Workplace violence.
In April, a Baton Rouge General Medical Center nurse, Lynne Truxillo, died from complications of injuries suffered after being attacked by a patient. The patient was subsequently charged with manslaughter. Although deaths are rare, injury to nurses from violence at work is not. According to the U.S. Bureau of Labor Statistics, violent events account for 12% of injuries to RNs on the job-an incidence rate three times greater than for all other occupations. The American Nurses Association (ANA) estimates the actual number at twice that, owing to chronic underreporting by nurses and health care organizations. A 2019 ANA issue brief, Reporting Incidents of Workplace Violence, concluded that one in four nurses has experienced an assault on the job-a higher rate than that of prison guards and police officers.
The problem is not new. A study by the Occupational Safety and Health Administration (OSHA) found that of roughly 24,000 workplace assaults reported annually between 2011 and 2013, more than 70% occurred in health care and social service settings. Currently, OSHA offers only "guidance" for preventing workplace violence, defined as physical assaults or threats of assault. It has not issued a standard that would obligate health care organizations to take action to protect health care workers. Legislation directing OSHA to do so is wending its way through Congress via the Workplace Violence Prevention for Health Care and Social Service Workers Act. Introduced last February, the bill passed the House of Representatives and is currently in a Senate committee. The ANA, meanwhile, has called on nurses to raise public and professional awareness to dispel acceptance of assault and abuse as "part of the job." Learn more about the ANA's End Nurse Abuse campaign at http://www.nursingworld.org/practice-policy/work-environment/end-nurse-abuse. The Joint Commission also has resources for nurses to improve safety in their work settings at http://www.jointcommission.org/workplace_violence.aspx.
NAM report addresses clinician burnout and suicide.
The National Academy of Medicine (NAM) has released the results of a two-year collaborative effort to study clinician well-being and resilience in view of "alarming rates of stress, burnout, and suicide among U.S. clinicians." Among the findings is that 35% to 54% of nurses experience significant symptoms of burnout, including emotional exhaustion, cynicism, and a low sense of personal accomplishment. Read the report, Taking Action Against Clinician Burnout: A Systems Approach to Supporting Professional Well-Being at http://www.nap.edu/25521.
Criminalization of medical errors.
Although it's not a new issue, the criminalization of medical errors drew attention again last year when a Tennessee nurse, RaDonda Vaught, was charged with reckless homicide after her medication error resulted in a patient's death. Criminal charges were also brought in Arkansas against a Veterans Administration physician, Robert Morris Levy, who allegedly falsified diagnoses and test results, contributing to the deaths of three patients. While such cases are rare, they spotlighted an ongoing debate about the appropriate boundary between confidential professional disciplinary processes and public accountability. The ANA issued a statement in response to Vaught's arraignment, expressing concern about the "chilling effect" such prosecutions could have on nurses' ethical obligations to report errors in the interests of patient safety and process improvement. The Vaught case is set to go to trial in July.
Upward trend in nurses with baccalaureates continues.
According to a February 2019 report by the Future of Nursing: Campaign for Action, the percentage of RNs with a baccalaureate is about 56%-an all-time high-up from 49% in 2010. Fourteen states have seen growth of more than 10%, with Delaware leading at 20.7%, followed by Missouri at 15%. The Institute of Medicine's 2010 Future of Nursing report called for 80% of nurses to have baccalaureates by 2020.-Gail M. Pfeifer, MA, RN