Hospital Violence is on the Rise

Liz Carey

Chicago, IL (WorkersCompensation.com) – Hospital workers say the level of violence directed toward nurses and doctors is on the rise.

In early May, employees at Chicago’s Mount Sinai Hospital described their workplace as a “war zone” to the Chicago Tribune. With gang violence contributing to an increased patient load, hospital employees face increased levels of physical and verbal assault.

“We see so much sadness, we work with good people, our Sinai family, and we have many patients who are, well, patient,” one Mount Sinai nurse told the Chicago Tribune. “But there’s the other side. Every night nurses are verbally abused, physically threatened, spit on. It’s a constant barrage. It can get scary. They say ‘I’ll get you after work.’”

The Tribune did not name the nurse so she could speak freely without fear of reprisal.

According to the US Bureau of Labor Statistics, the rate of hospital injuries intentionally injured on the job is higher than any other private industry. In 2015, there were 8.5 cases of injury per 100,000 full-time hospital workers. The national average for all private industries was 1.7 cases per 100,000 full-time employees.

And according to Occupational Safety and Health Administration (OSHA), 70 to 74 percent of all workplace assaults between 2011 and 2013 were in healthcare settings.

OSHA estimated in a 2012 study that total injuries in healthcare settings accounted for a total annual expense of $2 billion in the healthcare industry. The average hospital pays $0.78 in workers’ compensation losses for every $100 of payroll. Violence against nurses and nurses’ assistants accounted for 9 percent of the total injuries at hospitals during the study’s time period.

Nurses say they’re the ones on the front lines of the battlefield between patients and healthcare workers because they are the ones with the most contact with patients, and their families, during emotionally charged moments. Troubling diagnoses, long emergency room wait times or sometimes just general dislike of the healthcare and insurance system contribute to hostility toward nurses, experts say.

“Just going to work is a high-risk endeavor,” Lisa Wolf, a registered nurse and director at the Institute for Emergency Nursing Research at the Emergency Nurses Association told the Tribune. “You’re going to work and people in some way (are) feeling like they can kill you.”

Jeff Solheim, Emergency Nurses Association president, told WorkersCompensation.com that their study in 2011 showed that more than half of all emergency nurses experienced physical violence or abuse from a patient of visitor in the preceding week.

“Violence in the hospital is a major problem for healthcare providers. We experience physical and verbal attacks on a daily basis in the emergency department from patients and visitors,” he said. “A 2011 study conducted by the Emergency Nurses Association found that 54.5 percent out of 6,504 emergency nurses experienced physical violence and/or abuse from a patient or visitor during the past week. Unfortunately, the rate of workplace violence in the emergency department is likely much higher as many incidents are unreported as a result of the perception that assaults are ‘part of the job.’”

It happens across the country, in towns large and small, he said.

“We don’t currently have research regarding the impact of workplace violence regionally,” he said. “While at our recent Day on the Hill event, I asked 167 nurses to raise their hand if they have been a victim of violence in the workplace. Nearly everyone in the picture had their hand raised, and that group included members from 44 different states and communities of every size.

And the range of injuries varies widely, he said.

“The majority of injuries will be soft tissue injuries from being slapped, punched, pushed against objects or struck by objects thrown as missiles,” he said. “At times, the injuries can be more serious. Orthopedic injuries like sprains, strains and even fractures occur when nurses are struck by heavy objects like intravenous poles or the nurses’ limbs are grabbed and pulled or twisted. In rare cases, the injuries can be life-threatening or even result in death. Nurses have been stabbed or been hit over the head with heavy objects resulting in severe head injuries.”

Injuries aren’t limited to purely physical injuries, he said.

“One type of injury that is often overlooked is communicable diseases. Many of our patients have contagious diseases,” he said. “These patients will spit on nurses and I have had patients throw urine from a urinal on a nurse or intentionally splatter their blood on a nurse, exposing that nurse to the same disease the patient has.”

States are beginning to recognize the problem. California recently enacted legislation that addresses the reporting of violent acts, staff training and correcting any violence hazards. And in Alaska, the state House of Representatives passed the “Crimes Against Healthcare Workers” bill that would make willful assaults on medical professionals in the healthcare setting a felony. The bill is now in the Senate Rules Committee in that state.

Solheim said it is a felony to assault an emergency nurse in 32 states. But because assault is often considered “part of the job,” he said, assaults are likely to be underreported.

And, according to OSHA’s 2012 study, nearly one quarter of the nurses and nursing assistants used sick time, or changed shifts, in order to recover from an unreported injury, instead of filing a workers’ compensation claim for the injury.

The attitude of assault as part of the job may be sending nurses for greener, and less abusive, pastures, Solheim said, some, not by choice.

“From a personal standpoint, I know of at least five nurses in my career that were injured by a violent episode whose injuries were so severe they never returned to work,” he said. “I also know of several nurses that worked in my department when I was a department director who chose to leave the emergency department to work in a different area of nursing they felt provided less risk in regards to violence.”