Introduction
Workplace acts of violence have been found to have far-reaching consequences that disrupt societal aspects. Healthcare professionals are among those at a higher risk of workplace violence, according to 38% of total health professionals at a certain point in their career period (Abou-Abbas et al., 2023). There have been reported higher cases of workplace violence, often in North American countries and Asian nations, among physicians, nurses, emergency departments, and psychiatric units (Abou-Abbas et al., 2023). During the COVID-19 period, there was higher violence against health professionals, hence increasing the existing violence sources and opening more confrontation areas among families, patients, and healthcare providers (Abou-Abbas et al., 2023). The International Committee of the Red Cross got around 848 reports from January to December 2020 on violence against healthcare workers, which was linked to COVID-19 in 42 countries. Regions such as Asia, Africa, and Europe were accountable for the reported cases (Abou-Abbas et al., 2023). A review of literature from a middle-income country shows that the reasons for workplace violence include the death of a patient, lack of societal awareness, miscommunication, and overcrowding. The research paper aims to explore various aspects of workplace violence and develop potential solutions that can help address the situation.
Description of the issue in detailed
Healthcare workers play an important role in service delivery to the patients and the community, and hence, they deserve to work in a safer and supportive environment. It is essential to address the issue of workplace environments to get a detailed understanding of the problem against them (Rossi et al., 2023).
Types of violence in healthcare:
There are various types of violence which are seen against the healthcare professionals. There are a couple of signs of violence and which activities are considered to be violent. Based on the healthcare professionals in a study by Abou-Abbas et al. (2023) study, violence can occur in either verbal or physical forms.
Verbal forms of violence are included in various communication intended to intimidate or harm, including making derogatory remarks, swearing, or shouting (Hanizah Mohd Yusoff et al., 2023). Physical violence among healthcare professionals, on the other hand, includes intentional actions that would cause physical injuries, such as kicking, hitting, or even pushing (Hanizah Mohd Yusoff et al., 2023). There is also a subtle or nonverbal form of violence, which includes tone of voice changes and body language, which shows signs of hostility or aggression. Also, the use of weapons by the patients, families, and community members or threats were noted as forms of violence (Hanizah et al. et al., 2023). While most health professionals focus on the violence they can face from the families and the patients, some note that violence could also be from a colleague, for example. In this case, it has been acknowledged that violence in healthcare scenarios can also result from the care professionals to the patients.
Witnessed violent events among healthcare professionals:
According to research, the staff members have experienced various ranges of workplace violence, which range from verbal accusations like shouting, cursing, and threatening to be slapped or punched and even, at times, getting physical injuries in the form of fractures or wounds (Rossi et al., 2023). It is worth noting that female and male targeting forms of violence differ among different professionals. Males are at a higher risk of getting physical violence compared to female counterparts. On the other hand, female professionals often face verbal abuse, yet they are not entirely immune to physical abuse as well. Sometimes, weapons could be brought to the family and be used to harm or threaten staff members, which further increases the violence risk and harm affecting the professionals. An example is a case in the research by Abbou Abbas et al. (2023), where a relative to a patient admitted to the emergency department from stabbing injuries ended up threatening to destroy the emergency department with a bomb if the relative died or did not survive to “walk from the hospital walking” (Abou-Abbas et al., 2023). The relative event shot the emergency department roof with a weapon he held.
Caregivers note that such moments are some of the scarring times of their lives when they are forced to do anything to their avail to make sure the patient, even in the end-of-life stages, remains alive, yet nature could take its course any moment (Vento et al., 2020). However, think about it, would you be willing to be in an arena where your life is at stake? Not even me, either. In such a case, “saving your life is the best option so you can be at least with your family at home…” a healthcare professional states (Abbou-Abbas et al., 2023).
Workplace violence has also been found to occur among staff of all categories, including even those with no direct contact with families, relatives, or patients (Abou-Abbas et al., 2023). A cook in a facility could be a victim of this type of violence, where late food could be an issue even when the patient is not allowed to eat anything orally following a recent operation, among other medical orders (Abou-Abbas et al., 2023). On the other hand, pharmacists also could be threatened with their life or physical harm if the aggressive patient is never given narcotics.
On this note, it has been noted that any form of violence occurring among health professionals could be verbal aggression, which, however, does not escalate further. When caregivers act in such weird ways, they are likely to be undergoing some form of extreme stress or even depression, which could be attributed to the high demands of work or family issues (Abou-Abbas et al., 2023). A caregiver could say,” We are all stressed at times; we could often shout at uncooperative patients or colleagues due to the stress we are managing in and out of the facility surroundings” (Abbour-Abbas et al., 2023).
Causes of violence:
Violence can either be hospital-related or patient-related. Hospital-related issues are potential causes where lack of security could aggravate (Abou-Abbas et al., 2023). Time-consuming processes such as billing the patients, which are laborious and require one to go physically to different departments, could lead to frustration by the family and patients, hence escalating violence (Sari et al., 2023). The lack of clear visitation policies can be a significant concern for the patients because some visitors could come armed with weapons.
Patient-related factors include financial status, where patients expect free treatment in public facilities. When not informed of other costs associated with care, such as admission costs, they may become agitated or overwhelmed (Vento et al., 2020). Some cultures could also have tendencies such as shouting or threatening as their belief gives them more attention and favoritism, which can exacerbate the violence (Abou-Abbas et al., 2023). Also, poor medical knowledge and unwarranted expectations of care professionals, such as maintaining a patient’s life, could lead to escalated violence.
Plan to approach the issue of workplace violence.
