The healthcare industry is one of the most dangerous places to work in the United States. According to the Bureau of Labor Statistics, healthcare and social assistance workers experience almost 60 percent of the violent assaults that happen in the workplace.
In 2012, the California Safe Care Standard campaign – co-sponsored by SEIU Local 121RN and SEIU Nurse Alliance of California – began to educate, mobilize, and organize around the hazard of workplace violence and push for Cal/OSHA to promulgate a comprehensive workplace violence prevention standard for healthcare workers.
As part of that work, we designed an online survey so that we could hear from healthcare workers about their experiences with workplace violence and their thoughts about what they need to be safe on the job.
Our survey was developed and launched in July 2013 by two Occupational Health Internship Program (OHIP) interns working with the campaign. OHIP is a national program that is principally funded by the National Institute for Occupational Safety and Health and is locally run through UCLA’s Labor Occupational Safety and Health Program.
The anonymous survey consisted of nine questions, six of which allowed respondents to elaborate on their answers using free text fields. Our survey was shared via email blasts, the campaign’s website, and a variety of social media channels. Because workplace violence affects healthcare workers around the country, the survey was not limited to healthcare workers in California.
At the time we closed the survey in July 2014, we had received 137 completed online responses.
The results of our survey confirm what has been documented, analyzed, and reported about for years: there is a prevalence of workplace violence in the healthcare industry, an underreporting of incidents of workplace violence, and a lack of preventative measures in place around the hazard.
Eighty-five percent of respondents reported seeing or experiencing a violent incident, assault, or threatening behavior at work. When asked to identify the types of workplace violence they had witnessed or experienced, 86% identified the violence as verbal (threats, blaming, name-calling); 67% identified emotional (bullying, manipulation, intimidation); 63% identified physical (kicking, punching, spitting, biting, pushing, pulling, stabbing); and 27% identified sexual (harassment, stalking, unwanted contact). The frequency of workplace violence reported is staggering: 13% reported seeing or experiencing workplace violence at least once a day; 16% 1-3 times a week; and 27% 1-3 times a month.
According to the Occupational Safety and Health Administration, underreporting of workplace violence is significant. Half of our survey respondents indicated that fear of retaliation is a factor when it comes to whether or not they report a workplace violence incident. Even more people said that whether or not they report an incident depends on the severity of the incident, which speaks to the culture in the healthcare industry that violence is “part of the job.” Others said that they don’t report incidents because management doesn’t do anything about the problem even when they do report.
Most respondents said that they are unsure if their employer has a successful program in place to prevent violence (e.g., training programs, critical incident response plans, personal alarm programs), and 30% said that their employers do not.
What do healthcare workers want to see in a Cal/OSHA standard for workplace violence prevention? Adequate staffing levels, meaningful training, increased and better security, and management commitment and action were among the top responses.
In California, in just a two-year period (2010-2012), there were nearly 5,000 reported healthcare industry workplace violence workers’ comp claims files (excluding state hospitals and state prisons). That data is important because those claims had to meet established workers’ comp criteria and had to have been reported by claims administrators. Cal/OSHA notes that the number of similar incidents causing less severe injuries that do not rise to the workers’ comp threshold is likely to be significant.
Our survey results verify the pervasiveness of violence that healthcare workers face on a daily basis while on the job – everything from being physically and verbally assaulted by patients and their families to being harassed and bullied by their managers. And while all of this is going on, incidents of workplace violence go unreported because healthcare workers fear retaliation from their employers, think that violence is “part of the job,” and have little confidence that their reports will be taken seriously by management.
Thank you to everyone who participated in the survey. We will be sharing the full results at the first meeting of the advisory committee that will be developing a Cal/OSHA standard on workplace violence prevention for healthcare workers. That meeting will be on September 10 in Oakland.