Some people in healthcare professions have ultimately accepted that violence can be an inevitable part of the job. Unfortunately, nurses face a far higher risk of workplace violence as compared to other professions. According to the Bureau of Labor Statistics (BLS), in 2020, healthcare and social assistance workers overall had an incidence rate for injuries resulting from assaults and violent acts by other persons of 10.3 per 10,000 full-time workers. In contrast, the rate for nursing and personal care facility workers was 21.8. It is clear that guidelines for healthcare workplace violence are markedly needed.  

The Joint Commission defines workplace violence as: An act or threat occurring at the workplace that can include any of the following: verbal, nonverbal, written, or physical aggression; threatening, intimidating, harassing, or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults; or other behaviors of concern involving staff, licensed practitioners, patients, or visitors.

As a result of this continuing problem, The American Organization of Nursing Leadership (AONL) and the Emergency Nurses Association (ENA) have published an update to their guiding principles “to assist nurse leaders in systematically implementing measures to decrease and mitigate violence within the health care environment”. The organizations developed the Guiding Principles of Mitigating Workplace Violence in 2015.

The updated guidelines for healthcare workplace violence outline nine steps in particular to mitigate and reduce workplace violence which include:

1. Organizations should use evidence-based strategies to address all aspects of workplace violence.
2. Address workplace violence with comprehensive solutions from establishing a zero-tolerance workplace to recognizing the intersecting layers violence.
3. Mitigate workplace violence by establishing support from human resources, nursing staff, and all areas of staffing support.
4. Promote a culture of safety to create a healthy work environment.
5. Effective workplace violence prevention requires commitment and action from interprofessional teams including leadership, staff, patients and visitors.
6. Everyone in the organization is accountable for upholding the standards regardless of position or discipline.
7. Encourage the health care team to identify and address violence in the workplace.
8. Create a culture of nonviolence through intention, commitment and collaboration from everyone in an organization.
9. Address workplace violence to increase the effectiveness of nurse-delivered care and patient care experience.

Similarly, the groups’ accompanying toolkit provides resources to support efforts to mitigate violence on the job, including:

• Understanding and defining workplace violence
• Creating a culture of nonviolence
• Assessing facilities for risk factors
• Developing a prevention plan
• Training staff
• Evaluating the impact of prevention programs

“Workplace violence in health care remains a pervasive problem that touches all areas of a hospital, sometimes in unbelievably tragic ways,” said ENA President Jenn Schmitz, in a press release. “The toolkit and these guiding principles show how important teamwork is to developing and implementing solutions that create a path to safer work environments with improved protective measures for emergency nurses, their health care colleagues and patients.”

Not only has the updated guidance been released in the wake of a shooting at Methodist Dallas Medical Center on October 22nd that left two employees dead but also a fatal stabbing of a nurse in Durham, North Carolina on October 18^th.