COURSE WORK
Joanna Piotrowski
New York City College of Technology
November 11, 2018
Professor Irene Pearlman
Workplace Violence
Workplace Violence
There are several issues that transcend the nature of an industry and must be addressed by all large organizations in order to maintain a sense of order and safety among employees. One of these issues is workplace violence and preventing instances of violence. In the healthcare industry, this is especially important due to the stressful nature of the work that is being done, as well as the added risk of caring for patients. There are a number of risk factors that hospital leaders and administrative executives must identify in order to establish appropriate standards of practice when it comes to situations of workplace violence. Having the proper procedures in place to prevent and de-escalate a situation of workplace violence is essential to the overall operational structure of a healthcare system. The risks of workplace violence have the potential to impact the financial stability of a healthcare organization, the patient’s wellbeing and the nursing profession in particular. Since nurses have the highest level of patient interaction and healthcare providing, there is a significantly higher risk that nurses face for violence in interactions with patients, family members or other visitors, as well as other employees within the hospital or health system.
The first aspect of preventing workplace violence is understanding the nature of the problem and the risks that can befall a healthcare organization should prevention measures against violence not be taken. Hospital work can be deceivingly dangerous for healthcare professionals since some risks go unnoticed, or unidentified, the impacts of those risk factors can be increasingly devastating. Some of the hazards within hospitals that can lead to instances of violence can include simple measures such as lifting or moving patients, needle sticks, slips, falls and agitation from combative patients can all lead to instances of escalating situations leading to violence. The dynamic culture of a healthcare organization can be unpredictable, especially for nurses. Since patients who are ill can become increasingly combative and agitated, leading to a significant increase in risk to healthcare providers, especially nurses. This is an occupational hazard that is often misunderstood within the nursing profession and the overall healthcare industry. Additionally, the National Institute for Occupational Safety and Health defines workplace violence as violent acts that include assault on physical persons, or threats of assault toward a person employed by a hospital or providing healthcare services to a patient (National Institute for Occupational Safety and Health, 2018). An additional risk to providers, specifically in fields of behavioral and mental health services, is the risk of interactions with patients that have a history of drug abuse, or previous violent acts. This is also a heightened risk for professionals in terms of physical assault, or threats of assault while trying to provide healthcare services for patients. The rate of workplace violence, according to the National Institute of Occupational Safety and Health, has risen and is estimated to be four times more likely than in any other private industry, as an average (National Institute for Occupational Safety and Health, 2018). The number of threats and assault incidents in the healthcare industry is inconclusive due to the lack of reporting and therefore a high cost can be incurred to health systems if appropriate prevention is not implemented into the standards of practice within a large health system. The organizational risk factors that influence the prevalence of workplace violence can include the lack of policies and procedures aimed at protectionary measures, understaffing, high employee turnover, inadequate security personnel, and long waiting periods for clients or patients, and patient overcrowding. While this is not an exhaustive list of potential risk factors, many of these aspects can lead to workplace violence and place healthcare providers in precarious positions that could compromise patient care and the safety of others.
The strategies and tools that healthcare organizations can use to identify and prevent workplace violence have been created and distributed by authoritative bodies such as OSHA, JAHCAO, and CLIA. OSHA provides a five-step implementation plan to effectively mitigate the risks associated with workplace violence in the healthcare industry. Once the areas of risk have been identified, systems of prevention can be integrated into standard operating procedures. As outlined by OSHA, the guidelines that healthcare organizations should follow apply to all major hospitals, residential treatment centers, community care centers, field workstations, non-residential treatment centers, and long-term nursing care centers. In each of these settings, there will be specific, unique challenges that may require special attention and preparation. However, the general five-step structure is effective at preparing healthcare organizations for potential instances of workplace violence. The steps of this process include managerial commitment and employee participation, worksite analysis, hazard prevention and control, safety and health training and accurate record keeping and program evaluation. When implemented and executed appropriately, these programs should prepare healthcare organization for potential instances of workplace violence. Moreover, any prevention program should have clear and defined goals that can be measured, and accountability can be tracked and monitored as programs are implemented. The components of the prevention program are interdependent on one another and therefore each step must be executed with the appropriate knowledge of the setting in which it is being implemented as well as the challenges to implementation that may be faced. Regular instances of reassessment and adjustment are necessary to ensure accuracy and the overall success of a program in preventing instances of violence in the workplace in healthcare. An occupational safety health program, for instance, will need to take into consideration a number of state and federal regulations, as well as the overall structure of the program to ensure compliance standards are met.
