Every job comes with risks, and working in nursing can be riskier than many other occupations. Not only do we face risks due to many patient illnesses, but many times, we also encounter risks to our physical and psychological safety.

Nurse abuse, or abuse of nurses by patients or patient families, is an unfortunate reality that is often underreported, but health care facilities have a responsibility to look out for the safety of their staff. 

Here’s everything you should know about nurse abuse, and what we can do to prevent and put an end to it.

What Is Nurse Abuse?

Nurse abuse occurs when patients and/or their family members lash out physically or psychologically towards the health care professionals providing care to them. This includes incidents of abuse, threats, or assault of a nurse while on the job.

The Occupational Safety and Health Administration says violence in the workplace is four times greater in the health care industry than it is in the private sector. According to the World Health Organization, up to 38% of health workers experience physical violence during their careers, and many more are subject to verbal aggression.

The longer you work in the medical field, and more so in many specialties compared to others, you’re likely to encounter some or many of these common examples of nurse abuse:

• Scratching
•  Biting
• Pushing
• Pinching
• Spitting at
• Striking with object
• Kicking
• Bullying/name-calling
• Threatening
• Sexual harassment
• Stalking

Of course, this isn’t an extensive list. There are many other forms of abuse that nurses experience in their line of work. 

If you aren’t sure if a patient or patient family member’s actions towards you count as abuse, check in with your supervisor and safety department to let them know you don’t feel safe.

Why Do Patients Act Violently Toward Nurses?

Nurse abuse can happen in any health care setting where you directly interact with patients and their family members. But it most commonly occurs when patients or their families are under extreme stress or are under the effects of external factors, like a disease or medication.

When individuals, either patients or distressed loved ones, are in a hospital setting, they’re typically under much higher levels of stress than they normally feel. 

These feelings of fear, lack of control, and vulnerability can cause anger and aggression in even the calmest people. They may also look to place blame on someone or something, and nurses are in the direct line of fire.

Patients are often the main cause of any violence towards nurses. They may not be in their right minds, either because of their health condition and related symptoms or medications they might be taking.

What Are the Effects of Nurse Abuse?

Nurse abuse is a serious occurrence, and although it’s stressful for those of us who find ourselves, victims of it, we have to handle it quickly and with care. If left unaddressed, it can understandably have many negative impacts on individual nurses and their staff.

When nurse abuse happens, some of the common effects that can happen include the following:

• Low staff morale and burnout. Dealing with ongoing abuse, whether emotional or physical or both, can cause many health care workers to burn out and lose their passion and motivation to work.
• High turnover or absenteeism. Nurses might stop showing up to work out of fear or quit altogether because they feel unsafe or disrespected.
• Occupational injuries or potential lawsuits. Physical assault is not uncommon in the health care field, and any injuries on the job can lead to expensive lawsuits and other legal complications.
• Lower quality of care. It’s difficult for nurses to focus on their patients if they feel unsafe and on-edge from being harassed or assaulted.
• Psychological distress of abused nurses. Many health care workers experience anxiety and agitation after being exposed to abuse or assault from patients.

A nurse’s job is not easy, and it shouldn’t be made worse by unaddressed abuse.

What to Do If You’re Experiencing Violence or Aggression at Work

If you’re a nurse experiencing abuse in the workplace, there are several ways to handle the issue before it gets out of control. Here are some tips to help you navigate these tough situations:

• Review the facility’s policies and procedures for handling workplace violence.
• Remain as calm as possible.
• Call for help if needed.
• Maintain a non-threatening posture and talk calmly with the patient or family member.
• If possible, seek an exit.
• Report any and all abuse immediately.

It is crucial to immediately notify your supervisor or the HR department of any threatening or violent situations that you experience.

How Can Health Care Facilities Intervene?

Health care facilities and nurses in administrative positions also have a responsibility to protect their staff from physical, mental, and emotional abuse on the job. 

Here are some suggestions health care facilities should implement to protect all of their staff and prevent abuse towards staff:

1. Implement a Zero-Tolerance Policy

Violence should never be tolerated under any context. Facilities should always be concerned about the safety of their workers. If their staff’s well-being is being put at risk, they should have a process established where there is an immediate intervention in the situation with zero tolerance.

2. Explain and Document Proper Procedures for Reporting Abuse

Nurses shouldn’t feel confused or unheard when disclosing abuse by patients, visitors, and even colleagues. Facilities should make sure they’ve outlined the procedure of reporting an assault/harassment, so nurses can immediately alert the right people and seek support.

Communicating the proper procedures prior to any instances of abuse is also essential. Don’t wait for something to happen before offering guidance.

3. Rotate or Pair Up Nurses Who Are Caring for Patients With a History of Abusing Staff

No one nurse should have to deal with an abusive patient on their own or on an ongoing basis. Long-term violent patients with a concerning history should be cared for by paired nurses or a rotation of health care workers to limit an individual staff’s one-on-one exposures.

4. Increase Security and Make It Easy for Nurses to Call for Immediate Assistance

A health care facility should have the necessary security to adequately protect their staff and their patients. It shouldn’t be a difficult or lengthy process for nurses to call for help if needed. Security should be available immediately in the case of any violent situations.

5. Create a Psychologically Safe Space for Staff Members to Disclose Concerns

All staff should feel comfortable voicing any concerns they have regarding abuse. However, their worries should not fall on deaf ears. 

Facilities should do more than listen — they should act accordingly and provide solutions to violence or threatening situations that are experienced, and then they need to do the necessary work so it will not happen again going forward.

Nursing will continue to be an often high-risk occupation for many of us. But that doesn’t mean there isn’t anything we can or should do about making it a safer environment.