OSHA: Preventing Workplace Violence

The consequences of acts of workplace violence against a healthcare worker can exact a heavy physical and emotional toll. Beyond the immediate trauma, negative outcomes may also include which of the following?

- Diminished productivity. - Lack of trust in management. - Loss of team cohesiveness. - Increased job stress. - Absenteeism. - Worker turnover

What can you do to protect yourself from workplace violence?

- Participate in any training or violence prevention programs offered by your employer. - Dress for safety. - Be aware of your working environment

Josh arrives to give Mr. Wilson his medication. As he enters the room, Josh notices that Mr. Wilson is staring fixedly at a painting on the wall. He then turns to Josh, starts cursing and accuses Josh of trying to poison him by giving him the wrong medication. He starts to flail his arms in an attempt to swat Josh. What should Josh do next?

- maintain no-threatening eye contact, smile, & keep his hands open & visible - Ensure that he remains b/t the patient & the room exit - Use limit setting language such as, "Mr. Wilson please control yourself or I will call security

Alice is getting close to the end of her shift at the ER. It's been a really hectic night and the waiting room has been full to capacity all night. She is approached by a patient who starts to complain about the wait in a loud voice. As she talks to Alice, she throws her keys on the counter. Alice notes that the patient's breathing is heavy. What would be an appropriate way for Alice to start to address the issue?

Apologize for wait time; (showing empathy is the 1st step)

A patient strikes a nurse as he attempts to give the patient her medication. What type of violence does this scenario depict?

Client-on-Worker

Cameron is a nurse in a home health service for senior citizens and frequently visits two patients in their homes: Elise and Richard. Elise tends to forget that Cameron is her nurse, and can grow anxious and afraid due to her lapses in memory. She often points her fingers at Cameron, paces, breathes heavily, and clenches her fists. Richard, Cameron's other patient, is usually friendly, engages in conversation, and shakes Cameron's hand at the end of the visits. Which of Cameron's patients exhibits behaviors that could lead to violence?

Elise

Workplace violence (WPV) refers only to incidents that involve physical violence. Is this statement true or false?

False

Studies have found higher patient satisfaction levels in hospitals where more nurses are dissatisfied or burned out. Is this true or false?

False; opposite of this

Consequences can be both acute (short-term) and chronic (long-term). Is this true or false?

True

Workplace violence in the healthcare setting may lead not only to nurses leaving the profession, but to negative side effects on recruitment into the nursing profession. Is this true or false?

True

Workplace violence is a recognized hazard within the healthcare industry. Is this true or false?

True

Benjamin, a transport technician, was punched by a patient in the emergency room. He fell to the ground, hit his head on a table, he lost consciousness briefly, and required 8 stitches. Should this incident be reported to OSHA by Benjamin's employer?

Yes

During her shift Natasha, a nurse's aide, was walking one of her Alzheimer's patients to the dining hall. The patient was sundowning and acting very agitated. She pushed Natasha, knocking her off balance. Natasha hit her shoulder as she fell and irritated an old injury. As a result, she won't be able to work for 2 days. Should this incident be reported to OSHA by Natasha's employer?

Yes

Type 3: Worker-on-Worker

between coworkers is commonly referred to as lateral or horizontal violence. It includes bullying, and frequently manifests as verbal and emotional abuse that is unfair, offensive, vindictive, and/or humiliating though it can range all the way to homicide often directed at persons viewed as being "lower on the food chain" such as in a supervisor to employee or doctor to nurse though incidence of peer to peer violence is also common.

Margo, a newly-qualified physical therapist, has been working with her patient Simon for several weeks. He has made several comments on her appearance and clothing at previous appointments. At today's appointment he grabbed her breast and made some lewd comments. What type of violence does this scenario depict?

client-on-worker

Nora was mugged by a stranger in the hospital parking garage as she arrived to start her shift. What type of violence does this scenario depict?

criminal intent

Work Organization category

involved conflicts or aggression arising from failure to follow protocol, patient assignments, limited resources and high workload. Incidents of worker-to-worker violence and incivility stemmed from dissatisfaction with employee behavior or from organizational practices or work constraints.

Type 2: Client-on-Worker

most common in healthcare settings accounting for almost 80% of incidents, according to the Bureau of Labor Statistics. This course considers the customer/client relationship to include patients, their family members, and visitors, and will be referred to as client-on-worker violence Research shows that this type of violence occurs most frequently in emergency and psychiatric treatment settings, waiting rooms, and geriatric settings, but is by no means limited to these.

Ava works the intake desk at an emergency room. One of the people in the waiting area comes up to her and asks how much longer the wait will be while looking at his watch. Is this person exhibiting behaviors that indicate the potential for violence?

no

Work Behavior category

often sparked by unprofessional behavior, disagreement over responsibilities for work tasks or methods of patient care, and dissatisfaction with a co-worker's performance.

Type 4: Personal Relationship

the perpetrator has a relationship to the healthcare workers outside of work that spills over to the work environment For example, the husband of a nurse follows her to work, orders her home and threatens her, with implications for not only this nurse but also for her coworkers and patients.

Type 1: Criminal Intent

the perpetrator has no legitimate relationship to the business or its employees, and is usually committing a crime in conjunction with the violence (robbery, shoplifting, trespassing). For example: - A hospital administrator assaulted in the hospital parking garage - A home healthcare nurse is mugged while conducting a home visit occurs less frequently

Hailey has recently joined the hospital as a nurse in labor and delivery. Since she started, she has received verbal harassment from her colleagues. Often her possessions are moved and her paperwork goes missing. What type of violence does this scenario depict?

worker-on-worker

Brenton is a therapist in a psychiatric ward. One day, while he's visiting with one of his patients, the patient suddenly stands up, looms over Brenton, and begins speaking loudly. Is this person exhibiting behaviors that indicate the potential for violence?

yes