American Nurses Association calls for 'zero tolerance' on hospital violence

Nurses increasingly are the targets of violence, so much so that many consider it such a natural part of the job and call reporting it a "waste of time." Now the American Nurses Association (ANA) has announced a zero-tolerance policy for violence or abusive behavior.


Individual incidents cause obvious harm--but when they accumulate, it can created a "culture of silence" and a perception that things will never improve within the hospital, according to the position statement.

In addition to the zero-tolerance policy, the statement establishes several other concrete positions and strategies to address the problem. Nurses and their employers must come together and create a "culture of respect" through collaboration, open communication and mutual support, for example.

Moreover, ANA calls on nurses and hospitals to create evidence-based strategies that curb bullying and workplace violence while improving outcomes. Hospitals must actively involve nurses in the development of violence prevention programs, clearly encourage respectful communication and, when developing programs and policies, make sure to analyze the workplace to tailor the plan to risks and factors specific to the hospital or unit.

Hospital executives must create a non-punitive environment so nurses don't fear penalties or retaliation for reporting abuse or violence.

Nurses, meanwhile, should understand their employers' violence or abuse policies or, in their absense, help develop them, according to ANA.

They should also develop their situational awareness, learning to look for red flags, such as unfamiliar people in academic or work areas. Moreover, they should learn to use built-in aspects of the hospital environment, such as locks and alarms, to their advantage in a high-risk situation, as in the case of a recent shooting at Boston's Brigham and Women's Hospital.

To learn more:
- read the position statement (.pdf)