Assault on Healthcare Workers: A Proposal for Increased Penalties


Published: March 2016

Nurses and other healthcare providers have become complacent with a culture of acceptable violence while providing care. Nurses providing care in emergency and psychiatric settings are particularly vulnerable although violence may occur in any patient care setting. There are a surprisingly high number of assaults in Alaska, and this acceptance needs to change in order for nurses to safely provide care.

In Alaska, statistics for assault are published by the Department of Public Safety. The Department reported 3,224 assaults in the state of Alaska in 2014. This was an increase from 2013 of 4.1%. The report did not specify if the assault was aimed at a healthcare worker or not. However, it did include demographic information showing that most assaults are committed by males older than 18 years of age. Pertinent to healthcare workers, the Alaska Psychiatric Institute reported a total of 409 patient assaults toward staff and other patients in 2014 which was an increase from 273 assaults in 2013 (Mordini, 2015).

A retrospective study by Gascon, et al. (2013) conducted in Spain explored health care worker assaults and the relationship with burnout. Burnout was defined as emotional exhaustion, depersonalization and inefficacy. The results showed that, “11% of respondents (n = 826) had been physically assaulted on at least one occasion, 34.4% had suffered threats and intimidation on at least one occasion, and 36.6% had been subjected to insults.” The researchers concluded that physical and non-physical aggression showed significant correlations with symptoms of burnout.

A recent study by Speroni, Fitch, Dawson, Dugan, & Atherton (2013) reported that, “Over the past year, 76.0% of health care workers experienced violence from patients.” Approximately 54% reported verbal abuse, and 29.9% reported physical abuse. Sixty percent reported patients shouting or yelling, and 53.5% reported swearing or cursing. Nearly 38% percent reported being grabbed, and 27.4% reported being scratched or kicked. Emergency nurses experienced a significantly greater number of incidents (P < .001) than other types of nurses. The study also stated that, “Most serious career violence incidents (n = 595, 78.1%) were physical.” The results show the severity of workplace violence for healthcare workers, as well as the various types of abuse inflicted. The study also calculated statistics on assaults by visitors, which demonstrated that healthcare workers are assaulted by more than just patients. There is a need for deterrents to violence to reduce these percentages.

There have been several studies completed that look at the effectiveness of various deterrents. In Ohio, in accordance with House Bill 62, hospitals are allowed to post a notice in conspicuous locations stating assault on healthcare workers is a felony (n.a, 2013). Touzet, Cornut, Fassier, Le Pogam, Burillon, & Duclos, (2014) discuss the positive efficacy of removing all triggers of frustration and violence in the workplace. This was accomplished by implementing a “multifaceted program aimed at preventing incivility and violence against healthcare professionals.”

Massachusetts and Oregon have also been increasing the penalty for assaults on healthcare workers and Massachusetts has proposed, “H.B. 1931, which will create a special “difficult to manage” unit in the Department of Mental Health to treat repeat perpetrators of violence.” (Schildmeier, 2010). Oregon has increased assault in the third degree to a class C felony punishable by up to five years in prison and $125,000 in fines. (Rice, 2014).

In Alaska, there are many areas where legislation can be improved to help protect healthcare workers and medical professionals. There is currently a proposed piece of legislation that seeks to add additional protection to medical professionals from harassment using bodily fluids. The proposed bill will make it a Class C felony to use animal or human bodily fluids to harass medical professionals. This legislation also includes a proposed change to statute (12.55.135(d) which seeks to increase the sentence for those convicted of assault in the fourth degree to 90 days. This proposed modification of HB364 was submitted to Senator Coghill’s office for review on November 10th, 2015 and at the time of this writing is still awaiting review.

It is a felony in Alaska to assault anyone regardless of their profession except in the fourth degree where it is only a misdemeanor. One way this legislation could be improved is to lobby for assault in the fourth degree against a medical professional to be a felony instead of a misdemeanor. In addition to strengthening laws, policy developers should also investigate physical safeguards. Maybe metal detectors in emergency rooms should be required. Although they may not be very welcoming, safety must have priority over aesthetics. Another change should be mandatory visitor sign in. This may deter potential violence as people cannot hide behind the veil of anonymity. Finally, healthcare workers must report all incidents of violence.

Nurses and other medical professionals must speak out to change the laws regarding violence to healthcare workers. Zimlich (2014) reports that, “Almost 72% of nurses reported that their hospital employer did not respond satisfactorily to the violence that these nurses experienced and then reported either formally or informally. The study also noted that the majority of nurses who experienced violent events did not make formal reports documenting the incident.” Regardless of the response by the employer, employees must report violence if action and reprimand are to be taken at all. If the hospital employer does not report these events to authorities, nurses should.

It can no longer be part of the health care culture to experience violence, assault, or harassment while caring for patients. Healthcare workers must speak out regarding violence, and policy makers must strengthen the laws in Alaska.

Courtesy: A L D


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