Workplace violence is a broad and malleable concept and, depending on whom you ask, the definition can range from verbal abuse to physical assaults and even homicide. Workplace violence can involve and affect employees, clients, customers, and visitors in any industry or workplace, but it presents unique challenges in the healthcare industry. The Occupational Safety and Health Administration (OSHA) has broadly defined it as “any act or threat of physical violence, harassment, intimidation, or other threatening behavior that occurs at the work site.” Moreover, OSHA has asserted workplace violence is a recognized hazard in the healthcare industry. Prudent healthcare industry employers take appropriate action to mitigate these risks.
Healthcare workplaces are unique in that their “customers” (i.e., patients) are more likely to be violent than customers in most other industries. Victims may include workers, as in other industries, but are more likely to also include customers, visitors, and other third parties. Additionally, violence in the healthcare setting may not be “intentional” or “deliberate” in the common understanding. Patients sometimes believe they are protecting themselves from healthcare workers, and their verbal abuse, bullying, and physical aggression may result from thinking clouded by drugs, dementia or mental illness. These circumstances typically do not exist outside the healthcare workplace, and are difficult to effectively address.
Another unusual aspect is that healthcare workers, especially in emergency departments and services, tend not to report it “customer” violence as often as other industries’ workers. This is particularly true when the worker is not injured, because they consider patient violence “part of the job.” Some healthcare workers also feel reporting patient violence is inconvenient, or is a waste of time because nothing will be done about it. Some healthcare workers fear retaliation for reporting workplace violence, especially bullying and verbal abuse, more so than other industries; employees.
Additionally, hospitals and some other healthcare workplaces have numerous ingress and egress points and a wide variety of non-employees coming and going at all hours. The need for easy legitimate access makes it challenging to prevent access by would-be aggressors, such as shooters or terrorists. Other workplace violence issues peculiar to healthcare workplaces include gang violence in emergency departments, verbal and physical abuse by patients’ distraught family members, and even bullying by physicians. These factors and others can make it especially difficult for healthcare industry employers to prevent and respond to workplace violence.
Some states have attempted to address these challenges through legislation. For example, some have mandated comprehensive prevention programs for healthcare employers and increased penalties for persons convicted of assaulting healthcare workers. It is a felony to assault a healthcare worker in at least 32 states. Penalties, however, are unlikely to deter a mentally impaired person, and it is difficult to convict them.
No federal law requires most employers to take any specific action regarding workplace violence. Even OSHA has no specific requirements, although it has cautioned:
An employer that has experienced acts of workplace violence, or becomes aware of threats, intimidation, or other indicators showing that the potential for violence in the workplace exists, would be on notice of the risk of workplace violence and should implement a workplace violence prevention program combined with engineering controls, administrative controls, and training.
Tune in to next month’s issue to learn how healthcare industry employers can take steps to reduce the risk of workplace violence.
George Adams is a partner in Fisher & Phillips’ Louisville, Kentucky office. His practice is exclusively devoted to representing employers in matters of labor and employment law. This article merely provides an overview of certain legal issues, and cannot be construed as legal advice. For more information, please call (502) 561-3990.