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Workplace Violence: What Can Be Done?

When a disgruntled employee commits violence in the workplace, it garners a lot of attention in the media. Meanwhile, 91 percent of violence against healthcare employees in the workplace is committed by patients and visitors, and it doesn’t make the news. In this post, we discuss why workplace assault by patients and visitors is often overlooked and what can be done about it.

“Healthcare workplace violence is an underreported, ubiquitous and persistent problem that has been tolerated and largely ignored.” – Dr. James Phillips, Harvard Medical School

In a study of violence against emergency room nurses, three recurring themes arise to explain workplace violence: the environment, personal reasons and lack of cue recognition. These themes may illuminate barriers to successful violence prevention in your organization.

  1. The environment. The study revealed that the Emergency Department often sees patients who have waited for a long period of time under duress in addition to psychiatric patients and those under the influence of drugs and alcohol. Patients and visitors suffering from these conditions are known to be more prone to violence, so their behavior is often overlooked.
  2. In one study, 46 percent of nurses reported some type of workplace violence during their five most recent shifts, with one third being physically assaulted.Personal reasons. Nurses are not empowered to make a change. Nurses and their colleagues frequently deny the impact of violence in healthcare settings. Furthermore, law enforcement and the judicial system often refuse to prosecute patients and visitors who have assaulted staff. The study implies that violent behavior is culturally perceived as a job hazard that is beyond anyone’s control, and it is not worth trying to punish offenders in court. Because violence is tolerated by everyone from staff and administrators to police and prosecutors, assault is widely underreported.
  3. Lack of cue recognition. The study suggests that nurses and other staff are often blindsided by unprovoked violence. Because they don’t recognize the precursors to violence and have not been trained on intervention procedures, healthcare workers tend to consider these events to be isolated. Not realizing the frequency and severity of violence results in tolerance and underreporting of assault.

NOTE: There is currently no federal standard requiring protection from workplace violence. Organizations with increased risk of violence should implement their own prevention programs.


Violence cannot be eliminated, but it can be significantly reduced through a workplace violence intervention program. Here are some basic elements to include in your program that address the aforementioned themes:

  • Examine the role of the social and physical environments. What environmental factors contribute to the incidence of workplace violence in your organization? Completing regular assessments of the environment is your first line of defense.

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  • Eliminate personal barriers. What personal reasons exist that may cause your staff to minimize, tolerate or underreport workplace violence? Creating and enforcing policies and procedures helps workers trust that their safety is important to your organization.

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  • Increase cue recognition. Is your organization prepared to handle the unforeseen? Training can play a huge role in violence prevention.

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We hope your organization is aware that workplace violence is not a routine part of the job and that you will benefit from implementing your own, customized prevention plan. We also urge you to contact your elected officials to let them know that you support federal laws to protect healthcare workers from workplace violence. #workplacesafety


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