– Bijaya Deuja
As I went about my usual day working in my med-surg unit, I noticed something new on the nursing station’s center wall that caught my attention. It was a notice on a flex board that read:
“Our workers have the right to be treated with dignity and respect at all times.
We have a zero tolerance policy for:
Failure to comply may result in removal from our facility and prosecution from law enforcement.
Thank you for respecting their right to an abuse-free workplace.”
I was pleasantly surprised and felt ecstatic about seeing this information. In my decade-long nursing career, I had never seen anything like it. This notice on the board made me feel motivated and gave me positive energy to work. I felt secure and dignified, which is the essence of any job.
Workplace abuse is any offensive or threatening act directed towards employees while they perform their duties. Verbal abuse is a devious type of occupational violence that is commonly observed in healthcare settings. Nursing is a highly stressful job where nurses face numerous challenges every day. They are vulnerable to verbal and physical abuse, mistreatment, and numerous problems in the workplace. However, verbal abuse and mistreatment, particularly from patients, visitors, and senior colleagues, top the list.
Various studies show that nurses who report higher levels of verbal abuse have lower job satisfaction, less organizational commitment, autonomy, less retention, and higher turnover. The psychological effects of verbal abuse include fear, anxiety, depression, post-traumatic stress disorder (PTSD), intrusive memories, memory gap disorders, sleep or eating problems, hyper-vigilance, irritability, anger issues, alcohol and drug abuse, self-harm, and even suicide.
In the United States, there is a zero-tolerance policy for verbal abuse, harassment, and physical assault of healthcare professionals. This policy is implemented strictly, and employees call hospital security through a communication device called a vocera if the patient or their families disrespect, shout, or try to verbally abuse them. The security officers arrive within seconds and control the situation, and if required, the police officers also arrive immediately if the situation gets worse. The implementation of this policy is commendable, and the American workplace culture is generally more amiable, safe, and workers are confident in their skills.
To provide healthcare professionals with a safe workplace, organizations should clearly define acceptable and unacceptable behavior and have a system in place to report, investigate, and take action against such behaviors. Various quality improvement initiatives should be developed and implemented to reduce incidents of workplace violence. All healthcare professionals, including security, should be trained periodically and consistently in self-defense and response to emergency codes.
In Nepal, where I spent a long part of my nursing career, I have experienced and witnessed numerous situations where nurses are subjected to verbal abuse, harassment, and physical assault. This is a paradox, and Nepal should adopt and implement a zero-tolerance policy for physical assault, verbal harassment, abusive language, and threats strictly. This way, all employees will feel valued and safe. Similarly, a policy should be initiated and implemented stating that all healthcare workers have the right to be treated with dignity and respect at all times. Appropriate follow-up and support to victims, witnesses, and others affected by workplace violence, including psychological counseling, should also be implemented. Continuous monitoring and evaluation of workplace violence reduction initiatives are mandatory to create a healthy work environment that enables nurses to provide the highest standards of compassionate patient care. Healthy and safe workplaces can increase worker productivity, satisfaction, and job retention, ultimately helping to achieve the organizational goal.