ASRN Supports A National Zero Tolerance Policy On Violence And Aggression Against Nurses

Main Category: Nursing / Midwifery
Article Date: 18 Apr 2008 - 4:00 PDT

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Fifty-six percent (56%) of Registered Nurses have been either physically or verbally attacked by a patient in the past month, according to a national internet survey of 584 Registered Nurses conducted April 13 by the American Society of Registered Nurses (ASRN.ORG). In a separate internet survey conducted by ASRN on April 16, 54% of the 661 Registered Nurses who responded said they had been frightened by a violent patient within the past month.

In societies across the world nurses are highly regarded by the community, being consistently rated as the most honest and ethical occupational group. As a discipline where caring is a central value, nursing offers the opportunity to indulge intellectual curiosity, conduct rational inquiry, exercise problem-solving skills, and develop creativity, while retaining compassion, advocacy and holism as core attributes. Few people will pass through life without experiencing at some point the benefits of nursing care. Nurses more than any other health professional, care for the health of individuals and communities across the globe, and their safety should therefore be a community priority.

But there is an underlying truth many have just accepted as being part of the job: violence.

Campaigns to raise awareness in the health and aged care sectors and the community about the incidence of violence and its unacceptability as a workplace hazard are beginning to empower nurses to report violent incidents, to act to minimize risk, and to ensure their employers accept their legal obligations to provide a safe place for nurses to work and to provide care for the community.

The serious nature of many attacks, and the potentially catastrophic effects of violence on victims, their families, and ultimately on the nursing profession is of grave concern to all nurses.

ASRN strongly condemns all forms of abuse and violence against nursing personnel. Such actions violate the nurse's rights to personal dignity and integrity, and freedom from harm.

ASRN firmly believes that violence in the health workplace threatens the delivery of effective patient services and, therefore, patient safety. If quality care is to be provided, nursing personnel must be ensured a safe work environment and respectful treatment.

ASRN promotes the development of policies that reflect a "zero-tolerance" of violence, e.g. legislation, staff regulations, judicial sanctions, workplace environment standards, cultural norms. Sanctions should be taken that reflect the seriousness of any particular incident. Cooperation with other organizations having common goals in the campaign against violence is important.

Violence is a public health emergency that pervades all socioeconomic segments of society and is of growing concern in healthcare settings. According to the Bureau of Labor Statistics, in 2000, the injury rate for nurses was among the highest and 25 of every 10,000 full-time nurses were injured in workplace assaults. This rate is much higher than private-sector industries, which is 2 workers per 10,000. These statistics only reflect a portion of the incidents; the Occupational Safety and Health Administration (OSHA) has found that there is severe underreporting because many healthcare workers believe it is part of the job.

Inadequate staffing levels and skills mix, which lead to excessive workloads for nurses, all leave nurses vulnerable to violence as they struggle to meet the needs of clients in health care facilities. Funding cuts, which generate increased waiting times for care, also increase the frustration and aggression of patients and their relatives toward nurses.

The increasing incidence of mental illness in the community, mainstreaming of mentally ill patients into the acute hospital sector, increasing levels of drug and alcohol abuse in communities, and an aging population (increasing the number of individuals with dementia in aged care and acute facilities) have all been identified as contributing to increased levels of violence against nurses. Research indicates the most common perpetrators of violence against nurses are patients/clients. They are disproportionately male, affected by drugs and/or alcohol, and commonly have a history of violent or aggressive behavior. The inappropriate design of health facilities, which fail to take into account potential threats and the need to ensure the safety of staff and clients within them, also contribute to risk.

American Society of Registered Nurses