The Unthinkable: Violence in Healthcare from Bullying to an Active Shooter

The healthcare environment creates a major challenge in the prevention and intervention of violence. The rate of injuries and illness from violence in the healthcare industry is more than three times greater than violence in all private industries. The COVID pandemic has caused an increase in violence against nurses and physicians. Healthcare organizations include hospitals, outpatient clinics, medical office clinics, home health care, home-based hospice, long-term care/memory care, paramedic and emergency medical services, mobile clinics, drug treatment programs, and ancillary healthcare organizations. What makes violence in healthcare unique is that it carries negative ramifications for quality patient care.

In the U.S. some states, such as California, have passed legislation specifically addressing violence in healthcare. There are other federal and state laws that require the employer to address the hazards of workplace violence and laws that protect the victims of workplace violence.

OSHA identifies healthcare as one of three “high-risk” industries for violence and has written a Guidance document specifically outlining steps healthcare should take to combat the risk.

Violence in healthcare is perpetrated not only by patients, their families, and visitors, but as well among the health professionals themselves. It may include a patient admitted to the ER high on drugs and wielding a knife. Or, it may be an enraged physician in the operating room flinging a scalpel at a nurse. And, the violence may be one nurse bullying another nurse – depending on how the word “violence” is actually defined.

Learning Objectives

• To define workplace violence
• To provide examples of workplace violence in healthcare
• To discuss the relevant laws that address workplace violence
• To state the impact  and consequences of violence to the healthcare victims, the organization, and patient care
• To examine the causes of healthcare violence
• To discuss a violence prevention program to ensure patients, families, visitors, and staff are safe
• To outline the roles and responsibilities of the organization’s stakeholders
• To explain how to help the workplace and workers recover following a violent episode.