Reporting violence in the workplace—how and why to follow up

Shutterstock

As far as unpredictable settings go, hospitals sit pretty high up on the list.

While most nurses live for the miracles and prepare themselves for the tragedies, violence in the workplace is generally a bit more “left field.” And when you’re both caretaker and victim, the proper method of responding isn’t always clear.

Which is why you may not be shocked to read the following:

According to a recent article exploring violence within the healthcare sector, an Auditor-General’s report found that “doctors and nurses faced unacceptable, and preventable, risks but staff were reluctant to report attacks because the process was cumbersome and they weren’t confident it would make any difference.”

As for the violent attacks on healthcare workers that were reported, the system of categorization under which they were filed appeared to dismiss the severity of the incidents. “Cases that were classed as ‘mild,’ ‘near miss’ or ‘no harm’ included an attempted strangulation, a worker being punched, and sexually inappropriate conduct.” Also highlighted? An incident in which a pregnant nurse was kicked in the stomach, subsequently categorized as “minor.”

Not surprisingly, the report ultimately found that there were “systemic failures across the health sector when it came to collecting and analyzing data on violence against healthcare workers.”

Among these factors—under-reporting, and on a major scale. But why? The article highlights several factors:

• a complex and time-consuming complaint process
• fear of reprimand
• an assumption that management would not act
• the belief that violence is simply something to be expected—a “part of the job”
• a reluctance to report victims who are aren’t necessarily “at the wheel,” such as patients suffering from dementia or substance abuse

The conclusion? It’s absolutely essential for hospital administrators to encourage and support reporting, however sensitive the situation, in order to better shape the training, policies and procedures currently in place. To combat, in other words, “the normalization of any kind of occupational violence.”

Okay, so how does a nurse go about reporting an incident?

Should physical violence occur, your supervisor and/or the facility’s security service should be your first point of contact (although severe cases may require the attention of your local police).

The Massachusetts Nursing Association offers the following tips to ensure an efficient report:

• Report all violent incidents (past or impending). That includes incidents in which the victim is either yourself or your patient. Likewise, do so regardless of whether or not an injury occurred.
• All reports should be verbal as well as written.
• If the incident is severe enough to warrant a police report, don’t wait. File a report immediately.
• When filing a report with local police, it’s best (if possible) to have a supervisor or co-worker who witnessed the event accompany you.
• If a patient is demonstrating violent behavior, make sure this is reflected in their medical records. This is the most crucial piece of legal documentation—so don’t overlook it. 
• If you sustained any injuries, seek medical help. Again, document your condition, both mental and physical.
• Finally, if you sustain an injury, be sure to review the hospital’s policy regarding treatment and any relevant work restrictions.

Of course, the best-case scenario is a hospital that has policies in place to protect employee-victims from reprisal. However, because the worst-case scenario is never really outside the realm of possibility, it’s important to respond quickly, efficiently and thoroughly using the tips provided above.