“I’m gonna kill you” Is what he said just before grabbing Ashley Schade’s neck with both hands during her shift in a Washington ICU. She detailed the event in a social media post: “having a strong individual’s hands around your neck, the inability to breathe, let alone call for help, to the point where you can’t see a thing and can only hear an emergency “staff assist” tone going off, is one of the absolutely gut-wrenching, most terrifying feelings anyone could ever imagine”
How Much is Too Much?
Although Ashley’s encounter was extreme, violence against healthcare workers happens all too often. A 2001 study by the Department of Justice found that out of all workers across all industries 16.6 per 1,000 were the victims of violent acts, compared to 21.9 per 1000 nurses. Furthermore, according to the Occupational Safety and Health Administration (OSHA), approximately 75% of nearly 25,000 workplace assaults reported annually occurred in the healthcare and social services settings.
The statistics are staggering, especially when you take into account that violence in healthcare is often under reported, as most healthcare workers contribute violent acts to “just being part of the job”. In some circumstances, nurses and assistive personnel forgo reporting such incidents all together in fear of negatively affecting Centers for Medicare and Medicaid Services (CMS) scores, however most facilities lack a formal reporting protocol to do so.
We’re Here to Heal, So Why all the Violence?
Its safe to assume that the vast majority of nurses did not get into the field out of a desire to fight people, so why all the fighting? A study performed by the Emergency Nurses Association (ENA) detailed contributing factors of healthcare associated violence in emergency departments across the nation. Most factors were directly related to patient conditions such as an increase in the prevalence of mental health disorders and patients or their family being under the influence of drugs or alcohol, while other factors were related to facility shortfalls like under staffing and the lack of safe visitor policies.
What Can We Do About It?
While a large portion of workplace violence in the healthcare setting stems from factors which are difficult to control for, there are measures we can take to increase safety for nurses and other healthcare personnel, and arguably the most important is awareness. As the phenomenon of healthcare violence gains public attention, more and more nurses and other healthcare professionals are becoming vocal and sharing their experiences, most notably through the trending hashtag #silentnomore often broadcasted by popular social media personalities such as “ZDoggMd”.
While awareness may be necessary for change, understanding is how solutions are made. The lack of effective reporting protocols in facilities across the U.S. may potentially be the largest inhibitor of increased workplace safety. How can we possibly solve the problem when we don’t fully understand it? Furthermore, in order for reporting tools to collect accurate and useful data, nurses must be encouraged or inspired to report the incidents in the first place. That is why the notion that violence is “just part of the job” is so dangerous and counter to what we pledged as nurses: to do all in our power to maintain and elevate the standard of our profession.
So, while we continue to be healers and provide exceptional care to our patients despite what they may say or do to us, it is of utmost importance for the sake of safety and the progress of our profession, to maintain the belief that violence is not okay, no matter what.