Nurse abuse by patients can’t be tolerated or go unaddressed

A nurse emailed me about something she faces every day: harassment and verbal abuse by patients.

She stated her nurse manager does nothing to stop the nurse abuse and wonders how she can continue working in this facility if she is faced with this treatment on a regular basis.

Violence against nurses in the workplace is nothing new. Nursing literature, news reports and nursing blogs contain copious amounts of information on nurse abuse and reactions to it.

Workplace violence is generally defined by the National Institute of Occupational Safety and Health as an act or threat of violence, ranging from verbal abuse to physical assaults, directed toward persons at work or on duty.

NIOSH has categorized four types of workplace violence:

  • Type I: “Criminal intent” acts by persons having no relationship to the business or its employees
  • Type II: Acts involving a customer, client or patient with a relationship to the business, who is violent while receiving services
  • Type III: Acts involving a “worker-on-worker” relationship (lateral violence) in which an employee attacks or threatens another employee
  • Type IV: Personal relationship acts between a perpetrator and the intended target in which the violent act or threat occurs at the victims workplace

Types II and III are the most common in healthcare, according to the American Nurses Association.

Recent statistics support how common Type II violence is with nurses. A 2019 American Nurse Today survey of over 5,000 nurses showed 59% of nurses had been verbally assaulted by a patient.

Nurse abuse includes verbal abuse and harassment

Examples of nurse abuse by patients include:

  • Bullying
  • Ethnic insults
  • Name calling
  • Offensive teasing
  • Questioning professional competency
  • Requests for a date
  • Sharing obscene photos
  • Yelling
  • Threatening verbal remarks

There are many underlying causes of such patient behavior, including financial concerns of loss of work and the cost of hospitalization, fear of a lack of control over the illness or diagnosis, anger at being hospitalized and personality characteristics or psychological problems.

Regardless of the source of patient abuse and harassment, it is unacceptable and clearly considered violence against its victims, according to the Joint Commission.

Effects of abuse

Nurses who have been victims of patient abuse and harassment are affected in a number of ways, including:

  • Not wanting to care for patients
  • Absenteeism
  • Depression
  • Anxiety
  • Sleeping difficulties
  • Fatigue
  • Humiliation
  • Fear

All these results not only affect the nurse, but also affect the provision of safe patient care, including the potential for an increase in medication errors and patient infections, according to OSHA.

Legislation in the works

The most promising response to the prevention of patient and other abuse and harassment against nurses is the November 2019 passage by the House of Representatives of the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309).

If it becomes law, H.R. 1309 would require the Department of Labor to create an occupational safety and health standard requiring certain healthcare and social service employers to develop and implement a comprehensive plan for protecting healthcare workers, social workers and other personnel from workplace violence.

It also will require employers to investigate workplace violence incidents, provide training and education to …read more

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