At the height of the COVID-19 pandemic, considerable national attention was focused on the risks facing healthcare workers – not just the dangers of viral infection, but also stress, burnout, and other pressures that accompany their jobs.
Against that tense backdrop, actual violence in the healthcare workplace – which had already risen during the 2010s, per Bureau of Labor Statistics data showing that 12% of injuries sustained by registered nurses coming from violent acts – witnessed a rapid spike. During the period in question, the assault rate at hospitals spiked 23% in 2020, per a 2021 Association for Healthcare Safety and Security (IAHSS) study, then was followed by a 48% increase in 2021 reported in a 2022 National Nurses United survey.
Now, a recent Perceptyx survey of 1095 healthcare workers shows that violence remains high even as vaccines and other safety measures blunted the actual effects of COVID-19. More than nine out of ten survey respondents reported experiencing (or having been in close proximity to) violence from a patient or a patient’s caregiver in the past month. Three in four have encountered both verbal and physical assaults in the month and nearly half of workers needed to call for security or another coworker to assist.
The findings from this latest study have major implications for the workplace well-being and retention of healthcare workers. Of those surveyed, more than half said they didn’t have the staff to meet their workload. One-third reported that they were considering leaving their jobs in the next twelve months, 40% of those planning to leave the healthcare field entirely. Another recent study showed that even just being exposed to violence in the workplace had significant effects: nurses were two to four times more likely to report high levels of post-traumatic stress disorder (PTSD), anxiety, depression, and burnout.
Finding better ways to protect healthcare workers from the violence that has increasingly become a regular part of their jobs will be a crucial part of the retention and recruitment strategies for this embattled industry. Let’s take a look at the three levels where violence reduction strategies are being developed – or could be.
- At the legal and governmental level, legislative responses can impose reporting requirements or additional penalties. In the United States, the federal response to address workplace violence in health care settings is H.R. 1195 – Workplace Violence Prevention for Health Care and Social Service Workers Act. This act, passed by the House of Representatives in 2021 and supported by National Nurses United and the American Association of Critical-Care Nurses but not yet signed into law, requires employers to offer training, investigate acts of violence, and keep records about violent acts against employees. In the meantime, some states like Pennsylvania have already enacted their own legislation to make assaulting healthcare workers and technicians a felony.
- At the organizational level, policies can be adopted that will address violence in the context of other industry-wide challenges, such as a predicted shortage of 3.2 million healthcare workers by 2026. The Occupational Safety and Health Administration (OSHA) has published guidelines for best practices related to violence in the healthcare workplace. According to a recent security survey by the American Hospital Association (AHA), over 97% of hospital systems have workplace violence policies in place. Believing new federal legislation will cast too broad a net and impose burdensome administration regulations, the AHA has opposed H.R.1195. However, a recent systematic review of human resource management (HRM) practices at these healthcare organizations found that most “do not do enough to methodically mitigate and manage acts of violence in the workplace and its effects on nurses’ mental health” and should develop more and better policies specifically to this effect.
- At the employee listening and crowdsourcing level, organizations can bridge gaps in legislative and organizational policy-making by quickly surveying healthcare workers on the front lines to determine the policies that they believe will best address their needs. Legislative policy can sometimes be overboard and, while helpful, perhaps not applicable to all problems faced by all healthcare organizations. Organizational policymaking can be more tailored to specific circumstances, but it too suffers when implemented top-down and can be insufficient to meet the needs of the workers closest to the action, who might best know how to keep workers safe in their specific environment.
Legal protections and enforcement mechanisms are reactive measures. While these may be appreciated by those who are victims, in actuality, having legal protections is a way to address the issue after the fact, not prevent it ahead of time. And let’s be clear – it’s already against the law to assault someone, yet violence is still on the rise.
Organizational solutions may be both reactive – policies for dealing with violence when it occurs – and proactive, creating structure and an environment where violence is less likely to occur. Without the input of those in the direct line of fire, many important and often very simple solutions may end up overlooked. Without that listening and crowdsourcing level in place, which is used to collect direct feedback from registration staff to nurses to environmental services workers who interact with patients every day, employees may not feel heard and cared about – a lack of concern that also contributes to attrition.
By embracing a comprehensive employee listening strategy that combines the right listening methodologies for your healthcare organization, such as census surveys, exit surveys, and crowdsourcing programs, you can quickly hear actionable insights regarding the problem of workplace violence from those on the front lines. In doing so, you can remove many of the barriers that have prevented the implementation of right-sized anti-violence policies developed bottom-up, with the full input of workers faced most directly with the threat of violence. Without an employee listening strategy in place, many practical ideas for reform may never reach the C-suite.
A study of Perceptyx’ Healthcare Benchmark Database – which includes more than 1.36 million healthcare employees across 1,600 facilities – reveals actively listening and acting on employee feedback is critical to retaining and engaging talent. In a psychologically safe work environment, workers can openly voice their opinions, identify their mistakes, and ask for feedback without fear of negative consequences – critically important when dealing with hot-button issues like workplace violence.
Healthcare workers want to help make their organizations safer, and they have excellent suggestions for doing so. To understand how to retain employees who might otherwise wish to leave the industry to reduce their exposure to violence, you need to first ask for their input – and, more importantly, act on their insights with decisive action.
Perceptyx helps healthcare organizations create listening programs that facilitate retention and engagement. From crowdsourcing insights to developing always-on listening models, we provide organizations with crucial resources for limiting turnover and attrition. To learn more, schedule a demo today.