A safe and secure work environment is an undeniable right of every nurse and is an essential element of providing quality care. Violence against nurses must not be tolerated; a position of zero tolerance of violence is the optimal approach. Nurses, employers, governments and nursing organizations have a shared responsibility for ensuring a safe workplace.
Nurses work in a wide variety of settings providing care to individuals and families who may be mentally or chemically impaired, experiencing stress, and in danger of losing control. Anger and aggressive behaviours are frequent reactions to the anxiety experienced in illness situations and may be exacerbated by other stressors such as family difficulties, unemployment or poverty. As levels of frustration and violence in society generally increase, so does the likelihood that nurses will be assaulted or abused in the workplace.
Research shows that nurses experience high rates of verbal and emotional abuse, physical violence and sexual harassment in the course of their work. Conditions of employment must contribute in a positive way to client care and the professional satisfaction of nurses. Violence against nurses must not be tolerated; a position of zero tolerance of violence is the optimal approach.
Nurses must assertively refuse to tolerate violence and harassment, and support those who have been abused by taking individual and collective action within the workplace and through nursing organizations. The reporting of violence in the workplace must be treated with dignity and respect. The entire process must be free of the threat of reprisal.
The responsibility to ensure a safe workplace is shared by:
Individual nurses to increase their knowledge and skills regarding the issue of violence, and take a proactive stance in refusing to tolerate violence and harassment. Skills should include assessment of potentially violent situations, and the ability to defuse or cope with escalating situations. Everyone should recognize, however, that violent situations cannot always be predicted or prevented.
Employers to provide administrative support and structures to promote the safety of all employees, including nurses. Policies and procedures are the first step in ensuring a safe workplace. Security equipment and personnel should be provided as well as education in preventing and responding to violence. Facilities should be planned or modified to discourage aggressive behaviour. Clear documentation processes and follow-up mechanisms that support the nurse should be in place. This follow-up should provide critical incident stress debriefing and, if necessary, support for the nurse through the process of laying charges.
Governments to provide the legislative mechanisms and adequate resources to ensure safe workplace.
Nursing organizations to provide advocacy and information. This emphasizes the belief that nurses have the right to safe workplaces to provide client care.
Nurses have a role to play in promoting changes in societal attitudes regarding violence. Health care and the delivery of nursing services are best carried out in a climate of mutual respect. Every health care employee is entitled to be treated with dignity and respect.
June 1993
References
Canadian Nurses Association (1991). Code of Ethics. Ottawa: Author.
_____ (1991). Position Statement on Human Rights. Ottawa: author.
_____ (1992). Family Violence Clinical Guidelines for Nurses. Ottawa: Author.
_____ (1992). Position Statement on Management of Nurses' Worklife. Ottawa: Author.
_____ (1992). Position Statement on Family Violence. Ottawa: author.
National Federation of Nurses' Unions (1991). Position Statement on Violence in the Workplace. Ottawa: Author.
Ontario Nurses' Association (1991). Violence in the Workplace: A guide for ONA members. Toronto: Author.
Kushnir-Pekrul, Linda (1992). Nurse abuse in Saskatchewan. Unpublished master's thesis, Central Michigan University, Mount Pleasant, MI.
