An Analysis of Nursing and Workplace Violence: Prevention and Response

This report provides an overview of workplace violence in the nursing profession, highlighting it as a major occupational hazard in healthcare settings. It examines various contributing factors, including patient-related issues, environmental design, and legislative factors. The report contrasts OSHA regulations and the ANA position statement on workplace violence, offering insights into their differing approaches. It also outlines safety policies and protocols for preventing and responding to workplace violence, emphasizing the importance of comprehensive programs, legislative actions, staff training, and a culture of safety. The report concludes by stressing the significance of proactive measures and policy implementation to mitigate violence and improve employee safety, motivation, and retention in the healthcare environment. The report includes an author's note and references for further reading.

Running head: NURSING AND WORKPLACE VIOLENCE
Nursing and workplace violence
Name of the student:
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Author’s note

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Overview
Workplace violence is one of the major occupational issues in the health care
environment. Health care workers such as nurses and other care providers are at high risk of
experiencing workplace violence due to great deal of contact with public. Violence has been
experienced by nurses in several forms such as physical violence, verbal violence and sexual
harassment. It results in negative workplace environment and issues in quality of work too
(AnnMarie Papa, Jeanne Venella & CEN, 2013). In response to serious problem faced in health
care setting due to violence between patients and caregivers, this newsletters gives clear insight
to employees regarding the factors contributing to workplace balance and the OSHA regulation
and ANA position statement on preventing workplace violence. It also provides guidelines to
hospital employees to understand the protocols that they can follow to respond to workplace
violence.
Factors contributing to violence in health care setting:
` There are different source of violence in health care setting and in 80% of cases, patients
are the main source of violence. Apart from patients, coworkers, nursing students, customer,
family members of patient and other person also engage in physical violence. There might be
difference cause of violent behavior of patient. Patients come to health care setting suffering
from different illness. Some patients may have history of violence or some may be suffering
from psychiatric illness and mental disorder. There are other groups of patients who tend to show
irritation and violence due to the influence of drugs (Spector, Zhou & Che, 2014). Hence, in such
condition issues like poor quality of care, poor hygiene, medical errors or violation of privacy of
patients lead to physical or verbal abuse from patients.

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There are political causes of violence too which implies the role of health care provider
and health care organization in contributing to violence. The political factors in health care
setting includes presence of high quality infrastructure, arrangement for safety of patient, good
environmental design and development of effective communication protocols in health care
setting and active response to bullying incidents (Blackstock et al., 2015). However, when any of
these political factors are not adequately provided to health consumers, then this contribute to
risk of workplace violence related events. For example, poor environmental design might be a
concern for health care consumer and paying little attention to their complains might result in
physical or verbal abuse. Poor attention to addressing these issues also has an impact on turnover
intentions of nursing staff.
Inefficiency of staffs in carrying out their core responsibilities also results in long waiting
time and overcrowding in waiting rooms creating an environment workplace violence. In
additional, legislative factors like poor workplace policy, lack of safety protocols for patient and
guideline for reporting and responding to workplace violence issues leads to origin of disputes
and workplace violence. In such situation, implementing preventive measures to address
workplace violence issue is an immediate priority for health care provider. This is necessary
because it has a direct impact on job performance, quality of work, psychological demand and
control over task (Bordignon & Monteiro, 2016).
Comparison of OSHA regulation and ANA position statement on workplace violence
The Occupational Safety and Health Administration (OSHA) has provided the
Occupational Safety and Health Act which assure safe and healthy work environment for
workers by enforcement of relevant standards mentioned under the Act. The mission of OSHA is

