Rates of violence against employees in the healthcare sector are still increasing over time, despite efforts to mitigate the issue. Verbal abuse and physical abuse against healthcare workers is more common than most people realize.
In 2002, when the World Health Organization (WHO) published their ‘Framework Guidelines for Addressing Workplace Violence in the Health Sector’ in collaboration with the International Labour Organization (ILO), International Council of Nurses (ICN), and Public Services International (PSI), they estimated that between 8% and 38% healthcare workers suffer physical violence or abuse during their career.
Since then, new studies indicate rates to be higher. In 2018, incident data by U. S. Bureau of Labor Statistics showed that healthcare and social service workers were five times more likely to experience workplace violence than all other workers. Compared to employees in other industries, healthcare workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in USA.
M3 Global Research findings from our M3 internal survey about ´Healthcare Workplace Abuse´ reflect these growing rates, but also highlights the frequency of abuse, as opposed to an isolated incident during a career.
We surveyed 6,743 US-based, and 1,037 UK-based healthcare professionals across a broad range of specialties, asking them a series of questions about their experiences of verbal and physical workplace abuse.
M3 survey results shows a higher incidence of verbal abuse towards physicians in both USA and the United Kingdom.
At the time of the survey in Month, Year , 66% of respondents from USA and 64% from UK had been verbally assaulted at work by a patient or their family members in the last month. Respectively, 15% and 19% of US and UK healthcare professional report being physically assaulted in the past month.
Despite the publication of the WHO guidelines nearly 20 years ago, which highlighted the scale of the problem, 58% US respondents, and 68% UK respondents felt that workplace violence has increased over the last five years:
2019 AJMC1 blog article by Wallace Stephens reports that 75% of all workplace abuse takes place in a healthcare setting. Given the extraordinary stress that both patients and their families find themselves subjected to in hospitals and surgeries, it’s not altogether unsurprising that they ‘lash out’ at healthcare professionals; both in a verbally offensive or aggressive way and with physical violence. This, of course, does not make such behavior acceptable. However, understanding the triggers may help prevent hostility and aggression against healthcare workers rather than the current position of responding to attacks.
In our M3 internal survey, the specialties reporting the highest incidence of physical violence were clinical areas that could be expected to be ‘higher stakes’ and so invoke more stress and anxiety – emergency care was the highest, followed by general practice, psychiatry, critical care, and surgery.
Of particular interest is the reluctance to report incidents– the survey results show that nearly as many physical assaults go unreported as reported, and this is supported by the understanding and high tolerance that healthcare providers have for their patients and family members.
35% of healthcare professionals in US stated that ten or more cases of daily physical assaults were reported, while 29% answered that ten or more assaults were not reported. In the UK, the results were similar with 38% reported and 28% not reported. This would mean that three out of then physical abuse cases against healthcare professionals goes unreported every day. That is about 75 unreported cases of physical abuse per month for every healthcare professional in service.
A higher incidence of abuse cases in the UK is seen again with UK respondents seeing more cases of both physical and verbal assault on a daily basis. Sadly, this seems to be attributed to an acceptance that being abused at work is ‘part of the job’, especially in highly stressful specialties where fear and illness often manifest themselves as agitation and aggression, and there is a certain amount of sympathy for their reactions.
This is particularly the case with psychiatric and behavioral illnesses when potentially drugs are playing a part in impairing decision-making and contributing to aggressive behaviors. Healthcare providers understand, more than anyone, how behavior can be adversely affected by pharmacological substances, but this empathy should not extend to acceptance.
The long-term effects of abuse and violence should not be underestimated, negatively impacting both physical and psychological wellbeing. Motivation for their jobs inevitably suffers, and collectively risks healthcare provision and compromises the quality of care.
Unfortunately, measures intended to address violence against healthcare workers appear to have been largely ineffective, and policies have focused on response rather than prevention. Work into evaluating the effectiveness of specific interventions has been largely inconclusive, and attention must be paid to new approaches to promoting a safe working environment for our frontline healthcare workers.