Stop hurting the healers

Employers must encourage reporting and make violence towards healthcare workers unacceptable.

“Two dead in a shooting this weekend” is the type of headline that might not catch your attention until you learn that the setting was a hospital room and those shot were healthcare workers. In this case, a nurse, Katie Annette Flowers, and a social worker, Jacqueline Pokuaa, were gunned down in Dallas, Texas, on October 22, 2022. Unfortunately, violence against healthcare workers is not new, but it has worsened during the pandemic.

The first time I experienced violence from a patient was just after nursing school, almost 20 years ago. A long-term hospitalized patient who was verbally and emotionally abusive decided to throw his filled bedpan toward me. Eventually, he was discharged and told that he could never seek care at the hospital again. I wish I could say that my experience was rare or unique. Luckily, I could walk away, unlike the two victims in Dallas.

Crystal Grys

When healthcare workers care for patients that are disrespectful, rude, or worse—abusive, verbally, physically, or emotionally, nurses often internalize and think, “Why did that happen, and what could I have done to prevent it?” We also sometimes dwell on it so much that we worry about sharing it with our healthcare leaders and risk management team. We are concerned that the way we have been treated reflects on us and the care we’ve provided.

We worry about what our colleagues may think or say. That’s the classic victim mindset. The truth is, if healthcare organizations and leaders are not supportive or do not continually cultivate a culture of safety, these feelings may be genuine and a risk to the victim not reporting the event. We might also think that “it is all part of the job,” that it is too big of an inconvenience to report, or that nothing will change by reporting.

The Bureau of Labor and Statistics documented a doubling of violence against healthcare workers from 2011 to 2018. According to the Government Accountability Office, about one in four nurses experiences violence on the job, a rate five to 12 times higher than all other industries. The rates might be 2-4 times higher since many incidences do not get reported. In addition to the physical and mental harm caused to our healthcare workers, patient violence adds cost, estimated to be almost $12,000 per nurse victim for lost productivity, according to a study done in Texas.

It is difficult to imagine anyone opposing efforts intended to decrease violence. Some might consider increased regulations distasteful or obstructive to a free marketplace. The regulations in this situation are designed to protect the health and welfare of our nation’s healthcare workers. Past Occupational Safety and Health Administration legislation protecting workers led to increased safety, reducing workplace injury and death by 50%. The time is NOW to add specific language to federal regulations to protect the most trusted, empathetic, and skilled workers in our nation. Congress must pass the Workplace Violence Prevention for Health Care and Social Service Workers Act (S4182), the Senate companion bill to the already passed House Bill HR1195. This legislation would provide protections like those already established for flight crews, flight attendants, and airport workers by requiring the Department of Labor to develop enforceable standards to protect healthcare workers from violence.

We must honor the empathy of healthcare workers, the years they have spent in training, and the attention to detail they demonstrate. While these humans toil toward healthy outcomes for their patients, they are punched, kicked, grabbed, verbally assaulted, and routinely subjected to other violent behavior. Employers must encourage reporting and make violence unacceptable. Healthcare workers: ask your leaders for clear definitions of assault in the workplace. Other citizens: call your senators to support the passage of the Workplace Violence Prevention for Health Care and Social Service Workers Act (S4182).

Crystal Grys is a nurse in Scottsdale and a doctoral student at Duke University School of Nursing.