Safety is defined as a condition of being protected from or not causing danger, injury, risk or loss (Joint Commission, 2021). Safety from physical harm as well as psychological harm should be ensured in all workplaces. When we are at our worst, stricken by malady or injury, it is healthcare workers that we turn to for healing. But these same healthcare workers are being assaulted in their own workplaces. Though healthcare workers often support each other as they work under difficult circumstances, they are also impacted by lateral violence from their colleagues (USBLS, 2018). Incidents of physical and psychological harm to healthcare workers are reported in the news on a weekly basis. The stress caused by workplace violence is also contributing to the crisis of nurse suicide. Violence against healthcare workers needs to stop. What can be done to promote a culture of safety and well-being everywhere healthcare professionals work?

Let’s address the basic need of psychological safety.

Lateral violence, also known as “bullying” or “incivility” in nursing, is still present in our profession (Joint Commission, 2021). Between 40% and 70% of nurses experience lateral violence in their career and 27% of surveyed nurses report they experienced it in the past six months (Goh, Hosier, & Zhong, 2022). Psychological safety refers to feeling safe to speak up, take risks, and make mistakes without fear of negative consequences (Bush, 2018). Psychological safety is not a luxury; it is imperative to a culture that works to improve performance to mitigate patient harm. All healthcare teams make mistakes; however, many teams are not forthcoming about these errors due to fear of retribution. Those who work in an environment which has a culture of psychological safety are more willing to speak up. Organizations that support and encourage all members of the team to speak up about the need for practice and process change tend to have a culture that promotes well-being and safety (Bush, 2018).  

We need to protect healthcare workers from physical harm.

According to the World Health Organization, up to 38% of nurses suffer from healthcare violence during their career and healthcare workers in general have a six times greater risk of workplace violence compared to other industries (WHO, 2022). OSHA recently reported that one in four nurses are assaulted at work (OSHA, 2023). These statistics are not surprising; areas like the emergency department, psychiatric units, long-term care facilities, and waiting areas see the most violence because they are high stress areas (Lim et al., 2022). There is an increased risk of violence towards healthcare professionals when there is a stressful situation which involves patients, family members, or other visitors, long wait times to see a healthcare professional, overcrowding in treatment and waiting areas, or communication issues due to cultural and language differences (Lim et al., 2022). For the staff, the risk of violence increases when there is an inadequate number of experienced staff that are adequately trained to handle escalating situations (Lim et al., 2022).

Let’s keep healthcare workers safe.

Every healthcare worker deserves to be safe at work. Healthcare organizations are supporting this mission by investing in ways to provide healthcare workers physical and psychological safety. Having an adequate number of experienced and properly trained staff is paramount to keeping healthcare professionals safe. The use of technology and tools can help to ensure safe staffing across the entire institution and flex staffing up when needed. Providing more security officers and training them in de-escalation techniques is important for staff safety and reduces the risk of injury to  the person or persons causing the situation. Many healthcare organizations are installing metal detectors to help protect their employees and patients from weapons. Despite these precautions, some violent acts will still occur. In these cases, affected healthcare workers should work with their supervisor to pursue legal remedies.

Physical and psychological safety in healthcare can only work if the culture supports it and leadership is visible within the healthcare organization, is open to conversations, and has a zero-tolerance policy for bullying, physical violence, and verbal threats and harassment. Anyone who enters the door must act from a place of mutual respect.

It’s time to keep healthcare workers safe by ending violence where we practice and promote psychological and physical safety for all.
 

References:
Bush, M. C. (2018). A Great Place to Work for All. Oakland, CA: Berrett-Koehler Publishers.

Goh, H. S., Hosier, S., & Zhang, H. (2022). Prevalence, Antecedents, and Consequences of Workplace Bullying among Nurses-A Summary of Reviews. International journal of environmental research and public health, 19(14), 8256. https://doi.org/10.3390/ijerph19148256

Lim, M. C., Jeffree, M. S., Saupin, S. S., Giloi, N., & Lukman, K. A. (2022). Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Annals of medicine and surgery (2012), 78, 103727. https://doi.org/10.1016/j.amsu.2022.103727

Occupational Safety and Health Administration. (2023). Workplace violence. U.S. Department of Labor. https://www.osha.gov/healthcare/workplace-violence/

The Joint Commission. (2021, June). Quick Safety 24: Bullying has no place in healthcare. https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-24-bullying-has-no-place-in-health-care/bullying-has-no-place-in-health-care/

U.S. Bureau of Labor Statistics (USBLS),  (2018). Workplace Violence In Healthcare. 2018. https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018-chart2-data.htm

 

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