“Two million workers in the United States are victims of workplace violence every year, a statistic that includes construction workers,” says LIUNA General President Terry O’Sullivan. “No one should go to work in an environment where they have to worry about becoming a victim. More needs to be done to protect them.”

LIUNA General President Terry O’Sullivan

Construction sites were the scenes of 130 assaults on construction workers in 2014. But the possibility of violence exists in every workplace. What may be a surprise to some people is that health care settings are where it happens most often and health care workers, some of whom are LIUNA members, are usually the targets.

A Vulnerable Workforce

The most common types of violence in medical settings involve patients and visitors of patients hitting, kicking and beating health care providers. In 2014, more than 11,000 of these incidents were reported. Nurses are especially vulnerable, as they spend the most time with patients and their families. In 2014, three in 10 nurses reported physical abuse according to the Journal of Emergency Nursing. Verbal abuse is also common.

There are also homicides. Increasingly, these crimes involve guns. In the 12 months leading up to the January 2015 shooting death of a Boston surgeon killed by the son of a deceased patient, there were 14 other active shooter incidents in hospitals that left 15 people dead. Over the last 10 years, incidents involving active shooters in U.S. hospitals have increased to more than one a month.

Assistance from OSHA

Federal OSHA does not have a workplace violence prevention standard but a number of state OSHAs have developed their own. As of August 2015, nine states require certain health care facilities to have workplace safety programs. California OSHA, which has had its standard since 1993, is now proposing updates. Other state programs have incorporated elements of the current California OSHA standard and it is likely they will do so again once the latest updates are approved.

California OSHA’s draft standard classifies workplace violence into four categories:

• “Type 1 violence”: Violence committed by a person who has no legitimate business on the work site and who enters the workplace with the intent to commit a crime.
• “Type 2 violence”: Violence directed at employees by customers, clients, patients, students, inmates or any others for whom an organization provides services.
• “Type 3 violence”: Violence against an employee by a present or former employee, supervisor or manager.
• “Type 4 violence”: Violence committed in the workplace by someone who does not work there, but has or is known to have had a personal relationship with an employee.

The proposal also requires employers to develop an annually reviewed Workplace Violence Prevention Plan that includes:

• Risk assessment of environmental factors, such as poor lighting or employees working in locations isolated from other employees and procedures to correct these hazards.
• Procedures to assess visitors and identify and evaluate patient-specific risk factors such as a patient’s mental status and history of violence.
• Procedures for post-incident response and investigation.
• A Violent Incident Log.

Although federal OSHA does not have a workplace violence standard, it does offer guidance for health care and social service workers. NIOSH has also developed a course on workplace violence prevention for nurses.

Stop Violence before It Starts

No workplace, health care or otherwise, is immune to the possibility of violence and employees shouldn’t have to worry that there are no procedures in place to help keep them safe. The LHSFNA has developed its own workplace safety program that assists in the prevention and management of workplace violence. It can be ordered through the Fund’s Publications Catalogue.

[Janet Lubman Rathner]