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to protect employees from risk of serious hazards due to job related violence and in accordance
with the OSH Act, they have implemented guideline for preventing workplace violence for
health care workers and taking feedback from stakeholder to understand best practices to address
the issue. The OSHA is also involved in giving recommendation to eliminate workplace violence
by developing appropriate policies and procedures to eliminate violence in health care setting
(Workplace Violence - Enforcement | Occupational Safety and Health Administration, 2017). In
contrast to OSHA, the ANA position statement for incivility, bullying and workplace violence
states that the nursing professional will not tolerate violence of any kind from any source (New
ANA Position Statement: Incivility, Bullying, and Workplace Violence, 2017). .
The difference between OSHA regulation and ANA positional statement for workplace
violence is that OSHA regulation is directive in nature whereas the ANA statement is declarative
in nature. Hence, it implies that OSHA provides policies and procedures direction to health care
workers regarding the strategies needed to prevent workplace violence, however the ANA
statement is a professional statement indicating all registered nurse and employers to take the
shared responsibility to create a culture of respect and prevent bullying and workplace violence
issues. Hence, ANA give professional mandate to nurses and other staffs to adapt strategies to
mitigate violence, whereas OSHA regulation gives instruction to employers to implement
appropriate policies and procedures to resolve workplace violence.
Safety policies and protocols to prevent and respond against workplace violence
Some of the relevant safety policies and protocol that can help health care organization to
respond against workplace violence are as follows:

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 The OSHA has emphasized on establishing comprehensive workplace violence
prevention program by focusing five core elements. These includes management
commitment and employee participating in facilitation change in work culture, worksite
analysis and reevaluation of hazards, setting up processed for hazard prevention and
control, providing safety and health education to workers and keeping detailed record of
all workplace violence related incidents (Preventing Workplace Violence: A Road Map
for Healthcare Facilities, 2017).
 Apart from change in organizational cultures and staffs commitment to reduce violence in
health care setting, the ANA also recommends protecting violence victim by taking
legislative action against the offender. There is also support for imposing penalties for
those who engage in acts of violence against health care workers (AnnMarie Papa,
Jeanne Venella & CEN, 2013).
 Another important protocol for prevention of workplace violence is educating and
fulfilling training needs of staff to mitigate the factors contributing to violence. Specific
training for individual staffs or group enrollment may help to staffs to understand
different clinical scenarios and take the best action in such situation to prevent conflict.
The educational program can be tailored by health care provided address patient
population and their care needs. Readiness of staffs to learn and developing a culture of
safety is also critical to ensure that each patient is respected and feel safe in health care
setting (Hills et al. 2015).
Conclusion:
Workplace violence is a challenging issue in health care due to impact on performance,
motivation, safety and turnover in employees. To proactive takes steps to mitigate the issue and

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reduce rate of violence, the above mentioned protocols and implementation of policies by
individual health care setting would help to professionally respond to violence in workplace.

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Reference
AnnMarie Papa, D. N. P., Jeanne Venella, D. N. P., & CEN, C. (2013). Workplace violence in
healthcare: Strategies for advocacy. Online journal of issues in nursing, 18(1), 101.
Blackstock, S., Harlos, K., Macleod, M. L., & Hardy, C. L. (2015). The impact of organisational
factors on horizontal bullying and turnover intentions in the nursing workplace. Journal
of nursing management, 23(8), 1106-1114.
Bordignon, M., & Monteiro, M. I. (2016). Violence in the workplace in Nursing: consequences
overview. Revista brasileira de enfermagem, 69(5), 996-999.
Hills, D. J., Ross, H. M., Pich, J., Hill, A. T., Dalsbø, T. K., Riahi, S., ... & Martínez‐Jarreta, B.
(2015). Education and training for preventing and minimising workplace aggression
directed toward healthcare workers. The Cochrane Library.
New ANA Position Statement: Incivility, Bullying, and Workplace Violence.
(2017). Nursingworld.org. Retrieved 22 November 2017, from
http://www.nursingworld.org/HomepageCategory/NursingInsider/Archive-1/2015-NI/
Aug15-NI/New-ANA-Position-Statement-Incivility-Bullying-and-Workplace-
Violence.html
Preventing Workplace Violence: A Road Map for Healthcare Facilities. (2017). Retrieved 22
November 2017, from https://www.osha.gov/Publications/OSHA3827.pdf

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Spector, P. E., Zhou, Z. E., & Che, X. X. (2014). Nurse exposure to physical and nonphysical
violence, bullying, and sexual harassment: A quantitative review. International Journal
of Nursing Studies, 51(1), 72-84.
Workplace Violence - Enforcement | Occupational Safety and Health Administration.
(2017). Osha.gov. Retrieved 22 November 2017, from
https://www.osha.gov/SLTC/workplaceviolence/standards.html