A nurse speaks her truth on violence at work

A friend, let’s call her Beth, recently told me she is faced with the risk of violence every day in her job as a registered nurse in a hospital. Agitated patients try to kick, scratch, and punch her as she attends to their needs – not to mention verbal abuse from patients and their loved ones.

“If I was to report every time a patient actually tries to strike out at me or literally tries to claw me or kick me, we’d be drowning in a sea of paperwork,” said Beth, who has worked as a nurse for four years. “There’s huge under-reporting because it’s ‘just part of the job’ – but it shouldn’t be.”

She said the majority of violence comes from patients with dementia, who wouldn’t normally behave that way. Nurses in the psych ward and emergency room also face violence on the job.

Photo credit: cobalt123 on Flickr

“In the ER, they’re dealing with people who are coming in high or stoned or drunk, and the violence that you deal with then is extreme. That’s front line work, but by the time they get to the nursing floors, they’re often a little bit more controllable,” Beth said. “In psych units, you’re dealing with people with mental health issues. Being shop steward – I deal with a lot of the violence issues that go on in our psych ward and it’s just unbelievable.”

Her local health authority is addressing the issue by offering new training in violence prevention.

“In theory, what they’re talking about is great and they’re good skills, especially in a controlled environment, but the reality is, the world that we work in is not a controlled environment and my fear is that they can turn around and say you didn’t follow the curriculum,” Beth said.

Our conversation left me feeling grateful for our health care workers and sorry to think about the abuse they face from patients while trying to help. In most cases, you wouldn’t lay charges against patients who are confused, delirious, afraid, and/or in pain when they strike out because you can’t prove intent to cause harm. It sounds like Beth is saying that all you can do is try to stay safe and have good systems and security to back you up.

Let me know what your experience has been like.

See this video from Care for Those Who Care for You (Violence in Health Care).


4 thoughts on “A nurse speaks her truth on violence at work

  1. Chris Borden

    I remember years ago helping out the staff at the hospital in Comox because they were going to be sedating a patient one evening. I was a 6 foot 2 inch 255 lbs cop and I got a big smile from the ladies when I showed up. Luckily the patient cooperated with me out of his sight and his knowledge. I was thanked and headed back out with no call backs. Couldn’t believe they didn’t have an orderly to back them up. Hope things have changed but I doubt it. My size was my saving grace but my tongue was my ultimate tool. Dealing with irrational parties can be a challenge but size usually trumped the equation. Verbal judo was handy but you had to quick of mind and develop a thick skin. Not easy for lots of folks trying to do their job with grace. Thankfully now retired.

  2. Leah S.

    Susan, reading this article reminds me of another part of the population, z growing population that has safety issues in their work.

    Special ed workers. My son, diagnosed with ASD at age 3, had a few years where hitting seemed to be the only way he could get out his feelings. I have been hit and kicked and headbutted so many times, but as he is my son, I would just deal with it. At school, his aides would also be hit. Each time it happened, they would amaze me with how they would handle it. “It’s okay, we understand, he is doing the best he can, he doesn’t understand, he’s doing better all the time!” Every day, they’d smile and continue. I was, and continue to be amazed.

    I grew tired of school problems, on many levels, and we now homeschool. He has since learnt, mostly, to control himself, has found positive ways to deal with his feelings. I continue to be amazed at these women (it’s almost all women in these positions) as they continue to come in every day, knowing what might be happening that day. My son is in no way an unusual case, these workers are all prepared to be hit, attacked, pushed, yelled at, spit at even.. every day. And.. they don’t have the love I have for my son, they don’t get to hug it out at snuggle time. It is simply amazing, like the nurses you write of above, there is not much anyone can do to change the situation. And in both instances, the stories will continue and grow.. more special needs kids, older population growing means more dementia patients.. lots of scared people lashing out at safe people.

  3. Mari-Len

    Workplace violence is one of the hottest issues in Ontario these days, as Bill 168, adding workplace violence prevention provisions in the Occupational Health and Safety Act, just took effect last June. A lot of companies are scrambling to comply with the new legislation.

    It’s true, though, one of the sectors most affected is the health care sector. We did a video documentary on this issue, and spoke to a couple of health care workers about their day-to-day brush with violence at their workplace. Doing the interviews was an eye-opening experience for me.

    I’d like to share that video with you and your readers and hopefully it will help to get the message out there that, violence is not and should never be “part of the job.”

    This video is entitled Code White. Here’s a link to it:

    Thanks and I enjoy reading your blog!

  4. Hanne

    As a long-time OH&S steward I’m disappointed that this is still such a burning issue. I don’t know of any other industry that would tolerate such behaviour by its “customers”. If people have dementia or other mental illness that’s one thing, but why do clients without such challenges and family members feel entitled to lash out at staff both verbally and physically? And why are there few measures in place to protect staff better?

    Education and communication skills help, but sometimes facility policies are detrimental to a safe workplace. I remember working in a Special Care Dementia unit where the residents had to be toileted every two hours, if they wanted to or not. Knowing that personal care often triggers violence in these clients, it comes as no surprise that this policy led to many many violent interactions until management finally saw the light and implemented other measures to keep residents clean and dry and protect them from skin breakdown. It is a mistake not to report these incidents. Numbers count. What gets measured, matters.


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