1. Ehrmann, Gerry MSN, APRN
  2. Zuzelo, Patti Rager EdD, APRN,BC, CNS

Article Content


The purpose of this presentation is to provide CNSs with information specific to workplace violence and to promote an appreciation for proactive strategies that may reduce actual and potential violent events. A secondary purpose is to provide an overview of available resources that may be useful to CNSs interested in better understanding workplace violence.



Workplace violence is recognized as an occupational hazard for healthcare providers, including nurses. The Bureau of Labor Statistics (BLS) estimates that in 1999, there were 2,637 nonfatal assaults on hospital workers. In 2004, there were 551 workplace homicides in the United States, out of a total of 5,703 fatal work injuries (OSHA, 2005). The rate of nonfatal assaults in hospitals is 8.3assaults per 10,000 workers as compared with a private-sector rate of 2 per 10,000 workers.



Violence is serious and insidious problem yet remains unregulated and is not nationally tracked. CNSs are obliged to consider the risks of workplace violence and galvanize colleagues within the healthcare system to seriously evaluate risks, plan interventions, and develop programs to respond to crises related to violence.



This presentation is an informative overview of workplace violence with specific information related to the healthcare system.



CNSs need to consider strategies for assessing the risk of workplace violence, monitoring the frequency of violent events based on typology, and developing action plans that respond to violent victimization and meet the needs of employees affected by the aftermath of violence.



Workplace violence is rarely discussed within healthcare organizations. Patient safety is a priority, and yet, one aspect of keeping patients safe involves assuring a nonviolent healthcare setting.CNSs are in an ideal position to exert influence and minimize the risks and damages associated with workplace violence.


Implications for Practice:

There are many factors that contribute to workplace violence and place nurses at risk. Typical interactions with patients, family, and visits are potentially dangerous depending on thecontext of the interaction, the stress levels of the individuals involved, and the personal attributes and behavior patterns of each. Nursing is a "people business" and, as such, carries risk. This risk is compounded by inadequate or nonexistent policies regarding workplace violence. Assaults, particularly verbal, occur between healthcare workers of all types including physicians, nurses, ancillary staff, and multidisciplinary team members. Lateral and vertical violence occurs regularly in the healthcare workplace. Hospitals are microcosms of society and, as such, are socialized to violence. Larger economic forces and resource shortages create circumstances addressed through labor downsizing, layoffs, and terminations. Workplace violence is a multifaceted event with the potential to increase in frequency and scope. CNSs need to have a basic understanding of the risk for workplace violence in order to intervene in effective, efficient, and meaningful ways.