Workplace violence in healthcare is an often unspoken but harmful reality. And it’s only gotten worse since the pandemic. In fact, 8 in 10 nurses have experienced workplace violence since 2020. While this violence can manifest in many forms, it almost always impacts mental health. By learning about the mental health impacts, how to address workplace violence, and when to look for a new role, nurses can be empowered advocates for their careers and health.
What does workplace violence against nurses look like?
Workplace violence takes various forms, including verbal threats, harassment, assault with or without a weapon, written threats, or—in the most serious cases—homicide. While most cases of workplace violence don’t put nurses' lives on the line, they can cause physical and mental damage when it happens and can fill every shift after an incident with fear and anxiety.
The CDC defines 4 different types of healthcare workplace violence:
Criminal violence: This type of violence is part of a crime, such as an assault on a nurse when someone is trying to rob a healthcare facility. The perpetrator is not a patient or healthcare worker and has no real reason to be at a facility.
Personal violence: Sometimes, a nurse’s personal life spills over into the workplace. This could include a violent ex-partner stalking a nurse at work or a volatile family member disrupting a nurse’s workplace.
Worker-against-worker violence: Although it’s normal to have some disagreements at the workplace, it’s not normal for it to spill over into physical violence or personal attacks. When this happens, it’s considered worker-against-worker violence.
Patient violence: When a patient lashes out against a nurse, making threats or physically assaulting or harassing a nurse, it’s considered patient violence. This type also encompasses violence by a patient’s loved one or family. It is the most common type of violence against nurses.
About half of US states, including North Carolina, have specific legislation and consequences for violence against nurses. However, North Carolina law only considers violence against nurses to be a felony when it’s committed against emergency or hospital personnel, leaving punishment as a gray area for violence against nurses in other settings.
Nurse safety in the workplace
Safety in the workplace must encompass two groups—patients and healthcare workers. While there are rigorous protocols to protect patients (which you most likely learned about during workplace orientations and in your nursing degree), fewer facilities have prevention measures in place for violence against nurses.
In fact, the National Institute for Occupational Safety and Health does not require mandatory workplace violence prevention training in healthcare settings, though it does provide some guidelines on how workplaces can implement this training.
Their website provides various free trainings which can be used by healthcare facilities in order to increase safety for nurses. Nurses concerned about their safety at work should bring these prevention resources to HR or an administrator. If the situation doesn’t improve, the guidelines can serve as a good interview talking point with potential employers when on the job hunt.
How workplace violence and abuse impact mental health
While prevention measures against violence are important, it’s also important to understand how workplace violence impacts mental health and what nurses–and healthcare employers–can do to protect their mental health after a violent event.
A 2017 study looking specifically at violence against psychiatric nurses and other mental health workers found that after an incident, workers experienced psychological impacts such as:
PTSD
Guilt, shame, and self-blame
Increased fear and anxiety
Lower job satisfaction
Higher rates of nurse burnout
Dealing with workplace violence has a long-lasting and damaging impact on nurses’ health and quality of life.
Solutions to workplace violence
While the mental health consequences of violence can never be undone, there are measures nurses and healthcare facilities can take to mitigate the impact and help nurses heal emotionally.
Healthcare facilities can and should:
Provide mental health resources, such as therapy and online mindfulness tools
Make changes to prevent future incidents of workplace violence
Help workers find satisfaction in their roles again
Create workplace violence prevention trainings
Nurses can respond to workplace violence by:
Protecting your mental health: Take time to do the things you love, process what you went through, and seek the necessary resources to heal, including therapy.
Talking to an administrator about the problem: You shouldn’t have to deal with this alone. When facing mental health impacts from workplace violence, your administrators should be an ally who helps you find solutions.
Getting out of the situation: If administrators are unresponsive to your concerns, it might be time to start looking for a new role. A fresh start can be the mental health break. A new workplace could also lower your chances of experiencing violence against nurses in the future.
Signs of a safe workplace
If the administration is unresponsive to your concerns and you have to look for a new job, you might be worried about falling into the same situation at a different workplace. Luckily, there are some signs to look for that a potential employer cares about the physical and mental safety of their nurses.
A workplace that mitigates violence probably has:
Invested in continuing education for nurses and other hospital staff, including workplace violence prevention training and mental health resources
An open and honest HR department that listens to and addresses healthcare workers' needs
A culture that values nurses not just as employees but as individuals whose physical and mental health matters
Violence against nurses is a tragic reality. Yet working at places with proper prevention measures and training can mitigate your chances of experiencing an incident of violence. Prioritizing your mental health can give you space to psychologically heal if you do experience workplace violence.
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