Abstract
Workplace violence within the healthcare arena is a significant public-health problem that ignites growing concern within the USA. The National Institute for Occupational Safety and Health (2015) defines workplace violence as ‘violent acts, including physical assaults and threats of assaults, directed towards persons at work or on duty.’ Similarly, various types of violent behaviour include verbal abuse, threats, harassment and hostility which may illicit psychological trauma and stress. In fact, evidence suggests that compared to workers in the private industry, healthcare and social assistance workers (e.g. nurses) were four times more likely to report workplace violence that caused injury (and required time off to recuperate) than other industries (OSHA, 2015a). Given that the incidence of workplace violence in healthcare has increased substantially, coupled with the fact that front-line workers including nurses and other healthcare personnel are more likely to experience violence, the accompanying paper is timely and well needed. This research investigated nurses’ experience of workplace violence, their emotional exhaustion and their perceptions of patient safety. Culling cross sectional data from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS), the authors determined that not only do nurses experience violence from patients but also ‘visitor verbal abuse’ from patients’ friends and family. Investigating the mediating effect of emotional exhaustion, these authors examined the relationships between workplace violence, emotional exhaustion and patient safety, and hypothesised that nurses’ perceptions of the relationships between workplace violence would be mediated by nurses’ emotional exhaustion. Regression findings revealed that verbal abuse from patients and visitors significantly predicted emotional exhaustion. Further, lower perceptions of patient safety resulted from nurses who reported frequent occurrences of physical violence and high emotional exhaustion. Overall, workplace violence including verbal abuse from patients and their visitors affected the nurses’ emotional exhaustion, which in turn may negatively affect patient safety. Along with the aforementioned findings, the authors reported that incidents of verbal abuse from patients and families are rarely reported. Herein lies an area that could have been further discussed, specifically strategies to address workplace violence against nurses and/or healthcare workers.
Targeted interventions and specific strategies are needed to mitigate workplace violence now as researchers reported that emotional abuse, threat of physical assault and direct physical assaults occurred in various nursing specialties/disciplines and nursing roles (Havaei et al., 2020). First, acknowledgment, documentation and discussion of this potential crisis within the healthcare profession are critical in healthcare settings and beyond. Second, identification of workplace violence risk factors within the healthcare settings is important. Similarly, OSHA (2015b). suggests the following risk factors for workplace violence in various settings: employee’s perception that workplace violence is tolerated and reporting those incidents will have no effect; lack of training and policies to address workplace violence for staff; absence of a robust means for emergency communication; and lack of working with persons who have a history of violence and/or intoxication, just to name a few. Although, more simulation research is needed, a recent quasi-experimental study utilising simulation training to effectively manage workplace violence appears to be quite promising (Ming et al., 2019). Additionally, research on the impact of workplace violence and psychosocial support for nurses who may be traumatised from workplace violence is needed coupled with an infusion of human kindness within the healthcare setting, an ethos to be shared with patients, families and visitors. Further, a dedicated journal to address workplace violence and calls for abstract submissions is a step in the right direction.