COMMENTARY

Workplace Violence in the Healthcare Setting

Dan Hartley, EdD; Marilyn Ridenour, BSN, MBA, MPH

Disclosures

September 13, 2011

Editorial Collaboration

Medscape &

In This Article

Response to Assaults

Reporting and documenting all workplace violence (nonphysical and physical assaults) is critical; therefore, healthcare providers should encourage the injured employee to complete the facility's incident or event report as soon as feasible. All reports should protect employee confidentiality, yet permit root-cause analysis to assist with prevention of similar incidents in the future. Incident investigations should be conducted in a manner that determines the root cause of the incident without blaming or criticizing the victim for assaultive actions by clients.

If an act of workplace violence occurs, the injured employee should receive prompt and appropriate medical and psychological care.[16] Healthcare providers need to be aware of common nonphysical consequences of workplace violence suffered by many victims and witnesses, such as:

  • Short- and long-term psychological trauma;

  • Fear of returning to work;

  • Changes in relationships with coworkers and family;

  • Feelings of incompetence, guilt, or powerlessness; and

  • Fear of criticism by supervisors or managers.[16]

Some studies have found that nonphysical violence (eg, threats) result in as much as or more stress than physical injuries.[2,3] If necessary, report the incident to the appropriate local authorities (eg, police) as required by applicable laws and regulations.

Education about workplace violence and its associated risk factors can assist with prevention of future incidents. A work environment that encourages employees to openly communicate any verbal, written, or electronic threats by patients, their families, or visitors might prevent future incidents of physical or nonphysical violence before they occur.[13,16]

Support Services

Postincident debriefings (discussion in a context of group support and education about postevent psychological reactions) are usually led by nurse managers or other staff with counseling by trained individuals, such as psychologists or psychiatrists, and may reduce psychological stress and trauma levels among victims, coworkers, and witnesses of workplace violence.[20] Permitting the victim to share the negative emotional impact of a traumatic event is an important step in recovery.[21] In some situations, it may be necessary to reassign staff temporarily to prevent them from returning to the same unit where they might come into contact or interact with the assailant. This will prevent opportunities for the assailant to repeat the offense.

Employees should also be encouraged to use the employee assistance program to help them cope with these issues and manage or prevent future workplace violence incidents.[16]

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