End Nurse Abuse: 4 Actions You Can Take Today

As a former OR nurse and CNO, Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, Director of Nursing Programs for the American Nurses Association (ANA), knows all too well how nurse abuse can permeate a healthcare setting, especially in the closed quarters of a perioperative suite.

Maybe a patient struck you during a preoperative assessment when you asked them about exposure to illegal drugs. Or perhaps a person with hierarchical seniority verbally insulted you after a conflict during surgery. Maybe a fellow nurse made unwanted sexual advances in the privacy of an unoccupied surgical suite.

An Unspoken Occupational Hazard

Reports of nurse abuse show that one in four nurses has been physically or verbally assaulted.

Research indicates this number is much higher in reality, with data suggesting 40-80% of nurse abuse is not reported.

The ongoing COVID-19 pandemic has only increased nurse abuse, with additional strains impacting mental health of patients and healthcare professionals. The violence seen in the public over the past year is also being seen in healthcare, including racially-motivated harm to nurses, and all of this is adding to the abuses against nurses ANA is hearing about, Boston-Leary notes.

“Nurses tend to accept this violence as part of their job, but make no mistake, abuse has absolutely NO place in nursing or towards any person in any setting” she stresses.

AORN agrees. That’s why AORN is supporting ANA in the national campaign #EndNurseAbuse to establish a zero-tolerance workplace culture where abuse is not tolerated in any form, whether verbal, physical, psychological, or sexual, including racially-motivated abuse.

You can support this end to nurse abuse, too.

Taking a Stand

To end nurse abuse for good, Boston-Leary says it takes every nurse speaking up and reporting abuse within an organizational culture that has an established process for allowing nurses to report abuse without fear of recrimination and then follows up with a resolution.

Here are four actions she suggests any nurse can take to turn the tide against abuse in their own practice setting:

1. Know the Definition of Abuse
   The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as “the act or threat of violence, ranging from verbal abuse to physical assaults directed toward persons at work or on duty.”
   
   Agreeing on this definition is an important first step to achieving widespread acknowledgement of the different types of nurse abuse, particularly non-physical abuse, Boston-Leary explains.
   
   “Subtle forms of assault, such as through words, are considered concealed weapons because the words harmed you and you didn’t see them coming, but the abuse can also create a ‘shock and awe’ response that leaves you wondering if you really heard what you heard—you might second guess yourself or wonder if anyone will believe you.”
   
   She hopes with awareness and education, a nurse experiencing any type of abuse can realize they have been abused.
   
   
2. Report Abuse
   Ask about how your workplace handles abuse reporting, whether it is in your current workplace or when you are applying for a position, Boston-Leary suggests. “Ask about how reporting abuse happens during any shift because there should be a reporting mechanism in place for everyone, even if it’s on a weekend or evening shift with no manager easily accessible to report to.”
   
   If (when) you do experience abuse, it’s essential that you speak up immediately and note any witnesses who could corroborate your description of the incident, she says.
   
   Even after you experience abuse and even if you didn’t report it, it’s important to share your past abuse with others to empower them to report abuse they experience.
   
   
3. Change Your Culture
   Join or convene a committee to build or strengthen zero-tolerance abuse policies. Based on ANA’s Zero Tolerance Policy on Workplace Violence, Boston-Leary suggests these important elements of a zero-tolerance abuse program:

• Stop violence before it starts through education to identify risks and reduce vulnerabilities for workplace violence.
• Create an effective response to violence immediately after it occurs, including emergency care.
• Establish long-term responses that reduce the long-term negative effects of workplace abuse.

4. Speak to Your Legislator
   Congress is currently considering legislation to #End Nurse Abuse by passing The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R 1195). If approved, this law would require health care and social service industry employers to develop and implement a comprehensive workplace violence prevention plan that protects nurses and other healthcare professionals from on-the-job abuse.
   
   Boston-Leary believes legislators are very attuned to the trusted voice of nurses to share about what is happening in health care today. “Send an email to your legislator to explain why this legislation and ANA’s #End Nurse Abuse campaign is important to you.”