Strong Leaders Support Healthcare Worker Safety

In the past three years, the extent of on-the-job violence that healthcare workers face has received a lot of media attention and public sympathy. That attention has created pressure on political leaders to provide legal protections for the millions of professionals who dedicate their lives to healing.

Last week, Vermont became the latest state to take a more aggressive stance against healthcare workplace violence. The Associated Press reports that a new law in the Green Mountain State bumps up a misdemeanor assault to a felony when the victim is a healthcare worker on the job, with penalties ranging from up to a year in prison for first-time offenders to up to 10 years for repeat offenders. New York and Massachusetts recently passed similar laws, and the Emergency Nurses Association (ENA) says that several other states are focusing on the problem.

Will these laws end healthcare workplace violence? No. But they do reflect an increasing public awareness of the extent of assaults against healthcare workers. And, where there is informed public awareness of an issue, usually there is progress.

Let's review the numbers. Bureau of Labor Statistics data for 2008—the latest figures available—show 2,890 work-related assaults at hospitals. Remember, this reflects only assaults that are serious enough to inflict injury and force the victim to miss at least one day of work. Other BLS data show that for every 10,000 hospital workers, there were eight workplace assaults that resulted in missed work days.

By comparison, in the overall private sector, there were only 1.7 workplace assaults resulting in missed work for every 10,000 workers. An ENA nationwide survey found that between 8% and 13% of ED nurses say they are victims of physical violence every week. More than half (54.8%) of the 3,211 nurses ENA surveyed at three-month intervals between May 2009 to February 2010 reported physical or verbal abuse at work in the week before taking the survey.

ENA President AnnMarie Papa, RN, says she's happy with the strengthened protections for healthcare workers, and she's hopeful that more states will enact ENA model legislation that makes penalties for assaults on healthcare workers the same as assaults on police officers and firefighters.

She's quick, however, to call for more proactive measures that identify security risks in hospitals and other healthcare facilities before the violence occurs, and training programs that allow for healthcare professionals to defuse potentially violent encounters. Many of the ENA suggestions can be found in its workplace violence prevention tool kit.

"Most importantly, you need to have an organizational buy-in," says Papa, who is also interim director of emergency nursing at The Hospital at the University of Pennsylvania, in Philadelphia. "Zero tolerance is probably the one single most important factor for nurses. When we see that we know our organization is standing with us. We know they are on the front line, maybe not physically, but they are there to help us deal with these issues."

Papa says more and more hospitals are also doing a better job supporting their employees who've been assaulted on the job, although she says much work in that area remains to be done.

"If someone gets hurt at work, they break their ankle or there is a chemical splash, they have workers comp and other support. But often violence is overlooked as a worker's compensation issue. They have to use their vacation time or sick time to take time off," Papa says.

Also, Papa recommends that hospital leaders personally reach out to employees who've been assaulted on the job to offer their support. "I work in a Level 1 urban hospital in Pennsylvania. Whenever one of our nurses is the victim of violence, someone in our C-Suite calls that nurse to ask 'How can I help you?' Nine out of 10 times that nurses is going to say 'I'm fine. Thanks for the call.' But I can tell you that they talk about the fact that they received that call. They feel very, very supported."

The victims of assault are often frightened, angry, and confused. Imagine the impact that senior leadership could have on employee moral if the C-Suite is there both to support proactive antiviolence programs, and to offer assistance when on-the-job assaults occur.

If you're trying to build employee engagement in your healthcare organization, you can start by ensuring that you're there to support your employees when they are most vulnerable. They'll remember.