Hospital Violence Needn't Be 'Part of the Job'

MedPage Today, February 28, 2018

Tolerance may add to problem, expert says.

By Salynn Boyles, Contributing Writer

This article was originally published by MedPage Today.

SAN ANTONIO — Hospital staffers have a higher risk for experiencing workplace violence than workers in any other industry, but many of the most vulnerable just accept it as an unavoidable part of the job.

The fact that in-hospital violence is often not reported by staffers may be contributing to the problem, critical care surgeon Lewis J. Kaplan, MD, said Tuesday in a presentation to the Society of Critical Care Medicine's 47th Critical Care Congress.

Kaplan, who spent five years embedded with Connecticut's South Central Regional SWAT team as a medical team member, said that hospitals can be dangerous places to work, but proper planning and training can reduce the risk related to violence.

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According to the U.S. Bureau of Labor Statistics, in 2015, there were 8.5 injuries due to violence encountered on the job among every 10,000 full-time hospital workers, compared to 1.7 cases for all other private industry, Kaplan said.

He added that attacks on healthcare workers in hospitals account for almost 70% of all nonfatal workplace assaults.

"In-hospital violence is very much underreported, so we don't know the real figures," Kaplan told MedPage Today. "The emergency department is the most common setting for workplace violence, but it is not limited to the ED. Social workers, cases managers, advanced practice providers are all vulnerable."

In a nationally representative survey of several hundred emergency medicine physicians published in 2011, 75% reported experiencing verbal abuse in the previous year and 21% reported physical abuse. In a similar survey, 100% of nurses working in emergency departments reported experiencing verbal abuse and 82% reported experiencing physical abuse.

"Tolerance of this behavior is considered to be part of the job, but the tolerance allows it to continue," Kaplan said. "The problem is that when you tolerate one thing it opens the door for another. Verbal abuse is a risk factor for battery."

Kaplan said underreporting of workplace violence leads to missed opportunities for mitigation and prevention.

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