Safety, Quality, and Informatics

Running Head: WORKPLACE VIOLENCE 1

WORKPLACE VIOLENCE 5

Nursing and Workplace Violence

Samantha M. Tallarine

Capella University

Policy, Law, Ethics, and Regulations

May, 2019

According to the occupational safety and health administration (OSHA), more than 2 million workers are victims of violence in the workplace every year. Violence can arise in any workplace, and it may emanate from violent acts by coworkers, patients, their family members, criminals, and visitors, causing concerns about personal safety (Dehghan-Chaloshtari & Ghodousi, 2017). In the healthcare setting, violence can take different forms like physical assault, verbal aggression, or even the use of deadly weapons against patients, physicians, and other workers. Besides all these aspects, the employers in the healthcare setting have an obligation to provide a safe working environment that is free from recognized hazards.

The risk factors for workplace violence vary from one hospital setting to another, and some of the common factors include failure to train staff and facilitate policies that will prevent and manage a crisis in times of violent acts within the hospital setting and accessibility to firearms. Nurses, for instance, have experienced violence for a long time, and they have been told it is part of their job in the past. Currently, awareness is being raised that violence is not part of their job, and they do not have to be assaulted (Abdellah & Salama, 2017). There has been reluctance by the federal, states and local governments lawmakers to pass and approve legislation that will offer healthcare workers legal protection from workplace violence despite continuous advocacy by professional bodies in healthcare. In most states, violent assaults have been classified as 'class A misdemeanors,' but with effective law and advocacy, the assaults for instance in Texas have been classified as 'third-degree felonies' (Docksai, 2018).

Guns in the U.S. have been a highly politicized issue hindering effective regulation. They are easily accessible to patients, family members, among others, and contribute to healthcare workplace violence. On November 19th, 2018, in a Chicago based Mercy Hospital & Medical Center, four people died in a gun-related shooting (Rappleye, 2018). As a result of such kind of shootings and deaths, social workers, nurses, and physicians have joined hands to seek funds and lobby for government support for legal support against gun violence through facilitating effective violence prevention strategies.

There are other factors that contribute to workplace violence such as inadequate security, working directly with people who are volatile, for instance patients who are under the influence of alcohol, drugs, and others may have a history of violence, patients having to wait for long to be served and work environments that are poorly designed (Cdc.gov, 2019).

OSHA recommends that to protect against violence in the healthcare setting; providers develop an effective program that will prevent workplace violence (OSHA.gov, 2019). The program is to include;

· Commitment by the management and participation from workers: the management needs first to recognize that workplace violence is a safety and health hazard and also provide the needed resources to and motivation to workers to facilitate dealing effectively with workplace violence. Regular committees and team meetings can be held to ensure that violence prevention program is in operation (OSHA.gov, 2019).

· Analyzing the workplace and identifying hazards: this involves an assessment of the workplace to identify potential and existing hazards for workplace violence. The team should set the time within which a comprehensive workplace analysis should be done to single out the hazard and new situations that could result in violence.

· Preventing and controlling hazards: this is a guideline in which appropriate steps are taken to control or prevent hazards that were identified. The implemented controls should be evaluated more often to facilitate any needed updates (OSHA.gov, 2019).

· Enhancing training programs on safety and health: these programs will ensure that healthcare workers are aware of the potential hazards and how they can protect themselves. The training content can be reviewed on an annual basis to integrate other new relevant information.

· The final guideline is keeping records and evaluating the violence prevention program. This will be essential for the identification of any deficiencies or any changes that need to be made.

Concerning personal and shared roles as well as those of employers and registered nurses, the position of the American Nursing Association (ANA) is to create and maintain a culture of respect that is free from "incivility, bullying and workplace violence" (Nursingworld.org, 2015). The employers and the registered nurses have a legal, moral and ethical responsibility of facilitating a work environment that is healthy and safe for patients and their families, but also for all members of the healthcare team. The ANA intends to protect nurses from the different types of violence through the use of resources, policy, and advocacy, among other methods. The ANA has zero tolerance on workplace violence and its policies compared to those that healthcare organizations put in place concerning workplace violence. Some of the policies in its position statement include;

· Offering education programs on bullying and incivility as well as prevention strategies.

· Offering a mechanism through which RNs can seek support when they feel threatened.

· Encourage the registered nurses to report any incidence of violence, participate in educational programs, and learn the policies and procedures within the organization.

· The nurses and their employers should establish a shared commitment that will promote a safe environment, which will enhance dignity and respect (Nursingworld.org, 2015).

The employers should be in the forefront to prevent violence, and they, therefore, need to implement OSHA's safety and health program. This program should be evaluated periodically and enhance the specific prevention strategies and safety policies in different areas such as environmental designs, administrative controls, provide the hospital workers with safety tips and modifying their behavior (Cdc.gov, 2019). Employers can install metal detectors like security devices, and this will prevent people who are armed, e.g., with guns from entering the hospital environment. Good lighting in the hallways and cameras can be installed for security purposes. Monitoring, alarms, and signaling systems can be developed for use during an emergency. The healthcare employer should design and install a system in which the security personnel can be alerted in case of violence.

When responding to violence, hospital workers should watch for signals such as the presence of a weapon, threatening gestures, anger, and frustration. In return, they should maintain behavior that will dissolve the rage, such as avoiding giving orders, matching the threats, or avoiding any aggressive behavior (Cdc.gov, 2019). Safety policies and prevention strategies have been proven to be effective, and therefore, hospitals should develop a violence prevention program that is comprehensive to provide healthcare workers with a safer working environment.

Resources

Abdellah, R. F., & Salama, K. M. (2017). Prevalence and risk factors of workplace violence against health care workers in emergency department in Ismailia, Egypt. Pan African medical journal , 26(1), 1-8.

Cdc.gov. (2019). The National Institute for Occupational Safety and Health (NIOSH): Violence Occupational Hazards in Hospitals. Retrieved 2019 йил 16-05 from Centers For Disease Conntrol and Prevention: https://www.cdc.gov/niosh/docs/2002-101/#What%20are%20the%20risk%20factors%20for%20violence?

Dehghan-Chaloshtari, S., & Ghodousi, A. (2017). Factors and characteristics of workplace violence against nurses: a study in Iran. Journal of interpersonal violence , 0886260516683175.

Docksai, R. (2018). Lawmakers and Hospitals Take Action to Curb Violence Against Nurses. Retrieved 2019 йил 16-05 from Nursing Licensure Organization: https://www.nursinglicensure.org/articles/workplace-violence.html

Nursingworld.org. (2015 йил 22-07). ANA Positio Statement:Incivility, Bullying, and Workplace Violence. Retrieved 2019 йил 16-05 from American Nurses Association: https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/

OSHA.gov. (2019). Guidelines for Preventing workplace violence for Healthcare and Social Service Workers. (https://www.osha.gov/Publications/osha3148.pdf).

Rappleye, E. (2018 йил 20-11). Perspective: Addressing gun violence is 'professional, moral and ethical duty' of healthcare providers. Retrieved 2019 йил 16-05 from Hospital Review: https://www.beckershospitalreview.com/hospital-physician-relationships/perspective-addressing-gun-violence-is-professional-moral-and-ethical-duty-of-healthcare-providers.html