Workplace Violence in the Healthcare and Social Service Sector: Impacts and Insights
Healthcare and social service professionals are confronted with a substantial risk of experiencing workplace-related violence. Workplace violence, as defined by the National Institute for Occupational Safety and Health (NIOSH), encompasses violent acts such as physical assaults and threats directed at individuals during their work duties.
According to the Bureau of Labor Statistics (BLS), in 2013, out of 100 fatalities occurring in healthcare and social service settings, 27 were attributed to assaults and violent incidents.
While media attention often focuses on reports of workplace homicides, the majority of workplace violence incidents result in non-fatal yet severe injuries. Both BLS data and statistics from the National Crime Victimization Survey (NCVS) underscore the prevalence of workplace violence as a genuine threat in healthcare and social service settings.
BLS data reveals that the highest number of injuries resulting from workplace assaults requiring time off from work occurred within these sectors. Between 2011 and 2013, annual workplace assaults ranged from 23,540 to 25,630, with 70% to 74% transpiring in healthcare and social service settings.
For healthcare professionals, assaults accounted for 10-11% of workplace injuries necessitating time off, compared to just 3% for all private sector employees.
In 2013, a notable number of assaults resulting in time off from work occurred within healthcare and social assistance facilities, ranging from 13 to 36 incidents per 10,000 workers. In contrast, the private sector as a whole reported only approximately 3 incidents per 10,000 full-time workers due to violence in 2013.
These workplace violence rates, as highlighted by BLS data, are substantiated by the NCVS, which estimated that between 1993 and 2009, healthcare workers had an overall 20% higher rate of workplace violence (6.5 per 1,000) than all other workers (5.1 per 1,000).
Additionally, workplace violence incidents within medical occupations constituted 10.2% of all workplace violence occurrences. It's crucial to note that research indicates workplace violence is significantly underreported, suggesting that actual rates may be substantially higher than documented.
Risk Factors Assessment: Understanding Workplace Violence Hazards
Healthcare and social service professionals are confronted with a heightened susceptibility to work-related assaults, primarily stemming from the violent tendencies exhibited by their patients, clients, or residents. While there isn't a definitive diagnosis or patient type that can reliably predict future violence, consistent epidemiological studies underscore the prevalence of workplace violence in certain settings.
Identifying High-Risk Settings:
The healthcare and social service sectors encompass diverse work environments, each with its own set of risk factors. However, certain settings tend to be at a higher risk for workplace violence, including:
Inpatient and acute psychiatric services.
Geriatric long-term care facilities.
High-volume urban emergency departments.
Residential and day social services.
Complex Factors Contributing to Violence: Workplace violence can be triggered by a myriad of factors, including:
Pain and distressing prognoses.
Unfamiliar surroundings.
Mind and mood-altering medications and drugs.
Disease progression.
Understanding Individual Risk Factors: While risk factors can vary widely depending on the specific healthcare or social service setting and organization, some common factors include:
Patient, Client, and Setting-Related Risk Factors:
Direct interaction with individuals with a history of violence, substance abuse, gang affiliations, or patients' and clients' relatives. Patient and client transportation responsibilities.
Solo work in healthcare facilities or patients' homes.
Poor workplace environmental design impeding vision and escape routes. Inadequate lighting in corridors, rooms, and parking lots. Limited means of emergency communication. The presence of firearms, knives, or other weapons among patients, families, and friends. Working in neighborhoods with high crime rates.
Organizational Risk Factors:
Lack of facility policies and staff training for recognizing and managing escalating hostility and aggression.
Understaffing, particularly during mealtimes and visiting hours.
High turnover rates.
Insufficient on-site security and mental health personnel.
Long patient or client wait times and overcrowded, uncomfortable waiting areas.
Unrestricted movement of the public in clinics and hospitals.
A perception that violence is tolerated and that victims may not report incidents to the authorities or press charges.
Violence Prevention Programs:
Implementing a comprehensive workplace violence prevention program, integrated into an organization's broader safety and health initiative, is a proactive approach to mitigate the risk of workplace violence. Such a program should include:
Management commitment and employee participation.
Worksite analysis.
Hazard prevention and control.
Safety and health training.
Recordkeeping and program evaluation.
The program should align with the workplace's unique characteristics, such as size and complexity, and remain adaptable to changing circumstances. Routine assessment and adjustment are essential to address organizational changes effectively. Moreover, compliance with applicable state requirements should be verified, as several states have enacted legislation addressing workplace violence prevention.
Violence Prevention and Self Defense Resources
The goal of the Center for Violence Prevention and Self Defense is to stop violence by educating at-risk people and empower them with the skills needed to protect themselves both online and live training. CVPSD's live training is available to people of all ages in New Jersey including children, adults and the elderly.
Live conceptual seminars teach the origins of violence and how to assess risk and set boundaries for healthy relationships. Experiential classes teach hands-on interpersonal skills and strategies to prevent and stop assault.
The Center for Violence Prevention and Self Defense reaches individuals and communities through partnerships with schools and other nonprofits, community groups, as well as classes for the public.