patient punching bag, and we put up with it, or administration will find a reason to fire us.
What can I say?
JMHO and my NY $0.02
Lindarn, RN, BSN, CCRN (ret)
Somewhere in the PACNW

Amen, sister! Well said...

Here.I.Stand, BSN, RN · Sep 17, 2015

Does anyone know if any legislators (state or federal) have tried to pass laws against assaulting nurses? Kind of like the laws against assaulting LEOs? Actual law would be a tad more useful than an ANA statement, methinks.

One of my hospital's units won't admit this one patient, because he's become violent, and an RN or two have restraining orders against him. That's a step in the right direction!

NurseGirl525, ASN, RN · Sep 25, 2015

Everyone should feel safe in the workplace. Physical violence of any kind from patients, their families, and coworkers should never be tolerated. That being said, the first couple of paragraphs that call incivility gossiping and starting rumors about coworkers, is a little off. You can't control other people's behavior. You can't control one nurse gossiping about another nurse. Gossiping has been going on since the beginning of time. When you get into situations like that, it's a she said/he said kind of instance. I don't know how a lot of that can possible be enforced.

Not only that, but you also have people who claim they were bullied because somebody gave them a weird look. We see it all the time in here. I honestly do not think most of what was posted in incivility and bullying actually are the definitions of those words. I see bullying as name calling, being aggressive towards someone, constantly putting them down. I really hate what bullying has turned into these days. Basically, if you don't like someone, you are a bully. If you don't smile at them and coddle them, you are a bully. Nurses should be able to vent about other nurses. It can reduce stress in the workplace if you can just go express your feelings about why you are angry with someone. That is not bullying. I don't like everyone and I do not expect everyone to like me. I can be a huge people pleaser sometimes but if I have tried my hardest and they still don't like me, I am ok with that. Some people's personalities do not mesh.

I just kind of look at that as a politically correct article these days.

FlyingButterfly · Sep 26, 2015

OK, obviously, you don't know enough about bullying/incivility...Read some research articles...There is more than 80 kinds of bullying in the health care system...Sure, you do not like some of your coworkers...BUT, you better be aware of your nonverbal language/ body gestures while, for examle, there is two of you in med room...If you make her uncomfortable when even passing her by, that is a case of uncivility or even bully; if you know what I mean...