You are probably wondering which is the first, and as some of you may have guessed, it is law enforcement. However, we could argue that healthcare experiences the most cases of workplace violence, as the violence that law enforcement officers face from apprehending criminals does not really qualify. Enforcing the law inherently involves antagonism and physical confrontations but healthcare is intrinsically the opposite. It is about healing people, not getting hurt.
It is well known within the field that violence is ubiquitous. Trauma units are the final stop in crime activity. Drug seeking behavior has increased dramatically, the waiting rooms are filled with anxious and desperate family members experiencing emotional drama on a daily basis. Doctors, nurses and support staff have all encountered verbal abuse, with high numbers experiencing physical violence as well and it is not all related to the medical issue. From a recent visit to the emergency room, I can personally attest to the sticker shock faced at payment checkout.
A recent study in The New England Journal of Medicine, Workplace Violence against Health Care Workers in the United States, revealed some interesting findings. 41% of the shootings occurred outside, probably in the parking lot, with the next most common location being the emergency department. When the motive was able to be determined, 27% involved an act of revenge. Imagine a shootout between gang members where someone comes in the hospital to finish a job.
But related to our recent post, non-malicious, intentional injury (suicide) was a close second. 21% of the shootings were related to suicide and 14% were mercy killings, typically committed by family members. As a subcategory, mental health facilities are identified as the most dangerous, with the vast majority of workers (70%) having experienced violence while at work, an astounding 69 times more dangerous when compared to other industries.
Even then, the studies may not be capturing all of the cases as these incidences are notoriously under-reported. One factor for this is that healthcare workers are generally more forgiving and focused on helping their patients as opposed to reporting them. In our own study of domestic violence in the workplace, we found similar higher rates in the healthcare industry which may have the same basis. The people attracted to this industry are more likely to be the caregivers who put their own safety and needs behind others.
The solution to this issue cannot be a simple one step fix. It must be a combination of environmental controls, staff training and changes to procedures that will limit worker vulnerabilities. Fundamentally, a shift must occur within the culture that the abuse health care workers face is not “part of the job.”