Over half (64%) of nurses across all license types shared they have been subjected to verbal abuse by a patient or family member, according to the Nurse.com 2024 Nurse Salary and Work-Life Report.
Workplace violence in healthcare settings continues to be a concern, particularly for nurses who are at the front of patient care. This violence can take many forms, including physical assaults, verbal abuse, and threatening behaviors — and it has far-reaching effects on the mental health and well-being of nurses.
Understanding the impact of workplace violence in nursing is essential for developing strategies to mitigate these effects and create a safer, more supportive work environment.
Understanding workplace violence in nursing
Workplace violence in nursing and other healthcare settings can be perpetrated by patients, visitors, colleagues, or even supervisors. It includes any act of aggression, whether physical or verbal, that occurs in a work environment.
According to the Occupational Safety and Health Administration (OSHA), nurses and other healthcare professionals are at a higher risk of workplace violence, and nurses face a higher likelihood of experiencing such incidents due to their close and frequent interactions with patients. In the Nurse.com report, 12% of nurses revealed their organizations had weekly instances of workplace violence, while 10% reported monthly occurrences.
Types of workplace violence
- Physical violence: This includes hitting, kicking, pushing, or any form of physical assault.
- Verbal abuse: Verbal abuse can range from shouting and swearing to threats and derogatory remarks. It can be just as damaging as physical violence, leaving lasting emotional scars.
- Sexual harassment: Unwanted sexual advances, inappropriate comments, or gestures constitute sexual harassment and can create a hostile work environment.
- Bullying: This can involve persistent criticism, humiliation, or undermining of a nurse's work by colleagues or supervisors, leading to a toxic workplace culture. The Nurse.com report found that 34% of nurses across all license types said they experienced intimidation by a colleague.
How workplace violence in nursing affects mental health
The mental health consequences of workplace violence in nursing are profound and multifaceted. They can lead to a range of psychological issues, including:
- Stress and anxiety: Experiencing or witnessing violence can cause significant stress and anxiety. Nurses may constantly feel on edge, fearing potential future incidents.
- Post-traumatic stress disorder (PTSD): Repeated exposure to violent events can lead to PTSD, characterized by flashbacks, nightmares, and severe anxiety.
- Depression: The emotional toll of workplace violence can lead to feelings of despair, sadness, and depression, affecting both personal and professional life.
- Burnout: Chronic exposure to violence can result in burnout, a state of physical, emotional, and mental exhaustion. This can lead to decreased job satisfaction, reduced performance, and an increased likelihood of leaving the profession.
- Decreased self-esteem: Verbal abuse and bullying can erode a nurse's self-esteem and self-worth, leading to a lack of confidence in their professional abilities.
The ripple effect on patient care
The impact of workplace violence in nursing on a nurse’s mental health extends beyond the individual to affect the overall quality of patient care. Nurses who are stressed, anxious, or burned out may be less able to provide compassionate, high-quality care. This can lead to:
- Increased errors: Mental fatigue and stress can impair cognitive functions, leading to mistakes in tasks like medication administration or documentation.
- Decreased patient satisfaction: Nurses under duress may struggle to communicate effectively and provide the emotional support patients need, leading to lower patient satisfaction scores.
- Higher turnover rates: Nurses experiencing workplace violence are more likely to leave their jobs, leading to staffing shortages and increased workloads for remaining staff, which can perpetuate a cycle of stress and burnout. In fact, 13% of nurses in our report said the reason for leaving their last position was to lower the risk to their mental health.
6 strategies for addressing workplace violence
Addressing workplace violence in nursing requires an approach that involves individuals, organizations, and regulatory bodies. Key strategies include:
- Education and training: Providing nurses with training on how to de-escalate potentially violent situations, recognize early warning signs, and protect themselves is crucial. This training should be mandatory and regularly updated.
- Reporting and support systems: Establishing clear reporting procedures for incidents of workplace violence and ensuring that nurses feel safe and supported when reporting these events is essential. Support systems, including counseling and peer support groups, can help nurses cope with the aftermath of violence.
- Zero-tolerance policies: Healthcare institutions should implement and enforce zero-tolerance policies for workplace violence. This includes clear consequences for perpetrators and a commitment to protecting staff from harm.
- Environmental design: Modifying the physical environment to enhance safety can help prevent violence. This includes secure work areas, adequate lighting, surveillance systems, and alarm systems.
- Leadership and work culture: Leadership plays a critical role in shaping a culture of safety and respect. Leaders should model respectful behavior, address incidents of violence promptly, and foster a culture where safety is prioritized.
- Advocacy and legislation: Advocating for stronger regulations and laws to protect healthcare workers from violence is essential. This includes lobbying for stricter penalties for perpetrators and better protective measures for staff.
Workplace violence in nursing poses a significant threat to the mental health and well-being of nurses. The impact is far-reaching, affecting not only the individuals involved but also the quality of patient care and the overall healthcare environment.
Addressing this issue requires a concerted effort from healthcare organizations, nurse leaders, regulatory bodies, and nurses themselves. By fostering a culture of safety and providing adequate support, there can be a healthier, more supportive environment for nurses, ultimately leading to better patient outcomes and a stronger healthcare system.
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