Nursing Is the Most Dangerous Profession
And it’s only gotten worse since the pandemic
I’ll bet you thought that construction or coal mining was the most dangerous profession, but it turns out that the vast majority of non-fatal injuries happen to healthcare workers. Not only do nurses have back and other orthopedic injuries much more often than construction workers — nurses are often required to move patients weighing well over 100 pounds, many of whom are not cooperative — but there is also the escalating problem of violence, both from patients and at times from their family members.
Research studies indicate that nurses face greater violence than police officers and prison guards, and that this situation is largely underreported and ignored.
First, according to a 2018 government study — Healthcare workers accounted for 73 percent of all nonfatal workplace injuries and illnesses due to violence. (emphasis mine) Let that sink-in for a moment. Almost 3/4 of the injuries in this country from workplace violence occur among healthcare workers. Our nurses often face the worst situations. They see patients who are sometimes impaired by drugs, anger, or mental illness. Many patients refuse to cooperate with care. Some patients lash out at the nurses attending to them. In some hospital settings, you can add angry or upset family members to the mix.
Second, add the current pandemic to the mix. For the last year, healthcare workers have faced a crisis. They’ve worked through a pandemic requiring even longer hours and greater risks to their own health. They’ve worked under very difficult conditions of isolation, quarantine, extra equipment, and periods where hospitals were overwhelmed with patients. Blackwell
Research studies indicate that nurses face greater violence than police officers and prison guards and that this situation is largely underreported and ignored. Both hospital administration and many patients tend to view nurses and nursing aids as almost a kind of healthcare waitress, there to serve the patient’s needs with little right to their own authority or safety.
The International Council of Nurses reported that “Nurses are the healthcare workers most at risk, with female nurses considered the most vulnerable.” According to a recent U.S. study published in the New England Journal of Medicine, “Health care workplace violence is an underreported, ubiquitous, and persistent problem that has been tolerated and largely ignored.” Sage Journals
In studying this problem, occupational health researcher Jim Brophy (along with fellow researcher Margaret Brophy) learned that it wasn’t hyperbole when nurses said they faced violence every day and he discovered that often hospitals were not cooperative in helping to protect them.
Most nursing stations don’t have protective shatterproof barriers or exits behind the desk, leaving nurses vulnerable to attack. Another worker told Brophy about the time her co-worker was sexually assaulted by a patient. ‘[Th]e inspector recommended that they put glass up. The hospital fought them on it. They said it stigmatises the patients.’
Both the workers Brophy interviewed and the US’s Occupational Health and Safety Administration have highlighted several design features of traditional hospitals (‘unsecured access/egress; insufficient heating or cooling; irritating noise levels; unsecured items’) that compound the safety issue — all of which could be addressed without stigmatising anyone.
Perez, Caroline Criado . Invisible Women: Data Bias in a World Designed for Men (pp. 140–141). Harry N. Abrams. Kindle Edition.
In addition, the traditional layout of hospitals can leave nurses more vulnerable. Long corridors where many rooms are far from the nurse’s station leave nursing staff isolated and often without nearby support if they need help. The Brophys note that nurses often don’t report attacks because they don’t believe that anything will be done and they fear reprisals from a system that is more concerned about patient comfort than it is about the wellbeing of its staff.
‘We scream,’ one nurse told the Brophys. ‘The best we can do is scream.’
Perez, Caroline Criado . Invisible Women: Data Bias in a World Designed for Men (p. 139). Harry N. Abrams. Kindle Edition.
One of the main triggers for violence against medical personnel is wait times. If someone is in pain or worried about their injury/condition and they have to wait a long time to be seen, chances go up that they will behave inappropriately toward front-line medical staff. Increasing staff numbers costs money, but given how much time off injured nursing staff have to take, and the costs of constantly retraining new employees, it seems like it would be a good idea to invest in the safety and well-being of nurses and nursing aids.
“I was screaming at the top of my lungs” was the only way one nurse could get help during a vicious attack. After an assault, workers are often told to go back to caring for the very patient who just attacked them. Code White
Verbal abuse, sexual assault, and minor injuries may not lead to days away from work for physical healing but they still take a toll on the mental and emotional health of nurses, leading to burn-out, and perhaps a desire to leave the profession entirely. Underreporting of these types of assaults as well as on-the-job injuries and more major attacks such as stabbings or beatings means that nursing as a profession is under siege.
The risk factors for violence against healthcare workers have been well documented in this and countless other studies and many solutions have been put forward. These recommended measures, including policy changes, increased staffing, safer building design, improved security, new programs to minimize patient agitation, and others need to be implemented by the healthcare institutions with the participation and control of those at risk. The healthcare staff and their unions or associations should be fully involved. Further research should then focus on evaluating the effectiveness of these new measures. Sage Journals
Much of what goes on in any given environment is due to what is tolerated there. One nurse that the Brophys spoke with noted that there was a sign in the gift shop indicating a zero-tolerance policy for aggressive or hostile behavior there, but no such sign in the patient rooms. In addition, nurses must have adequate ways to report problems or ask for assistance — and their concerns need to be taken seriously.
Some of the hazards of nursing come with the job, but many are due to a culture that too often doesn’t recognize or take seriously the violence and aggression that nurses routinely face. Healthcare workers shouldn’t face more violence than police officers and prison guards and nursing need not be the most dangerous profession.
© Copyright Elle Beau 2024