To address the problem of workplace violence among care professionals, taking a multifaceted approach is essential. The Plan Do Study Act cycle, a quality promotion guideline, could be significant. Preventive interventions such as violence and harm risk assessments, training the staff on patient and family de-escalation skills, and having proper security protocols are essential. Here, organizational support to the professionals, reporting systems, and communication channels allow the caregivers and patient to speak their minds, hence addressing various issues in time (Abou-Abbas et al., 2023).
A logistical solution to the violence and harm issues includes the installation of metallic doors with restricted access to individuals without staff identifications. Having at least one security guard on each floor could help reduce the unwanted access and number of visitors (Sari et al., 2023). Metal detectors by security could be helpful to ensure visitors are checked for weapon ownership when entering the facility gate.
Policy interventions such as limiting the number of visitors for each patient and entrance limitations for harmed or aggressive family members could be helpful. At the community level, there is a need to raise awareness of the importance of respecting the facility staff and hospital property, which is a significant intervention (Lim et al., 2022). This allows the community members to understand the vital role of the workers in disease management and treatments, hence promoting their security instead of violating their rights. The involvement of non-state armed groups within the community to help regulate violence could be essential. International Committee of the Red Cross 2014 set an example where a meeting and counseling session with the community was implemented. It allowed them to sign an agreement to protect caregivers and hospital work. Such interventions include stakeholders from all levels and have been reported to have a significant impact on preventing healthcare worker-related violence in recent research (Abbou-Abbas et al., 2023).
My best suggestion for a solution to workplace violence.
Taking comprehensive interventions towards healthcare-related violence against healthcare workers needs a preventive, responding, and supporting intervention. Preventive interventions include educating staff and security on signs of aggression, taking security measures such as limiting access to many visitors and advocating for a culture of respect towards care professionals. Response measures include effective and immediate response to a violent incident where the patient’s safety is promoted with adequate security personnel for each unit and respected wards (Abou-Abbas et al., 2023). After a violent case, offering supportive care is essential, including engaging the care professionals in counseling, debriefing sessions, and mental health management (Lim et al., 2022). Social learning theory is a significant informant of the interventions that emphasize the need for observational learning to determine behavioral aspects (Li et al., 2021). Promoting the culture of safety and nonviolent involvement is important while incorporating this with desired resources such as security officers and other tools such as security alarms, which promote resilience and coping and offer a safe environment in the healthcare organization.
The reasoning behind this approach is based on the understanding that workplace violence can be prevented by advocating various policies, having adequate staff and community training, and promoting a respectful working environment for care professionals. Investing in various safety-promoting interventions, the facility offers safe working environments that reduce the risk of violent incidents (Abou-Abbas et al., 2023). Some anticipated results include reduced workplace violence among staff, promotion of job satisfaction, and improved staff morale. Offering a supportive working arena for the professionals is essential to reduce the turnover rates and reduce economic demand to train and include new workers while enhancing safety for all. This supports the ethical obligation of the care facilities to offer protection and promote the staff’s well-being in all organizations.
Conclusion
Workplace violence among healthcare professionals is a significant concern that affects the quality of care and safety among patients and healthcare workers. The problem of violence from this research can be stated to be multifaceted, hence having several causes. Community, organizational, and patent-related factors could result in escalated violence. Taking interventions at different levels, such as education interventions, visitation policies, and logistical measures, can help address and reduce workplace violence. Community-level measures, including promoting awareness and engagement of non-state armed groups, are essential to encourage respect and violence limitation. Various stakeholders, such as the community, governments, policymakers, and health organizations, need to work together towards a common goal to ensure the safety of healthcare professionals to allow them to care for patients safely and without fear of harm or violence.
References
Abou-Abbas, L., Nasrallah, R., Yaacoub, S., Mendoza, J. A., & Mahmoud Al Wais. (2023). Healthcare workers’ experiences of workplace violence: a qualitative study in Lebanon. Conflict and Health, 17(1). https://doi.org/10.1186/s13031-023-00540-x
Hanizah Mohd Yusoff, Ahmad, H., Ismail, H., Naiemy Reffin, Chan, D., Faridah Kusnin, Norazlah Bahari, Hafiz Baharudin, Aris, A., Huam Zhe Shen, & Maisarah Abdul Rahman. (2023). Contemporary evidence of workplace violence against the primary healthcare workforce worldwide: a systematic review. Human Resources for Health, 21(1). https://doi.org/10.1186/s12960-023-00868-8
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Lim, M. C., Jeffree, M. S., Saupin, S. S., Giloi, N., & Lukman, K. A. (2022). Workplace violence in healthcare settings: The risk factors, implications, and collaborative preventive measures. Annals of Medicine and Surgery, 78. https://doi.org/10.1016/j.amsu.2022.103727
Rossi, M., Beccia, F., Cittadini, F., Amantea, C., Aulino, G., Santoro, P., Borrelli, I., Oliva, A., Ricciardi, W., Moscato, U., & Gualano, M. (2023). Workplace violence against healthcare workers: An umbrella review of systematic reviews and meta-analyses. Public Health, 221, 50-59. https://doi.org/10.1016/j.puhe.2023.05.021
Sari, H., Yildiz, İ., Baloğlu, S. Ç., Özel, M., & Tekalp, R. (2023). The frequency of workplace violence against healthcare workers and affecting factors. PLOS ONE, 18(7). https://doi.org/10.1371/journal.pone.0289363
Vento, S., Cainelli, F., & Vallone, A. (2020). Violence Against Healthcare Workers: A Worldwide Phenomenon With Serious Consequences. Frontiers in Public Health, 8(570459). https://doi.org/10.3389/fpubh.2020.570459
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