Addressing Violence in the Workplace: A Nurse’s Perspective

• The staggering figures of violence in the workplace continue to increase. 
• The Workplace Violence Prevention for Health Care and Social Service Workers (SAFE) Act has recently been reintroduced. 
• If approved and signed into law, the measure would bring added protections for workers and stiffer penalties for people who knowingly inflict violence on healthcare and social service employees. 

Workplace violence is becoming an increasing problem among healthcare and social service workers. Those employed in healthcare are 12 times more likely to encounter violence on the job than in any other profession (S. 1567 117th Congress). This staggering figure continues to rise, necessitating change. 

The Workplace Violence Prevention for Health Care and Social Service Workers (SAFE) Act S. 1567 was recently re-introduced in congress. This ground-breaking movement for positive change was initially introduced by Sen. Tammy Baldwin on May 11, 2021 (1. S. 1567 117th Congress), and again on April 18, 2023. 

Violence in the healthcare setting does not just affect the recipient of the violence, it affects everyone. Incidents of violence cause healthcare workers to develop dissatisfaction in their role as a caregiver. This dissatisfaction and fear of harm results in shortages of workers available to care for patients. This greatly increases the risk of violence due to high patient ratios, causing a decline in the quality of care each patient receives. 

The Workplace Violence Prevention for Healthcare and Social Service Workers (SAFE) Act would require the Occupational Safety and Health Administration (OSHA) to issue guidelines to prevent acts of violence in the workplace. These standards would be enforced by citations and other disciplinary action if violations are discovered.  

Violence in the Workplace Isn’t ‘Part of the Job’ 

The act, if it becomes law, would be great motivation for employers to follow these standards and maintain a safe environment for both patients and employees. Employers would be held accountable for maintaining the safety of their workers. This would be a great start in establishing a workplace free of violence. Healthcare and social service workers are on the frontlines caring for our community in their respective roles. These workers being put in dangerous, violent situations should not be tolerated or accepted as something that is “part of the job.” 

Many positive changes would follow this act, such as mandating adequate staffing, establishing minimum direct caregiver-to-patient ratios, increased monitoring and improved quality measures among the many. These actions alone would do so much in ending the cycle of violence against healthcare and social service workers.  

Healthcare and social service workers put their lives on the line for a position that can, at times, be thankless and quite difficult, despite the amazing rewards these roles offer. The least we can do is protect them while they serve our families and communities.  

Those who knowingly commit acts of violence against these professionals would face criminal action. The key word is “knowingly,” which means the person is aware of what they are doing and who they are trying to inflict harm upon. This is a big difference from someone who is incapable of understanding their actions, in which the situation is handled differently. This would be a great deterrent for violence, making someone think twice before being violent with a healthcare or social service worker. 

Managing Your Safety Along with Patients

The Workplace Violence Prevention (SAFE) Act would require employers to provide adequate staffing, training programs, and targeted education to address workplace violence and provide resources towards prevention. 

Would the measure completely eliminate acts of violence against these professionals? Perhaps not. However, it is a huge step in the right direction. It would greatly increase accountability among employers and have a positive effect on the clinical outcomes for patients. It would also change the perspective of those committing these offenses by exponentially increasing the consequences of these acts of violence. 

As a registered nurse, I personally have had patients be violent toward me. I have also witnessed violence aimed at other professionals. Working in certain specialties, such as psych nursing or caring for patients who have dementia, can exponentially increase your risks of encountering violence. While working in these facilities, you usually receive specialized training to minimize risk of injury in the event of stressful, escalated situations that can produce violence. This includes therapeutic communication and tactics such as redirection, which can be quite effective in violence prevention. 

If you find yourself in a situation in which someone is very upset, it is important to get another staff member to assist you should the situation become dangerous. Advocate in your workplace for adequate staffing, training and education on how to keep yourself and those around you safe.  

As healthcare and social service workers, our job is keeping patients safe. However, we also must consider our own safety. This act, if approved, would make these measures to prevent violence a requirement. But you also can advocate for these safety measures with your employer.  

It greatly benefitted to me receive training on how to consider my patients’ perspective in mental health/psych nursing and approach them in different ways. Using therapeutic communication and validation, I successfully diffused many difficult situations that could produce an increased risk of violence. But that is not always the case.  

The Bottom Line

Communicating with your supervisor if you feel there may be measures that could be taken to promote the safety and wellness of both patients and staff is always a great idea. Your supervisor is there to support you and assist you in maintaining a safe environment for everyone.  

Thank you to all of our healthcare and Social Service heroes for all you do! Hopefully you are as excited as I am to see these promising and exciting changes being made which will have a huge positive impact on our profession and those we care for. 

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