Combatting Workplace and Horizontal Violence in Healthcare

Many people are surprised to learn that healthcare workers face significant risks of workplace and horizontal violence. Several factors contribute to risks associated with workplace violence, including directly dealing with patients who have a history of violence or who may be delirious or under the influence of drugs.

The United States Department of Labor noted that from 2002-2013, the rate of serious workplace violence incidents (those requiring days off for an injured worker to recuperate) was more than four times greater in healthcare than in private industry on average. A most concerning fact—healthcare accounts for nearly as many serious violent injuries as all other industries combined.

Emergency Physicians and Nurses Unite Against Workplace Violence

Designated by the Alliance Against Workplace Violence (AAWPV), Workplace Violence Awareness Month (recognized annually throughout April) is a great time for promoting prevention. One effort healthcare workers can take to promote awareness is taking part in a new campaign launched by ED clinicians.

The American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA) have teamed up to launch “No Silence on ED Violence,” a new campaign aimed at addressing the rising number of workplace violence incidents that take place in the ED.

The move comes amid surveys conducted by the two groups that reveal nearly half of emergency physicians and about 70% of emergency nurses report experiencing a physical assault at work.

The campaign is designed to raise awareness about the on-the-job dangers ED personnel face daily, and to prompt action among key stakeholders and policymakers toward ensuring emergency clinicians and staff can operate in a safe environment.

Through the campaign website, emergency personnel are invited to share their experiences with workplace violence to build public awareness about the problem.

The site also offers links to resources for training and education, important research on the topic, and expert advice on how to address or prevent workplace violence in the emergency setting.

Further, the site includes information about proposed legislation as well as current state and federal laws focused on reducing violence in healthcare. Campaign developers are making this information available so emergency medicine leaders can better advocate for positive changes in their own states and communities.

Horizontal Violence in Healthcare

Did you know that while about 10% of all professions report disruptive behaviors in the workplace, reports for healthcare professions are three times higher? Hostile behavior is most prevalent in nurse-to-nurse interactions with 65-80% of nurses reporting they have either experienced or witnessed it.

Horizontal violence, or also known as lateral violence or workplace bullying, is described as non-physical, hostile, aggressive and harmful behavior toward a co-worker or group via attitudes, actions, words and/or behaviors. It is characterized by behaviors such as:

  • Making snide, belittling or sarcastic comments
  • Public humiliation
  • Gossip
  • Isolating a colleague from a group
  • Ignoring or avoiding
  • Patronizing or condescending language
  • Undermining personal values and beliefs
  • Mocking
  • Passive aggressive behavior
  • Harassment
  • Intimidation

Effects of Horizontal Violence

Horizontal violence can be devastating. Victims can suffer from reduced self-esteem, depression, anxiety, panic attacks, and sometimes even attempt suicide. Physical symptoms are also common and can include weight loss or gain, musculoskeletal problems, intestinal issues, insomnia and cardiac arrhythmias. These negative impacts increase the incidence of sick leave and unplanned absences.

Horizontal violence also impacts teamwork and communication. Safe, quality healthcare is dependent on respectful working relationships, teamwork and collaboration. But horizontal violence increases the occurrence of adverse events, medical errors and patient mortality.

Research has also linked nurse hostility with turnover, by associating three retention outcomes: job satisfaction, organizational commitment and turnover intentions. Victims of horizontal violence have a higher likelihood of leaving their employment within six months of the first incident. Per an online nursing forum, approximately 60% of new graduate nurses leave their first places of employment within the first few months due to horizontal violence. Also, among clinical leaders, abusive conduct has led to decreased quality of care and increased motivation to quit among nurses.

In the healthcare workplace, horizontal violence is estimated to cost more than $4 billion dollars each year due to lost time, productivity and turnover. It also leads to lawsuits, compensation for disability, loss of profits and poor patient satisfaction.

How Can Organizations Address Horizontal Violence?

  1. Create a zero-tolerance policy
  2. Ensure healthy behavior starts from the top
  3. Assess root cause to violence
  4. Provide education on conflict management
  5. Allow for time to reflect for all involved

For more details on the five ways to address horizontal violence in healthcare listed above, read this blog post.

How Relias Can Help

CE Direct, powered by Relias, boasts a variety of content libraries with thousands of award winning courses, providing learning solutions tailored for specific audiences and topics.

Relevant courses include “Preventing Violence in the Healthcare Setting” and “Do You Reflect a Positive Image of Nursing?”.

CE Direct’s unmatched interprofessional content and non-clinical skills development courses deliver the right education to support an organization’s key initiatives. Additionally, 50+ certification review courses help staff self-prepare for certification exams, earn specialty for recertification or earn CE hours and improve knowledge.

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Natalie Vaughn

Content Marketing Manager, Relias

Natalie is a Content Marketing Manager at Relias. She has worked in marketing and communications for more than 15 years, with more than half of her experience dedicated to healthcare quality improvement. At Relias, she partners with physicians, nurses, curriculum designers, writers, and other staff members to shape healthcare content designed to improve clinical practice, staff expertise, and patient outcomes. Natalie obtained a Master of Business Administration degree with a focus in marketing, driven by a passion for understanding consumer behavior, branding strategies, and leveraging thought leaders as innovators within a given industry.

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