Addressing Workplace Violence in Health Care Settings
The archetype of the nurse as a healer brings with it an idealized picture of a capable and compassionate caregiver who provides empathic but skilled care to an appreciative patient. Although the nurse finds joy and meaning in caring for the sick and wounded, they are rational as well as intuitive, capable of detachment when necessary and reliant on empirically proven best practices to inform their actions. The patient in the archetype may be deeply troubled and even disturbed by their afflictions, but mostly, they are respectfully grateful, and rarely do we imagine them as resentful, confrontational, and combative in their interactions with nursing staff. It’s an emotionally resonant portrait—but is it true?
The unblinkered reality is that workplace violence is all too common in health care settings. According to the Bureau of Labor statistics, workers in health care settings are five times more likely to be targets of non-fatal assault than average workers in other fields. An American Nurses Association
(ANA) survey found that 43% of registered nurses have been verbally or physically threatened by a patient or a family member of a patient. Additionally, 24% have been physically assaulted by a patient or a family member of a patient while at work.
Anna Dermenchyan—senior clinical quality specialist, nurse, and workplace violence prevention expert—presents a candid and authoritative overview of the problem as well as an inspiring look at how nurses can confront the issue through constructive solutions.
Central to those solutions is a set of best practices that align with CPI’s Nonviolent Crisis Intervention®
training—understanding how challenging situations escalate, emphasizing prevention, implementing a team approach, and debriefing—each a critical tool in effectively combating workplace violence in the health care setting. Anna’s expertise makes this a must-listen interview for anybody working in health care, presenting both an in-depth exploration of best practices as well as excellent advice for proactively addressing the very real risks associated with workplace violence.
This interview also brings up a critical imperative to hospitals everywhere: that administrators cannot afford to wait until state laws are passed to do something about workplace violence against health care professionals. According to the ANA
, at this time only eight states require
employer-run workplace violence programs, and one of those states is limited to public employers only. Meanwhile, the daily risk of harm from one of the NIOSH-established four types of workplace violence nurses face remains statistically undeterred.
In her article, “Addressing Workplace Violence
,” Anna addresses the important benefits of violence prevention training, even in the face of uncertainty: “Sometimes there are no clear answers to what should be done in violent situations,” writes Anna. “However, having additional training in the areas of prevention policies and procedures will be instrumental in making effective decisions during high-risk situations.”
Anna’s overarching message to nurses and health care workers is that they can help change the conversation about workplace violence by getting involved through efforts like the ANA’s #EndNurseAbuse, by reporting abuse when it happens, and by developing and supporting zero-tolerance and prevention policies.
For a discussion about how a team approach can better manage workplace violence in healthcare, listen to CPI's podcast
interview the Deb Fabert and Joe Anderson of the Indiana University Health Center (February 2019).
Anna’s Session at the American Association of Critical Care Nurses (AACN) Conference
Our thanks to the AACN for facilitating our interview with Anna. Anna will present a session
, “Protecting Your Practice: Individual Strategies to Recognize and Prevent Workplace Violence,” at the AACN’s annual National Teaching Institute conference
, happening May 21-24 in Boston. The conference is sold out; the AACN urges you to join them at next year’s conference, happening May 19-23 in Orlando, Florida.
Anna Dermenchyan is a Senior Clinical Quality Specialist in the Department of Medicine at UCLA Health and PhD student at the UCLA School of Nursing. She started her nursing career in the Cardiothoracic ICU at the Ronald Reagan UCLA Medical Center where she cared for the transplant and surgical patient population for five years. In her current role, Anna leads, facilitates, and implements improvement initiatives in the areas of hospital readmissions, mortality reduction, and population health management. Her professional interests include leadership, health care ethics and policy, quality and patient safety, critical care, work environments, and global health. Her passion for the profession and networking skills led her to establish the first hospital-based AACN Chapter at UCLA in 2010 and she currently serves as the Program Chair.