Mistreatment of Health Care Workers Is Our Problem
Health care workers in the United States are five times more likely to experience workplace violence than workers in any other profession.
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The COVID-19 pandemic was a difficult time for health care workers. They faced staffing shortages due to illness and departure of colleagues, as well as exposure to a deadly virus, often without appropriate ways to protect themselves. As a result, maintaining a healthy workforce is one of the top challenges faced by health care leaders today. My colleagues and I wanted to understand what organizational experiences health care workers were having during and after the COVID-19 pandemic and identify ways to improve their desire to stay in the workforce and to continue providing patient care.
We collected data on health care worker experiences at a large academic medical center from 2020-2022 and were alarmed at the growing reports of both physical violence and verbal mistreatment reported from patients and visitors toward health care workers. We also collected comments on experiences at work, and looked at national trends using data from several sources.
What we found was unsettling. U.S. health care workers are five times more likely to experience workplace violence than workers in any other profession. Nearly a quarter of the health care workers we surveyed reported mistreatment from patients or visitors as a major stressor, and about 15% said workplace violence from patients or visitors was a major stressor.
Our analysis revealed that certain groups are more vulnerable. Nurses, reported the highest levels of stress from mistreatment and violence. We also found that younger workers (age 18 to 24), women, and gender minorities were more likely to report these stressors. The emergency room (ER) showed the highest percentages of stress from mistreatment (62%) and violence (56%) from patients or visitors.
[W]hen we protect [health care workers], we’re also protecting the quality of care for all of us who depend on their dedication and skill.
We didn’t stop at identifying who was most affected; we wanted to understand why. Our analysis showed that a lack of necessary supplies or equipment was a top predictor of stress from both violence and mistreatment. Other factors included patient attitudes about COVID-19, heavy workloads, and low perceived organizational support. These findings give organizations clear areas to focus on for improvement, and highlight issues that are not typically associated with increased violence.
One of our most troubling discoveries was the evidence of underreporting. The discrepancy between our survey results and national data is stark. A quote from one of our survey participants drives this home: they described multiple assaults on staff in a single month, but said it happens so often that they “hardly ever report these events.”
The consequences of this violence and mistreatment are serious. Previous research shows that it can lead to burnout, increased medical errors, and high turnover. Productivity can drop by up to 50% in the weeks following a violent incident. As researchers, we see these impacts not just on individual workers, but on patient care and the health care system as a whole.
So, what are we recommending? First, health care organizations need robust violence prevention plans and support systems for affected workers. They must also ensure workers have necessary supplies, reduce unnecessary job demands, and make it clear to patients and visitors that mistreatment will not be tolerated.
We’re also calling for policy changes. As of today, there are no federal protections for health care workers against workplace violence. While the Safety from Violence for Healthcare Employees (SAVE) Act has been introduced in Congress, it has yet to pass. Some states have taken steps, like making it a felony to assault a health care worker, but we need more comprehensive action. We’re committed to continuing this research and working with health care organizations and policymakers to create safer, more respectful environments for health care workers. After all, when we protect them, we’re also protecting the quality of care for all of us who depend on their dedication and skill.
