Certified nursing assistants who become victims of workplace violence may feel that nothing in nursing school could have prepared them for this experience, which left them afraid, brutalized, and feeling alone.
What is workplace violence?
The National Institute for Occupational Safety and Health defines workplace violence as "violent acts including physical assaults and threats of assault, directed toward persons at work or on duty."
Examples are pushing, shoving, punching, kicking, stabbing, and shooting someone. These are violent attacks that cause serious physical harm and even death in some cases. Verbal assaults such as threats, verbal abuse, hostility, and harassment are considered workplace violence, too, and easily lead to physical violence.
If you have been a CNA for some time, you may have already heard similar stories in your unit or even been a witness or victim to violence.
As it turns out, deciding to join the healthcare workforce is itself an act of bravery, and caring for patients in hospitals and nursing homes can be a dangerous profession. Why? Forty-five percent of all cases of workplace violence are in healthcare. In fact, from 2002 to 2013, serious workplace violence (requiring victims to take days off to heal and recover) were four times more common in healthcare than other industries.
And, CNAs have a special place in the list of healthcare workers who experience the highest rates of violent injuries resulting in days away from work: they rank second to psychiatric aides and almost four times higher than registered nurses. Aggressors are often distraught patients, at other times, they are the patient's family, visitors, and even the CNA’s coworkers.
The perfect recipe for workplace violence.
One reason nursing assistants are commonly attacked is that they are constantly in contact with patients and their family. As CNAs assist with activities of daily living, opportunities to become a target of aggression are more frequent because they work closest to patients, feeding them, assisting them with bathing, or helping them move around.
Violence also happens when workers are alone with the aggressor or because they are working in a hostile community. The risk of being a victim of an assault is also high when dealing with patients who have psychological problems.
Victims of physical aggression can suffer unimaginable stress, physical and mental trauma, psychological disorders, and other unhealthy consequences such as lack of sleep and appetite, and burnout. In turn, their work is severely affected. They may miss work for days, go AWOL (absent without official leave), or lose focus at work and commit errors, putting patients at risk. Their relationships at home may also turn sour because of the experience.
Workplace violence not only takes a toll on the victims, but on organizations as well. Along with creating a hostile work environment for all employees, cases of assault are costly, and hospitals and nursing homes can owe a considerable amount if they shoulder the burden of an employee victim’s medical treatment. They may also cover lost wages. If a worker must leave their job because of the horrible experience, the management will spend thousands to replace them. The estimated cost of replacing a nurse is $27,000-103,000, a considerable cost to most healthcare facilities.
One of the biggest challenges of stopping violence in healthcare is the underreporting of assault cases, even in settings where there are existing policies to deal with workplace violence. The present numbers do not represent the significance of the problem, and solutions are not adequate to address it. The result: a cycle of violence that continues to worsen over the years.
This is a sad fact for nursing assistants, who are at a higher risk of becoming victims.
What can you do to help end violence in the workplace?
Be mindful of your institution's policies and don’t be afraid to come forward if you are a victim. When you witness a coworker being abused, do not be a mere bystander. Instead, show that such aggression is not tolerated and refer to institutional policies in place. When the attack comes from a patient, call your nurse or another staff member to witness the event, and then immediately document every detail of the incident. Be an active participant in policy development and voice your opinions on how to address violence in the workplace. CNAs and their healthcare colleagues should work together to prevent future incidents.
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