Keeping nurses safe is not an easy feat and the financial statistics that go along with nurse safety initiatives prove how much of an issue this is becoming for the healthcare industry.
Those working in healthcare might know all too well what nurse Trish Powers experienced, when a 350-pound patient became combative as he woke up from anesthesia. “He got a hold of my arm. It took three people to get him off of me,” says Powers. “It’s not like I reported that or anything. It’s an accepted norm.”
Abuse that nurses face should not be an accepted norm. Nurses make up the largest part of the healthcare industry in the United States. There are 3.9 million registered nurses (RNs), 270,000 nurse practitioners (NPs), 724,500 licensed practical nurses and licensed vocational nurses (LPNs and LVNs respectively), and 4 million home health aides-- nearly all of them have experienced some form of verbal or physical abuse. The Occupational Safety and Health Administration (OSHA) reports that workplace violence is four times more common in healthcare that in the private industry.
Without any forms of protections in place for nurses, healthcare organizations can find themselves at a $4 million loss.
Why are patients violent?
Data on healthcare workplace violence is often hard to find since many do not report incidents. There’s a notion that dealing with unruly patients is just part of a nurse’s job. “We always feel discouraged from reporting it,” Bonnie Castillo, a registered nurse told The Atlantic. Last month, the Joint Commission on Accreditation of Healthcare Organizations released a report encouraging healthcare workers and organizations to more reliably report incidents of workplace violence, including verbal abuse, which the Joint commission said is too often written off as just “part of the job.”
A report published in the Journal of Emergency Nursing found that patients with dementia or Alzheimer’s and patients on drugs were the most likely to hurt nurses. Another report found that healthcare workers are four times more likely to be victimized than any other industry.
Alan butler, president of the International Association for Healthcare Security and Safety (IAHSS) says that the violence “initiates from security-sensitive areas, like the emergency department or the behavioral unit, but violence often ends up in other areas of the hospital, such as a medical surgical or intensive care unit.”
Patient violence risk factors are everywhere. From long patient wait time or crowding in clinical environments, nurses have restricted or no access to emergency communication (such as call buttons) and even just the time of day can trigger a verbal or physical patient assault on a nurse.
How far does the violence go?
A survey conducted by the Public Institution Health Center of Sarajevo Canton in 2017 found that 90.3% of respondents reported some form of workplace violence during their professional life. Nearly half of nurse respondents had faced two forms of workplace violence in their career. The most frequent forms of violence range from patients was verbal, rude behavior, to indirect physical violence, slamming doors, throwing objects, banging on the table, to stalking, and assaults.
JCAHO has 68 documented instances of homicide, rape, or assault of hospital workers since 2010, but estimates the actual number is much higher.
The causes of workplace violence is starting to become a factor in hiring and retaining nursing personnel. Replacing a nurse who leaves can cost anywhere between $22,000 and $64,000 depending on experience. Hospitals are losing between $300,000 and $4 million each year recruiting, hiring, retaining, and training each nurse.
If any of the nurses who are victim to workplace violence hold their healthcare organization liable, the organization can face penalties starting at $13,260 per violation and increasing to $132,598 for willful and repeat violations.
The average out-of-court settlement for workplace violence is about $500,000. Negligent lawsuits average about $2 million. The average jury award is approximately $3 million.
- The cost for hospitals to provide uncompensated or insufficiently compensated care and treatment to victims-- $850 million.
- Absenteeism related to workplace violence incidents costs hospitals $53.7 million per year.
- Disability annually cost $90.7 million.
Without proper protections in place for nursing staff everywhere, healthcare organizations not only garner a bad reputation but also find themselves losing millions of dollars on preventable and actionable incidents.
Read more about the violence nurses faces and solutions that can be implemented.