On Unsafe Ground

Susan Trossman, RN


Am Nurs Today. 2018;13(1) 

In This Article

Abstract and Introduction


Healthcare facilities are a microcosm of society, where like the general population, patients, family members, and visitors can have financial difficulties, violent histories, and poor coping skills, as well as struggles with behavioral health and substance use disorders. Add in pain, fear, and interventions involving physical contact, and these factors can create the perfect storm for violence against nurses and other healthcare workers.

"The ER is the front door to the hospital—open 24/7," said Lisa Wolf, PhD, RN, CEN, FAEN, director of the Institute for Emergency Nursing Research of the Emergency Nurses Association (ENA), an organizational affiliate of the American Nurses Association (ANA). That means that anyone, understandably, can walk in at any time.

"Also, any dynamic or condition that destabilizes [the environment] can lead to workplace violence—understaffing, long wait times, overcrowding, and factors that affect communication," Wolf added.

The persistence—and some say increased—incidents of violence within healthcare settings has led ANA, specialty and state nurses organizations, and other stakeholders to renew their call for the implementation of effective strategies and policies that address this hazard without further delay. And they want this problem to be treated with the seriousness it deserves for the safety of nurses, patients, and communities.

ANA is encouraging nurses to add their names to #EndNurseAbuse, which calls for zero tolerance when it comes to abuse against nurses, reporting abuse when it occurs, and asking others to sign the pledge. Utah Nurses Association member Alex Wubbels, RN, is helping to lead this initiative. Additionally, ANA is working to bring together nurses, other healthcare stakeholders, and consumers to determine ways to systematically reduce the incidence of violence and abuse within health care. A key area of their focus will be barriers to reporting violence.