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Violence against caregivers is on the rise. Here’s how we stop it.

Healthcare is a high pressure industry, and the skilled, dedicated workforce providing care realizes the inherent stress of this line of work. But these everyday challenges were magnified by COVID-19, which drove record levels of burnout and turnover among healthcare employees. On top of everything, Press Ganey data also points to an alarming problem in healthcare workplaces: violence against caregivers. In the U.S., two nurses are assaulted at work every hour, according to our analysis. And with many assaults going unreported, there’s near certainty that actual number is even higher.

Violence against healthcare workers has been a problem for years. But the external environment during the pandemic fostered mistrust among some patients, and contributed to an increase in violence in the workplace. As politicians deliberate laws aimed at reducing violence against caregivers, leaders and front-line healthcare workers can take steps to help.

How COVID-19 drove a wedge between some patients and health systems

While many hailed healthcare workers as heroes during the pandemic, public discourse around COVID-19 led to confusion and mistrust of the healthcare system among others. Questions around the vaccine, safety protocols like masking policies and social distancing, use of unproven medications, and inadequate communication around constantly changing advice drove a divide between some patients and medical professionals.

The healthcare industry has yet to rebuild that trust as the pandemic receded. Despite healthcare professionals’ best efforts to deliver top-notch care, patients often don’t always see (or appreciate) their good intentions. Difficulty contacting the office or booking an appointment, long wait times to see a provider, anxiety over a diagnosis or course of treatment, as well as insurance and reimbursement complications, compounded patient frustrations. The friction in the system is so significant that 70% of Americans feel disappointed by U.S. healthcare in some way. And Press Ganey data shows a clear relationship between friction and trust; as friction increases, trust declines.

Create a culture of psychological safety for healthcare providers

Most people who enter the field of healthcare do so because they want to help others. But, in order for healthcare professionals to effectively deliver compassionate, high-quality care, they must feel they’re in a supportive environment—one that establishes safety as a core principle of the organization’s culture.

For healthcare professionals, violence has physical and psychological implications. Those who experience violence at work understandably tend to trust patients less, adding to wariness in interactions. One pre-condition for organizations to address workplace violence is to have a zero tolerance policy; when the workforce trusts the administration to protect them, to have their back when they are threatened, caregivers can focus on the job they get up every day to do.

Patients seek healthcare when they need help—they are often, sick, confused, or scared.Some come with a background steeped in trauma, believing they must fight for the help they need. Patients generally assume that healthcare workers have the technical skills to do their job. What they don’t always believe is that those providers will listen carefully, optimizing their diagnosis and treatment. Patients want respect and courtesy; occasionally patients believe the only way they will be granted the care they need is to fight for it. One in nine patients in our emergency rooms present with or for a mental health issue, which can contribute to confusion, fear, and/or anger. Listening to patients—and ensuring they feel heard—helps identify opportunities to lead with empathy, build trust rapidly, and de-escalate otherwise high-risk encounters. Investing in both communicating with empathy and in de-escalation training can help front-line providers lower the risk of events spiraling out of control.

Human connections are essential to building trust, and preventing violence against caregivers

Knowing that both healthcare workers and patients want the same outcomes—i.e., healing, and optimal health—doesn’t make it easy to overcome mistrust. Clinicians who go to work each day worrying they might be assaulted are on guard. Patients who don’t feel safe are tense and fearful. Under those circumstances, the likelihood of misunderstandings runs high, and those misunderstandings can snowball into even more mistrust and anger. In order to build trust, providers and patients must be able to form honest human connections. Nurses, physicians, and other personnel need to know that their workplace has a zero tolerance policy on violence, and they need to feel safe in reporting and escalating incidents to leaders. High performing organizations ensure the people who do the work have voice in improving the work through strategic action teams—groups of caregivers focused on identifying and reducing sources of workplace violence.

Once healthcare workers feel confident that violence won’t be tolerated, it’s easier to forge human connections with patients. Effectively addressing workplace violence is a critical step to rebuild the trust so vital to a thriving healthcare ecosystem.

By recognizing and addressing the underlying causes of violence, and mitigating the risks that can lead to violent behavior, healthcare organizations can improve caregiver safety and patient satisfaction, and deliver better outcomes, for all. 

To discuss this topic—and any others—in greater depth, reach out to a member of our strategic consulting team.

About the author

As Press Ganey’s Chief Clinical Officer, Dr. Amy Compton-Phillips’ main focus is on improving healthcare value at scale. She is responsible for leading the Strategic Consulting team and Centers of Excellence. Prior to joining Press Ganey, Dr. Compton-Phillips was the President of Clinical Care at Providence, responsible for clinical operations and care including improving health, care, and value outcomes delivered by the 52 hospitals, 1,085 clinics, and 120,000 caregivers of the $25 billion health system.

Profile Photo of Amy Compton-Phillips, MD