IFSEC Insider explores the complexities of protecting healthcare workers, as research demonstrates how risk extends beyond the workplace. Domestic violence, for example, is a hidden – but clear – problem as health providers seek to adopt new strategies against violence and aggression.
The harmful consequences of violence and abuse against healthcare workers are widely recognized by hospital administrators. The daily reality of increased aggression takes a heavy toll on staff concentration, performance and motivation; this increases illnesses and absences; and makes retention and recruitment more difficult.
This is an issue that directly affects how healthcare resources are managed, as providers struggle to maintain quality care delivery and patient experience.
This is also an international problem; the same pattern of growing concern about violence is evident in healthcare systems from the US, UK and Europe to Australia.
In a new article on this topic written by Eric Clay, president-elect of the IAHSS (the International Association for Health Care Safety and Security) in the United States, violence statistics from the last decade, taken from various credible sources, all point to a steady rise.
Multiple causes of violence
“Twenty years ago, it was attributed to the combined effects of increased workload, work pressure, excessive work stress, deterioration of interpersonal relationships, social uncertainty and economic constraints. All of these factors still apply today, with the added challenges of staffing shortages, bed shortages and an increase in behavioral health issues among patients,” says Clay.
It’s also a fantastically complex question to address.
Two facts clearly illustrate this point: First, and perhaps not surprisingly, the majority of attacks on healthcare workers are generated by patients. Emergency department personnel, nurses and doctors are the most victimized, according to ample evidence.
Further reading: Healthcare sector ‘must focus on safety and security of NHS staff’ amid growing workplace violence, says NAHS
Second, a fact that gets much less attention: healthcare workers are also more likely than the population as a whole to be victims of domestic violence.
Why is this relevant and why is it important for employers?
It is a hidden but pernicious form of abuse that can affect an individual’s ability to do their job, and can also spill over into the workplace where it impacts colleagues and patients . In the United States, for example, the greatest number of deaths of healthcare professionals in hospitals are linked to domestic violence.
Hidden problem
Data on the problem has been available for years. In a 2010 American study, 45% of healthcare professionals (a large majority of women) reported having been victims of domestic violence (BMC Women’s Health Journal); and almost half of deaths of private health workers in hospitals were linked to domestic violence, according to 2018 The figures from the U.S. Bureau of Labor Statistics.
In the United Kingdom, a nursing charity report In 2016, it was estimated that nurses, midwives and care assistants were three times more likely to be survivors of domestic violence than the population average.
But while general violence and aggression in health care settings is visible and easy to understand, domestic violence is largely hidden.
It’s no surprise that health care workers are disproportionately affected by domestic violence, warns Kim Urbanek, CEO of K4 Consulting and public safety manager for an Illinois health system.
Nursing positions, for example, are still predominantly female, and women are at much higher risk of domestic violence.
Additionally, people working in caring professions are predisposed to putting their own well-being second, increasing their risk of being mistreated. In other words, they have some of the characteristics that make them “perfect victims,” Urbanek warns.
Don’t ask for help
“We are resilient, we always give help instead of asking for it, we always make sure everyone is okay. We’re the ones who didn’t take a lunch break, who didn’t get enough sleep, who didn’t take care of ourselves, because caregiving is about meeting the needs of others.
“And when you have that mindset, it can be very difficult to ask for help. There is a sense of shame that accompanies domestic violence and it is embarrassing, so there is a tendency to compartmentalize it, rationalize it, or push it away to avoid it.
In a 2010 American study, 45% of healthcare professionals (a large majority of women) reported having been victims of domestic violence.
It’s an issue Urbanek is working to highlight, alongside like-minded colleagues in the UK and Australia.
A forum in August 2023 brought together leading violence prevention practitioners, including Danielle Austin, incident response manager at St Vincent’s Health Network in Sydney, Australia, and Laura Smith, clinical violence prevention specialist. Violence, Dorset Healthcare NHS Trust, United Kingdom, and Sienna Kozin, Subject Lead. from CriticalArc, a technology provider that works with healthcare providers around the world to support new workforce safety strategies.
“Domestic violence must be a priority”
Ms. Austin believes that domestic violence is a risk factor facing health care settings, but that the threat has not been adequately addressed, in part because the functions of senior management as well as maintenance of the Order, security and safety planning are traditionally male-dominated roles.
“It’s a societal problem, but if you don’t expect it, look for it and plan for it, you’re burying your head in the sand.
“When a person escapes domestic violence and goes to a safe place, they still have to work and earn money. So, for abusers, one of the easiest places to locate is at work, especially if that person has a predictable work schedule.
Most violence occurs after the victims have left; most life-threatening situations occur once they break free, she points out.
Thus, making domestic violence a greater priority in safety planning and risk management policies can have a dual benefit: improving the well-being of the individual and reducing risks to the facility and the organization.
But another reason this hasn’t happened is that it’s a very difficult and sensitive problem to solve, says Laura Smith.
“When a patient is aggressive, the nurses will manage the situation. But when it comes to domestic violence, nurses need support from other nurses and colleagues, but do they have the skills and resilience to deal with it? Burnout and empathic distress are already at very high levels.
From an organizational perspective, staff expected to intervene and support colleagues affected by domestic violence – whether clinical staff or security and police teams – will themselves need better support and better structures.
“Where do they go with this information once it’s been reported? What support mechanisms are in place? There needs to be a real increase in staff skills.
Urbanek argues for a grassroots effort to convince administrators that the issue needs to be better understood and discussed more openly. As a next step, she is working with other invested organizations to develop training resources for healthcare providers and says she will work with her peers in the UK and Australia to advance the conversation.
New strategies and reasons for hope
We’re also starting to see healthcare providers adopt new strategies against violence and assault in general, which offers some hope, says Darren Chalmers-Stevens, group operations director at CriticalArc.
“Less reactive and more proactive approaches are being developed by a generation of professionals who see the problem differently. They see that established strategies are not working, or not working well enough, and they are determined to influence change. »
Importantly, because the solution to violence and assault requires collaboration across disciplines and agencies, emerging influencers include leaders in policing, clinical practice, and leadership positions.
Solutions encouraging wider participation
Efforts to establish these broader and more effective partnerships are receiving a practical boost through the introduction of workforce security solutions that involve the participation of multiple stakeholders, says Darren Chalmers-Stevens.
“We have supported projects in challenging health service settings in the UK and Australia, as well as the US. So we know from practical experience that collaboration works.
“In practical terms, a police or security control room team can have the latest technology at their disposal which allows them to have a much clearer picture of events in real time – instantly showing them which member of staff is calling for help, where is this person, who they are. are, what is their risk profile – but that’s only part of the equation.
“For example, for a restraint solution to be truly effective for healthcare workers, department heads and clinical teams must be fully involved. Every staff member should have an easy-to-use way to request help. The technology must work wherever the employee is, on-site, off-site or on the move.
“And for a system to have real impact, it must earn a high level of trust by demonstrating a consistent, timely and effective response. »
Further reading: Global Healthcare Security Leaders See Benefits of Collaboration
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