Is Workplace Violence Taken Seriously in Healthcare?
According to reports, healthcare has become the most violent sector in the United States. This was surprising when I first learned of this and Iām sure that many others are unaware of the threats that our healthcare workers face each day. Even professional associations, like the Georgia Hospital Association, will tell you that workplace violence is one of the top concerns for hospitals. Still, as I discussed in my previous blog post, many healthcare executives, especially with hospitals, are very reluctant to discuss the topic.
Mum’s The Word
I was working with a client a while back who wanted me to conduct conflict resolution skills training for his entire staff. I was glad that this executive saw the need and benefit for this type of training. The training went well and had good interaction among the training participants. Towards the conclusion of the training, I really wanted to go through an exercise of practical application for the techniques we had covered. So, to do this, I wanted the participants to give me examples of conflicts that they had had in the workplace, inform me of how they handled it, and then for us to debrief as to how things could have been better utilizing the strategies that we covered in the training. I guess this idea didnāt sit well with the executive as he was quick to tell everyone not to discuss any interpersonal (coworker) conflict, which I found understandable, and to not talk about any conflicts that they had had with patients. His reasoning was that doing so would have violated HIPAA, although it wouldnāt if no identifying information for the patients were mentioned. Either way, I found this ironic since I was brought in to help resolve instances of conflict that the staff were having but, yet we couldnāt discuss the actual conflicts that they were having.
Is this type of behavior normal for healthcare executives? Are they willing to say āyes, we need helpā but then shy away from what they specifically need help with? How does this work towards finding a solution to the actual problem?
Fa-get-about It
There was another instance where I had a meeting with four different nursing directors over different departments in a hospital. Each one of them discussed how their nurses were facing increasing incidents of conflict with patients and family members of patients. Although this hospital had armed security officers, the nurses needed help in trying to defuse these type situations. As a result of the conflicts, many of the nurses regularly gave patients forms where they could leave against medical advice just as a means to get rid of the conflict although the patientās leaving may not have been in their best interest, medically. After meeting with the four directors, I had a meeting with one of the executives at the hospital. This executive was very interested in what the directors said they needed help with and then, the executive identified other areas where the hospital needed improvement. As of today, this particular executive and hospital has yet to act on any initiatives to address these areas of needed improvement. No wonder this hospital has a high nurse turnover rate, according to one of the directors.
Are the challenges of front-line workers being heard and taken seriously by executives? Is patient and staff care and safety our focus, as an institution, if we continually turn a deaf ear to their pleas for help in such critical areas as conflict and workplace violence?
An observant person can easily detect whether hospital administration takes conflict and workplace violence seriously. Usually within 30 seconds of entering a hospital, I can tell you whether these threats are taken seriously and whether the hospital is a secure environment. Yes, many of these hospitals have armed security but that doesnāt mean that theyāre secure. From a legal perspective, the presence of armed guards dramatically increases the liability for the hospital, and it is questionable as to whether they are more effective than unarmed security, considering that most instances of conflict does not require an armed response.
Introspection
It’s clear that healthcare institutions desperately need a moment of inflection. We need to honestly assess our organizational environment. If weāre in a position that is far-removed from the frontline, we need to solicit feedback from our frontline supervisors and staff and then act on what is needed, especially if it impacts patient and staff health and safety. We also need to honestly look at how we may contribute to the presence of conflict and violence. Do we exhibit behaviors or mannerisms that frequently lead to conflict? Is there something systemic within our organization, such as particular policies, that often creates conflict? Depending on the answer to these type questions, individual and organizational change may be necessary.
Status quo thinking will not prevent workplace violence or protect the people that we employ or serve. Innovative thinking is needed to determine the scope and extent of the problem or threat and then to develop strategies to mitigate these factors. Many medical facilities pride themselves on being on the cutting edge of medical technology, especially hospitals, yet are extremely slow to adapt to needed change in other areas. The bureaucracy and decision-making process of many healthcare facilities and hospitals only exacerbates this and creates decisional paralysis. In the meantime, the problem of conflict and the threat of workplace violence persists.
A mentor of mine, when discussing mediations and helping parties work through conflict, often said āpay attention to what youāre paying attention toā. Too often we get distracted, especially when someone else is talking. Either they are talking about something that we arenāt interested in, we donāt feel that it is important, we may not like the person talking, or we may have other pressing issues to deal with, regardless, weāre not paying attention to what is being said. Thereās no doubt that healthcare executives must juggle many different responsibilities in their day-to-day work, but when it comes to workplace violence, are they āpaying attention to what theyāre paying attention toā? On more than one occasion, Iāve heard individuals say that they do not have the funds to invest in conflict resolution or workplace violence reduction initiatives. Is the budget more important than the safety of the employees and patients? What message is being sent when we canāt invest in measures to reduce conflict and workplace violence, but we can find the funds to remodel the executive suite or other areas of the facility?
Perhaps the challenge is regarding our perception of conflict resolution and workplace violence prevention initiatives. My impression is that many healthcare executives view these as an expense, which is why they fall back on budgetary constraints, while they view other things, like building an addition to the medical facility, as an investment that they will reap a return from. Conflict and the potential for workplace violence does impact employee and organizational performance, workplace morale, and the quality of patient care. Conflict costs American businesses approximately $359 billion annually with roughly 85% of employees experiencing conflict in the workplace. In other words, even if you do nothing, conflict is costing your organization tremendously ā it is estimated that the average worker spends 2.8 hours every week dealing with conflict. What would be the cost savings or even return on investment if we got serious about reducing conflict and workplace violence in healthcare? This doesnāt even take into consideration the many intangible benefits of these initiatives.
Conclusion
I frequently tell my daughters that āyouāve got this until you donāt have thisā when discussing various challenges and hurdles of life. Based on my experience, many healthcare entities feel that theyāve got things under control when it comes to workplace conflict and violence until the moment comes when they realize that they ādonāt have thisā. Unfortunately, that moment of realization doesnāt normally happen until there is a crisis and incident of workplace violence. Hopefully, no one is seriously injured or killed in that situation but if they are, the question for the executives then becomes one of whether the decision to forego initiatives to address conflict and workplace violence worth it?
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