Workplace violence in healthcare: Underreported and often ignored

Workplace violence is rampant in healthcare but several factors make the problem difficult to assess and solve, according to a new article in the New England Journal of Medicine.

"Healthcare workplace violence is an underreported, ubiquitous and persistent problem that has been tolerated and largely ignored," writes James Phillips, M.D., of Harvard Medical School and the Department of Emergency Medicine, Beth Israel Deaconess Medical Center in Boston.

Phillips said the tragic shooting death of a surgeon at Brigham and Women's Hospital in Boston last year spurred widespread concern throughout the healthcare industry. However, he wrote, follow-up reports failed to address the extent of workplace violence in healthcare or offer realistic solutions.

"Workplace violence with nurses, physicians and other healthcare workers is a much bigger problem than the general public knows," Phillips told Medscape Medical News. "Healthcare providers also seem to be unaware of the extent of the violence."

But based on his research, Phillips said the problem is getting worse and healthcare workers are approximately four times as likely to miss work because of violence than from other injuries. Although killings are rare, verbal and physical attacks are common.

Other startling statistics:

  • Almost 75 percent of all workplace assaults between 2011 and 2013 happened in healthcare settings

  • 80 percent of emergency medical workers will experience physical violence during their careers but less than half will report the incidents to police

  • Thirty-nine percent of nurses reported verbal assaults each year and 13 percent report physical abuse

  • 70 percent of staff members in mental health settings are physically assaulted each year

"One reason healthcare providers are reluctant to report these is that we have compassion for our patients, and we don't want to treat patients like they're criminals or the enemy," Phillips told Reuters. "So we probably make excuses when we shouldn't, and we overlook patients who are intoxicated or on drugs, and other patients who have altered mental status because of chronic dementia or acute delirium. They are already vulnerable, and we don't want to treat them as if they are criminals."

Possible solutions, he told the news outlet, include a tough response to verbal assaults, changes in law to make a physical attack on a healthcare worker a felony and flagging incidents of violence in a patient's chart. 

To learn more:
- read the NEJM review article
- here's the Medscape coverage
- check out the Reuters article

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