The pervasive issue of abuse toward nurses has significant implications in healthcare. For individual nurses, it can mean the end of their job or career. For healthcare organizations, it exacerbates the ongoing nurse staffing shortage.
Here we delve into how nurse abuse adversely affects retention and recruitment in healthcare. Let’s explore strategies to create a safer, more supportive environment for the nursing workforce.
The scope of nurse abuse
For the first time, our Nurse.com 2024 Nurse Salary and Work-Life Report asked nurses about their experiences with workplace violence. Over half (64%) of nurses reported having been subjected to verbal abuse, and 23% reported having been physically assaulted by a patient or family member.
Nurses may face physical threats from patients who are confused, agitated, or under the influence of substances. This form of abuse can lead to injuries, long-term physical harm, and psychological trauma.
Verbal abuse includes yelling, swearing, and other forms of disrespectful communication. Emotional abuse can be more subtle, involving manipulation, intimidation, or persistent negative remarks that undermine a nurse’s confidence and emotional well-being.
Sexual harassment encompasses unwanted sexual advances, comments, or behaviors that create an intimidating or offensive work atmosphere. Nurses are vulnerable to such harassment from patients, visitors, and sometimes coworkers, leading to significant emotional and psychological distress.
“Horizontal” violence, or workplace bullying, includes behaviors such as gossiping, exclusion, and undermining professional competence. This form of abuse disrupts team cohesion and creates a toxic work environment, making it difficult for nurses to perform their duties effectively.
The impact on recruitment
News stories, social media accounts, and word-of-mouth reports about abusive environments deter potential nursing candidates. Here are some ways that nurse abuse negatively impacts nurse recruitment:
- When aspiring nurses hear about nurse abuse, some reconsider entering the profession. This negative perception reduces the number of applicants to nursing programs and job vacancies.
- Healthcare organizations with a reputation for poor workplace culture and high levels of abuse will struggle to attract nurses. If a facility is known for failing to support nurses, it’s going to have an uphill battle recruiting qualified nurses. Recruitment efforts, such as job fairs, campus visits, and digital advertising campaigns, are likely to fail.
- Talented nursing candidates, especially those with multiple job offers, will choose employers who prioritize safety. Prospective nurses seek workplaces where they feel safe, respected, and supported. In competitive job markets, healthcare facilities are vying for the best nursing talent. Institutions with poor reputations due to nurse abuse find themselves at a distinct disadvantage.
- Nurse abuse hinders efforts to diversify the nursing workforce. Diverse candidates, including those with different cultural backgrounds or those who are part of the LGBTQ+ community, may feel particularly vulnerable in environments where abuse is prevalent. This can lead to a homogenous nursing workforce, as potential recruits from diverse backgrounds opt for other professions, or for institutions with better reputations for inclusivity and respect for nursing staff. A lack of diversity can negatively impact patient care, as a diverse nursing staff is better equipped to meet the varied cultural and personal needs of patients.
- The financial implications of nurse abuse on recruitment are substantial. Difficulty in attracting nurse candidates means that organizations must invest more in recruitment efforts. That may entail hiring recruiters, attending job fairs, and offering sign-on bonuses.
The impact on retention
Research shows that nurse abuse contributes to high turnover rates. Nurses who experience abuse are more likely to leave their jobs. Some nurses move to different healthcare facilities, while others leave the profession altogether. In fact, 13% of nurses (across all license types) ranked lowering the risk to their mental health as a top reason for leaving their last nursing role, according to the Nurse.com report. Here are some ways nurse abuse affects retention:
- The constant cycle of hiring and training new staff places a significant financial burden on healthcare organizations. It also disrupts continuity of care for patients.
- Repeated exposure to abuse can lead to burnout, characterized by emotional exhaustion and a reduced sense of personal accomplishment. Burnout significantly decreases job satisfaction, making nurses more likely to resign.
- Nurses subjected to abuse often experience stress, anxiety, or depression. Physical consequences, such as injuries from assaults, can lead to nurses taking extended leave or permanent departure from the profession.
- Even when new nurses are successfully recruited, exposure to abuse can result in early career burnout. High levels of stress and dissatisfaction among nurses due to abuse lead to high turnover rates.
- The cost of training new nurses, only for them to leave shortly after being hired due to abusive work environments, represents a significant financial burden. Those resources could be better spent on improving working conditions for nurses.
- When experienced nurses leave the profession or change jobs frequently, it creates a cycle of instability. The constant churn of nursing staff signals potential recruits that the nursing profession may not offer the stability and job satisfaction they’re seeking. In this way, nurse abuse can undo even the most effective recruitment efforts. This contributes to the ongoing shortage of experienced nursing staff.
Strategies to mitigate nurse abuse
Here are some strategies healthcare organizations are using to mitigate nurse abuse:
- Enforcing zero-tolerance policies, with clear guidelines on unacceptable behaviors, and the consequences for violating these policies
- Providing nurses with training in areas like conflict resolution, de-escalation techniques, and self-defense
- Establishing support systems for nurses, such as counseling or peer support
- Offering nurses with access to mental health resources and opportunities to debrief
- Creating a positive work culture for nurses, which promotes respectful behavior and open communication
- Investing in security measures, such as surveillance cameras, security guards (especially in high-risk areas, including emergency departments and psychiatric units), and wearable panic buttons
- Regularly surveying nurses about their experiences with workplace violence
- Encouraging nurses to report abuse, including anonymous options, to ensure all incidents are documented and addressed appropriately
The deeper impact
The consequences of nurse abuse are far-reaching, from increasing turnover rates to making it difficult to attract new talent. To attract and retain a skilled, diverse nursing workforce, healthcare organizations must create safer, more supportive environments.
By doing so, they enhance the well-being of their current nursing staff. It also ensures a steady pipeline of new recruits ready to provide high-quality patient care. Investing in the safety of nurses is not only a moral imperative, but also a strategic necessity for the sustainability of the healthcare system.
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