News in Nursing

Congress Introduces Bill to Protect Health Care Workers from Violence

Congress has recently introduced a bill to protect healthcare workers from incidents of violence.

Congress Introduces Bill to Protect Health Care Workers from Violence

It's surprising that those make their living helping people are at a higher rate of on-the-job-violence than prison guards or even police officers. Statistics from 2016 state that 70% of healthcare workers were affected by violence, out of all professions in the United States. In fact, workers who take care of patients directly are 12 times likely to experience violence than other professions. Nurses, who are on the frontlines, often deal with the most injuries, and more often than no, they deal with their injuries without telling their supervisors. 

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Some employers view violence as a part of the job. They expect nurses to shrug off abuse and keep working. There have even been incidents when health care workers have called the police for protection and been punished by their employers.

There are no federal laws that to protect healthcare workers. Some states have passed laws that help healthcare workers when subjected to violence, but not every state has these laws. In California, they passed the most comprehensive plan to protect workers in the country, and theirs is a great model for other states to follow. 

On November 16, 2018, the House Democrats have put forth the Workplace Violence Prevention for Health Care and Social Service Workers Act, H.R. 7141. This act addresses violence in the workplace for health care workers and provides them with protection. The law includes guidelines from the Occupational Safety and Health Administration Act or OSHA into binding laws.

“We expect health care and social service employees to care for us in our times of need, but we know that each year, these men and women are faced with rising rates of violence, often from patients and their families,” said Joe Courtney (CT-02). “This legislation compels OSHA to do what employees, safety experts, and Members of Congress have been calling for years – create an enforceable standard to ensure that employers are taking these risks seriously and creating safe workplaces that their employees deserve.” 

Some highlights from the bill include:

  • Training for staff on how to deal with violent patients.
  • Hospitals will be required to improve security, including hiring more security guards and adding surveillance cameras.
  • Employees who call 911 are protected against professional retaliation.
  • Employers are required to follow-up and investigate incidents of violence.
  • Hospitals and medical facilities are needed to create a safety plan. A protocol must be in place to help workers when patients become violent.

A registered nurse in New Jersey, Judy Danelle, said about the bill, “Recent patient violence against staff at my hospital has led to nurses with broken jaws, open facial wounds, back injuries requiring surgery, and injuries from a chair being smashed over a nurse’s head. Injuries from combative patients shouldn’t just be part of the job. Health care workers need strong protections so that they can provide quality patient care without fear of violence and injury.”

Hopefully, this will be a bipartisan bill and go through the process quickly.

Violence in Health Care

Health care workers are at high risk of violence all over the world. About  35% of all health workers suffer physical abuse in their careers. Many are threatened to vocal aggression. Patients and their visitors commit most of the violence.

Violence is not acceptable. Not only does it have a negative impact on the psychological and physical well-being of healthcare staff, but it also affects job performance. Violence compromises the quality of care and puts health care workers at risk. This violence is also an immense financial burden in the health care sector.

There have been interventions to prevent violence against health care workers in nonemergency settings. These include better strategies to manage violent patients and high-risk visitors. Interventions for emergency settings focus on ensuring the physical security of the facilities and staff.

An example of workplace violence took place last December at 2:00 a.m. in the intensive-care unitl. Alysha Shin’s patient attacked her. Shin is a neuroscience nurse who was monitoring the patient and checking her vitals. She came with a sitter or an aide who helps care for intensive care patients.

The sitter was called away to attend to another patient, and later that night Shin’s patient grew agitated. She twisted in her restraints, kicked Shin in the face and punched her. Then, in a fit of violence she ripped away from her restraints.

Shin yelled for help, and it took a nurses’ aide, four nurses, and other staff to maneuver the patient into a chair. During the attempt to get the patient into a chair, she kicked Shin in the chest and stomach. Shin needed to take the next two nights off to heal from the attack.

Just one example of the violence nurses and other healthcare workers have to endure. Violence in health care settings has been rising steadily in recent years. Violence has taken a toll on the nation’s 15 million health care workers. It has prompted executives, providers and policymakers to act.

Hospitals have tried technologies and launched awareness programs. Many states have initiated laws in health care workplaces to create anti-violence procedures. Unions are pushing for minimum nurse-to-patient ratios.

Why violence happens in health care is due to many factors that defy easy solutions. Nurses, aids and other caregivers are often shouted at, hit, kicked, shoved, and bitten. Most of the time patients are the abusers. There are also times when abuse comes from visitors or other staff.

In a violent and disastrous example, a cardiovascular surgeon at Brigham and Women’s Hospital in Boston was shot and killed by the son of a patient.

Violent threats happen to physicians, nurses, healthcare staff, patients and visitors. It also increases health care costs and undermines the quality of care and patient outcomes. Trying to find a remedy has frustrated providers and advocates.

We've been working on this for decades,” said Bonnie Castillo, a registered nurse, and director of health and safety for the California Nurses Association-National Nurses United. “You can't predict exactly when they're going to happen, but you know that they are going to happen.”

Will Joe Courtney’s legislation help? If it is a law that OSHA must instigate and investigate violence in health care, something might happen. Maybe if more nurses are hired, and the nurse to patient ratios will be limited and violence will slow down. Violence in health care needs to be curtailed so care levels will rise.