Commitment from management and worker participation is an essential part of reducing the instances of workplace violence that occur in the healthcare industry. Effective management and leadership begin with the recognition that workplace violence is a safety and a health hazard to patients and employees alike. When management acknowledges the value of a safe and violence-free workplace, through the assurance of exhibiting equal commitments to safety and healthcare quality, the success of a protectionary program will assure the safety of employees within the healthcare industry. The allocation of appropriate authority and resources to all the responsible parties in order to make workplace violence protections a priority is essential to the effective operations of a healthcare organization. When management and workers are committed to preventing workplace violence and ensure that proper measures are taken, risks can be mitigated. Employee training and educational resources related to workplace violence are also essential to the reduction of incidences that can be considered workplace violence. Empowering employees with the knowledge of how to handle situations that could escalate to be violent and taking measures to de-escalate situations appropriately is essential in the healthcare industry.
In addition to the necessary commitment from management and employees, the workplace analysis and identification of specific hazards for individual environments is essential. Since each environment is unique and has specific challenges that need special consideration, internal analysis for each organization is necessary. The cooperation between management and workers should serve as a foundation for the identification of hazards and allow for a comprehensive approach when establishing standard operating procedures to mitigate instances of workplace violence. The assessment of an organization should include previous records of violent instances, as well as a review and process mapping of the procedures and operations. Through this analysis, there will be ample opportunity for the identification of potential hazards. The control measures and hazard mitigation techniques can be implemented once there is a clear identification of specific needs and risks to an organization (Occupational Safety and Health Administration, 2018).
Workplace violence is a considerable risk to the healthcare industry, and one of the major risks to the nursing profession. Nurses have the greatest risk to experience instances of workplace violence, especially due to the nature of the organization in which they are employed. However, a concerted effort between managerial staff, analytical analysis and prevention planning should ensure the overall safety of healthcare providers and the reduction of violent incidents within the healthcare industry. The risks associated with workplace violence have the potential to be incredibly detrimental to patient safety within a hospital or healthcare organization as well as a provider’s ability to provide for patients. Since this is such as considerable concern, there can be resulting financial implications to the lack of appropriate measures in place to handle and de-escalate potentially violent situations. The authoritative bodies and public health professionals that aid in guiding major healthcare institutions with creating and implementing protection plans are able to lay the foundation for risk mitigation of workplace violence. These measures will protect providers, and especially nurses who are likely to be in the midst of violent situations and could have the opportunity to avoid violent incidents given the proper training. The healthcare industry should aim to focus on this aspect of risk mitigation to reduce the overall number of incidents that occur within the industry each year.
References
Lee, G. (2012). Workplace violence in healthcare settings: Risk factors and protective strategies. Journal or Rehabilitation Nursing. https://doi.org/10.1002/j.2048-7940.2010.tb00045.x
National Institute for Occupational Safety and Health. (2018). Violence prevention. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/
Occupational Safety and Health Administration. (2018). Guidelines for preventing workplace violence for healthcare and social services workers. Retrieved from https://www.osha.gov/Publications/osha3148.pdf
THANK YOU LETTER
August 14, 2018
Jessica Mattice, RN
Nurse Manager
Samaritan Hospital
2215 Burdett Ave
Troy, NY 12180
Dear Mrs. Mattice,
It was a great pleasure to have an opportunity to meet with you and discuss the position of Registered Nurse at Samaritan Hospital.
I found the interview to be very informative and I left with a better understanding of St. Peters Health Partners values and philosophy. While shadowing the nursing staff, I was pleased to see the staff members uphold the philosophy of SPHP. It would be a great honor to be a part of your team.
Thank you again for your time and I look forward to hearing from you soon.
Sincerely,
Joanna Piotrowski, RN
CONTINUING EDUCATION
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| 10/24/2018 |
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Continuing Education Certificate
10/19/2018
Completion Date
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