HEALTHCARE ORGANIZATIONS

By: Eugene Schmuckler; PhD, MBA, Certified Trauma Specialist 

Director of Behavioral Finance and Economics

Institute of Medical Business Advisors, Inc. 

Director of Admissions

Certified Medical Planner Program, iMBA Inc.

Introduction

The impact of workplace violence became widely exposed in Edmond, Oklahoma. In August 1986, Patrick Henry Sherrill, an employee of the U.S. Postal Service, angered by perceived injustices against him by his employers, shot and killed fourteen people, wounded six, and then killed himself. This shocking event added the term “going postal” to our lexicon.

Incidents of workplace violence have continued to spread. A veteran employee at the General Dynamics facility in San Diego, California, shot and killed his supervisor along with an industrial relations representative when he was fired after 25 years on the job. A fired Mount Pleasant, Michigan, sports editor used a pair of scissors to stab his boss in the head. A Tampa, Florida, man returned to his former workplace and shot three of his supervisors as they sat eating their lunches. He wounded two others before killing himself. These incidents are not solely perpetrated by males.

An upset female worker at a Bennington, Vermont, battery plant shot and killed the plant manager and wounded two others after trying to set the plant on fire. A woman in a Corona, California, opened fire with a .38 calibre handgun, wounding a nurse and spraying the infant nursery with bullets. Before she was arrested, she horrified hospital workers with her words, “Prepare to die.”

Assessment of Workplace Violence in Healthcare

 What Is Medical Workplace Violence?

Medical workplace violence is more than physical assault — it is any act in which a person is abused, threatened, intimidated, harassed, or assaulted in his or her employment. Swearing, verbal abuse, playing “pranks,” spreading rumors, arguments, property damage, vandalism, sabotage, pushing, theft, physical assaults, psychological trauma, anger-related incidents, rape, arson, and murder are all examples of workplace violence. The Registered Nurses Association of Nova Scotia defines violence as “any behavior that results in injury whether real or perceived by an individual, including, but not limited to, verbal abuse, threats of physical harm, and sexual harassment.” As such, medical workplace violence includes:

·     threatening behavior — such as shaking fists, destroying property, or throwing objects;

·     verbal or written threats — any expression of intent to inflict harm;

·     harassment — any behavior that demeans, embarrasses, humiliates, annoys, alarms, or verbally abuses a person and that is known or would be expected to be unwelcome. This includes words, gestures, intimidation, bullying, or other inappropriate activities;

·     verbal abuse — swearing, insults, or condescending language;

·     muggings — aggravated assaults, usually conducted by surprise and with intent to rob; or

·     physical attacks — hitting, shoving, pushing, or kicking.

Violence can be brought about by a number of different actions in the medical workplace. It may also be the result of non-work related situations such as domestic violence or “road rage.” Workplace violence can be inflicted by an abusive employee, a manager, supervisor, co-worker, customer, family member, or even a stranger.  The University of Iowa Injury Prevention Research Center classifies most workplace violence into one of four categories.

·     Type I Criminal Intent — Results while a criminal activity (e.g., robbery) is being committed and the perpetrator had no legitimate relationship to the workplace.

·     Type II Customer/Client — The perpetrator is a customer or client at the workplace (e.g., healthcare patient) and becomes violent while being assisted by the worker.

·     Type III Worker on Worker — Employees or past employees of the workplace are the perpetrators.

·     Type IV Personal Relationship — The perpetrator usually has a personal relationship with an employee (e.g., domestic violence in the workplace).

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