Patterns Of Violence Against Nurses In The COVID-19 Pandemic Rise: Here’s What You Can Do About It

COVID-19 has disrupted our lives in many ways. The healthcare industry, particularly nursing, is hard-hit. As cases continue to rise, nurses place themselves at risk for exposure and burnout. But COVID-19 is raising alarms on another concern — increased violence against nurses.

History of violence against nurses

Violence against nurses is not a new discovery. The National Institute for Occupational Safety and Health defines workplace violence as physically and psychologically damaging actions in the workplace or on duty. In a recent article by Becker’s Hospital Review, the numbers are staggering:

• 76% of registered nurses report experiencing workplace violence, according to a 2014 study published in the Journal of Emergency Nursing.
• 54.2% of nurses experienced verbal abuse from patients, and 29.9% experienced physical violence.
• Almost 33% of nurses reported verbal abuse by visitors, and 3.5% reported physical abuse by visitors.
• 13% of nurses’ missed workdays are due to workplace violence, the organization found.
• In a study published by the Journal of Emergency Nursing, seventy-six percent of registered nurses reported experiencing workplace violence.

Rise of violence against nurse since COVID-19

As facilities place stricter restrictions on patients and visitors during this pandemic, healthcare workers are receiving the brunt of the violence. A recent BMJ blog post identified patterns of violence into groups: 

1. Violence from patients or family members. These attacks often start when nurses attempt to enforce COVID-19 restrictions and guidelines.
2. Aggression from the general public. In April, 22 nurses in New York found their tires slashed. An Oklahoma City nurse was attacked on her way to work. The suspect believed she exposed the community to COVID-19.

PW: What can we do to ensure the safety of work environments for nurses?

CC: National legislature is the first step in ensuring that we have safe work environments for nurses. It helps create a framework for comprehensive workplace violence programs in healthcare institutions.

PW: What can organizations do to support nurses with training, resources, and leadership to recognize and report threats and violence?

CC: Organizations need to assess their unique environment and what their needs are. Depending on their organizational needs, they need to come up with a comprehensive workplace violence plan that involves training that focuses on the needs of the organization.

Prevention training is vital because nurses and other providers need to understand how to prevent or de-escalate a person in crisis. Part of the organization’s plan should involve a non-retaliation policy that allows staff to report events. Leaders need a commitment to upholding a zero-tolerance to workplace violence.

PW: How can nurses de-escalate volatile situations?

CC: As nurses, we need to always be mindful of our environment. Our patients, visitors, and colleagues are always giving us verbal and non-verbal cues.

One way to de-escalate a situation is to truly listen to the person that is in crisis. Often, a person in crisis will be trying to communicate to you what they want, and we have to have the ability to listen. If a person in crisis asks you to leave the room and leave them alone, you should listen to them because they need some space to come down from their state of crisis.

At times, you might need to have someone else on the nursing team tag you out of the situation.
Sometimes the person trying to de-escalate the situation might not be successful, and they need another staff member to come by and take over the de-escalation process.

The most important tip to remember is that, as a nurse, we cannot take the volatile situation personally because then we also go into crisis with the other person, and that only escalates the situation.

PW: What signs should we look for?

CC: Signs can vary for different individuals, but some common ones to look for are:

• Abusive language
• Threats
• Threatening, nonverbal body language
• Any act of physical violence

Remember, we should focus on prevention. The moment we start noticing aggressive, non-verbal, and verbal cues, we have to begin escalating and reporting to someone in a leadership role. When we don’t report or wait too long to report, verbal violence can become physical, and that’s when true harm occurs.

PW: What impact does workplace violence have on nurses?

CC: Workplace violence can have many different impacts on nurses. A nurse can suffer physical harm that can differ in severity from case to case.
We also need to recognize the mental impact that comes along with workplace violence.
Some organizations offer different programs to care for victims, and our nurses should utilize them so they can recover from the event. It’s important for the organization to create an environment that is non-retaliative because a victim of workplace violence needs the support to overcome the event.

PW: How can nurses protect themselves against workplace violence?

CC: On a simple level, always keep the following in mind:

• Where is my exit?
• Don’t wear jewelry
• Don’t wear a lanyard
• Never turn your back to a person in crisis
• Always keep sharp objects away

On a more grand level, nurses need to become informed of their organization’s comprehensive workplace violence plan and how the organization plans to implement it. Know what resources your particular organization offers so that you are aware of all of the educational opportunities. You should also know who is the designated workplace violence expert in your organization. Take advantage if your organization offers any course that helps you with de-escalation techniques.

It’s also essential to know your state’s law regarding workplace violence. For example, California has a bill that outlines regulatory components of comprehensive workplace violence programs in the healthcare industry. On a national level, Congress passed Bill HR 1309 to help protect healthcare workers from workplace violence and is awaiting approval from the Senate.

PW: How can nurses advocate for safe workplaces?

CC: Make sure:

• There’s a plan in place in your organization for workplace violence
• To always report any act of violence that you are a victim of or in the presence of

The more we report, the more resources that will be allocated to keep our nursing staff safe. Currently, workplace violence is a hot topic across the country due to HR 1309. It will make organizations more transparent when reporting workplace violence and accountable for developing a prevention program.

PW: Is there a way to prevent violence against nurses?

CC: Proper training is key, but it comes at a cost. That cost is justified because it should be our employers’ duty to keep nurses. Providing appropriate training of all staff would lead to more favorable outcomes when trying to de-escalate a person in crisis. When you have a properly trained team, you’ll have a team that speaks the same de-escalation language and will know what role they play in de-escalating a potentially violent situation.

Want to contact Cat and discuss more? You can email her: catherine.cerda.npd@gmail.com

Portia Wofford is an award-winning nurse, writer, and advisor for nurse writers. After dedicating her nursing career to creating content and solutions for employers that affected patient outcomes, these days Portia strives to empower nurses to use their voices to start freelance writing businesses–while empowering health-related businesses to grow their communities through engaging content that connects and converts. Follow her on Instagram and Twitter for her latest.