Workplace Violence: The Conversations That Healthcare Executives Try to Avoid
Over the past few months, Iāve read a lot of reports and articles regarding workplace violence in the healthcare setting. In fact, when I first began looking at the topic, I was surprised to learn that healthcare has quickly become the most violent profession in the United States. Ideally, workplace violence should not be present in any profession, but reality is much different. A quick Google search on any given day will reveal recent news reports of some form of workplace violence being perpetrated in the healthcare or hospital environment. The sad truth of this is that healthcare workers are not trained or educated to deal with this type of violence. In fact, if you were to ask any healthcare worker why they chose their profession, most, if not all, of them will say they entered the field due to a desire to help their fellow man during their time of injury or sickness. Basically, they wanted to make a positive difference. Never did they intend to have to be aware of and deal with actual or potential acts of workplace violence.
Workplace violence isnāt something that is unique or isolated to healthcare as this type of violence can be found in every career field. What distinguishes these professions from each other is their willingness to accept the degree of violence in their facilities and their openness to look for effective ways to reduce them. What is ironic about this is that, according to the Georgia Hospital Association, the topic of workplace violence is within the top three topics of interest to the hospitals that they serve, yet, when contacted, many hospitals seem to be disinterested in discussing the topic.
Why The Reluctance to Discuss Workplace Violence
Iāve talked to several hospital executives over the past few months about the topic of workplace violence and conflict within the hospital environment. One executive mentioned that many people in hospitals are reluctant to talk about conflict or violence in the field because they donāt really know what to do about it. So, instead of discussing it, they often choose to either ignore or minimize it instead of admitting that there is a problem, at least nationally, with violence in healthcare. Perhaps the unwillingness to admit that thereās a problem with violence is because these individuals feel as though it is a sign of weakness or incompetence to admit that they donāt know what to do about it. This shouldnāt be the case because, as mentioned earlier, the healthcare field should not involve violence and most people entering the profession receive no training on how to respond to violence on the job.
Another executive that I talked to mentioned that some hospital systems will state that they already have internal āteamsā to address workplace violence and conflict, so thereās no need to discuss the topic further. Unfortunately, these āteamsā are not adequate and regular employees and their direct supervisors at these hospitals will tell you that these alleged āteamsā are deficient. Why? Most of these āteamsā are simply poorly trained security staff who cannot be everywhere at every moment within the hospital setting. Some of these security staff members are either current or former police officers which does bring a certain degree of credibility but standard police tactics, particularly regarding physical restraint tactics are not appropriate for responding to conflict or violence within a healthcare setting. In fact, these tactics frequently increase the liability that the healthcare facility assumes tremendously. Either way, delegating conflict resolution and workplace violence prevention to security staff is simply a tactic for executives to say āsee, we did somethingā which is ultimately minimal and ineffective at addressing the root problem.
Potential legal liability is another reason some healthcare executives choose to ignore conflict and workplace violence. There could easily be this perception among executives that if you admit the presence of a problem, then it opens the door for legal liability against the organization. This was common in medical malpractice cases a few years ago. In mediations, the doctors involved in medical malpractice cases were advised against saying āIām sorryā to the plaintiff(s) because there was a perception that doing so would imply guilt or fault. What has been witnessed in the years since then is that the issuance of an apology in these types of cases helps to bring the case to resolution. The original fear has been unrealized. This could also be the case with workplace violence. For hospitals and healthcare organizations, the admission that they have issues with conflict and violence could be used against them should an issue arise that results in legal action. In reality, this is far from the truth.
How to Start Addressing the Problem
What should healthcare executives do? To begin to address the problem of conflict and workplace violence in healthcare, there are a few things that executives must do. Here are five things that executives must do to begin the process of reducing these events:
- Be real! Be open and honest about the problem of conflict and workplace violence. Recognizing and admitting the problem is the very first step in finding a solution to the problem. Oftentimes we do not like this stage as the problem is ugly, embarrassing, uncomfortable, etc., but we have to be real with ourselves and others about the extent and magnitude of the issue.
- Know your limits. No one is expected to know something about everything. While you may not have an actual answer for conflict and workplace violence, no one really expects you to. Thereās absolutely no reason to be ashamed to reach out to external help. A true leader knows his/her boundaries and then seeks others who supplement the leaderās weak areas. There are individuals highly trained in conflict resolution who can help reduce the conflict and instance of workplace violence that your organization is experiencing. I understand that you have a security team that may be led by a person with years of experience in law enforcement ā thatās not sufficient and could add to the problem! This is another reason why external assistance should be sought in these cases. Everyone knows how to cut someone open but not everyone has the skill or expertise to be a surgeon.
- Allocate resources to address the problem. Granted, allocating funds to build a new trauma tower or remodel the administrative suites may be more appealing and sexier but if we are going to get serious about trying to reduce conflict and workplace violence in healthcare, we must start allocating monetary resources towards this endeavor. This is another area that is usually poorly funded by executives. You get what you pay for ā and this is no exception. Whenever more emphasis and resources are applied to hospital grounds maintenance (i.e., mowing the lawn, etc.) than reducing conflict and workplace violence, you have a problem.
- Lead by example. Your employees, especially those on the frontline, will tell you that they are struggling with conflicts and potential instances of workplace violence at the hands of patients, patient family members, and sometimes co-workers. Theyāll tell you that what you are currently doing isnāt cutting it. Show them that you hear them and that their message isnāt going unheard. Take initiatives to act on what they are telling you and work with external resources to find a solution ā now! Not ten years from now. Many executives say they care about their employees, lead by example and prove it by providing your employees with a safe place to work!
- Be committed and consistent. Donāt operate under the mindset that conflict resolution and workplace violence reduction will be a one-time event. For hospitals particularly, their accreditation standards often specify that conflict resolution training should be provided to every employee at least annually and that newly hired personnel should go through this type training prior to starting their official duties. How often is this actually done? What type of training are they being exposed to in terms of quality? What are the qualifications of the trainers? The entire executive team should be committed and consistent, year after year, in taking part in initiatives to improve the overall work environment by reducing conflict and workplace violence.
- Stop using budgetary constraints as an excuse! I heard several individuals say that they arenāt allowed to spend any money due to budgetary restrictions. Granted, I understand the financial bind that many hospitals are faced with but the truth of the matter is that funds are available, itās just a matter of priorities. The fact is that, even with the financial challenges, hospitals are regularly adding on to their facilities. In addition, theyāre still spending money for their grounds to be properly manicured and for the parking lot to be repaved. Yes, I understand that money may have been specifically allocated towards these items while nothing was allocated to conflict resolution and workplace violence reduction initiatives but even that excuse is very weak. What happens in a hospital if something was to break or go wrong with their da Vinci surgical robot system? Surely they wouldnāt wait until next year to allocate funds towards itās repair. What would happen is that they would find the funds to repair the equipment now because they see the urgency of it. Conflict resolution and workplace violence reduction initiatives should be responded to with similar urgency.
Conclusion
Conflict and workplace violence has increased dramatically over the past few years in the healthcare field. Many healthcare facilities and hospitals have tried to address these problems while being mindful of severe budgetary constraints. Unfortunately, many of the tactics that have been implemented have had very little impact on the presence of conflict and workplace violence in healthcare. These lack of results must be recognized and addressed by executives instead of the realities being glossed over and viewed upon with rose-colored glasses. Itās past time that we have open, honest conversations about the problem of conflict and violence in healthcare because the problem will still be there even if we elect to ignore it. There are effective measures to put into place whereby healthcare employees can become better at responding to potential conflict and thus reduce violence. These measures start with having difficult conversations about the problem.
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