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Show Wellness Amid Workplace Violence: Strategies for Nurses in Oncology and Across Specialties Scott S. Christensen, PhD, MBA, APRN, ACNP-BC, Chris Snyder Eliza D. Parkin, DNP, APRN, FNP-C, Mary Jean Austria, MSN, RN, OCN Key Findings: This overview confirms a notable escalation in workplace violence incidents within nursing during the pandemic that continues today, with several factors exacerbating the typical stressors in healthcare settings. To address this issue, healthcare organizations and nursing professionals can use evidence-based practice to assess risk factors and enhance workplace safety. Background • • Workplace violence incidents in nursing increased during the past decade and skyrocketed during the pandemic Oncology-nursing-specific data related to workplace violence is less reported than in areas of higher risk (Emergency Department, Mental Health, etc.) Aim • This workplace violence overview aimed to raise awareness of trends and personal safety issues relevant to clinical oncology nursing practice, offering strategies to enhance the safety of any nursing care setting. Methods Literature review • Review of Scopus, PubMed, and CINAHL databases for nursing workplace violence trends National and local experts • National guidelines, recommendations, and best practices • Publicly reported data (e.g., BLS, OSHA, ICRC) • Expert opinion from local security and nursing personnel. Narrative oncology nurse experiences • Collection of real-world clinical oncology practice scenarios and recommendations for enhanced workplace safety. 10 PERSONAL SAFETY STEPS FOR NURSES TO MINIMIZE THEIR RISK FOR WORKPLACE VIOLENCE* 1. Learn to recognize warning signs of escalating behavior before entering an unsafe environment. 2. Consider all aspects of communication when interacting with others, including proximity, body language, and paraverbal communication (e.g., word choice, tone, pitch, pace). 3. Understand that people in distress cannot communicate as they would normally. Allow time for an individual in distress to process what you are telling them. 4. Slow down and assess the environment before interacting with an aggressive or distressed individual. Use an interprofessional team approach to handling critical situations. 5. Identify what an individual (e.g., patient, family member, visitor) wants and what options are available to offer to them. 6. Use empathy and active listening to help ensure others feel valued and supported. 7. Be flexible and willing to negotiate when appropriate. 8. Know yourself and when to tap out before you escalate and become part of the problem. 9. Attend to the basic physiologic needs of escalating individuals before and after an event. 10. Ask for help because it is difficult to solve complex emotional events independently. QUESTIONS FOR IDENTIFYING HEALTH SYSTEM OPPORTUNITIES TO MITIGATE WORKPLACE VIOLENCE* STRONG ORGANIZATIONAL CULTURE • • • • • Are employees empowered to confront disruptive or inappropriate behavior? Are frontline employees involved with developing policies, training, and response? Are patients, staff, and visitors held accountable for undesirable behavior? Is the organization committed to a zero-tolerance approach to workplace violence? Are there systems in place to provide the victims of workplace violence with resources for emotional and physical support? PREVENTION • • • • • Are engineering controls (badge access, cameras, duress alarms, personal alarms) in place? Is there a visitor management program to control a location’s ingress and egress and identify patients, staff, visitors, and vendors? Is there a threat assessment program and partnerships with key groups, including healthcare leadership, security, law enforcement, risk management, legal, and human resources? Is there a robust workplace violence policy that is regularly updated and accessible? Are healthcare policies (masks, construction, traffic delays, changes in locations) communicated to incoming patients, staff, and visitors? Results • Broad and oncology-specific workplace violence trends assessed and organized, including: o Best practice recommendations for evaluating and mitigating the risks of workplace violence o Vignette examples of real-life workplace violence incidents in oncology nursing settings o A description of the factors contributing to the rise in workplace violence in nursing Conclusion • This overview emphasizes the critical need to address workplace violence trends in all nursing clinical practices, including oncology. • Best practices for reducing the risk of harm can be applied to promote the safety of nursing professionals. *The Published Overview Highlighted in this Poster: New Research About Workplace Violence in Nursing: TRAINING AND EDUCATION • • • Do staff receive training about situational awareness, recognizing workplace violence warning signs, de-escalation, and personal safety? Is this training conducted regularly and offered to workers in all healthcare disciplines? Are new hires educated about workplace violence policy, response, and training? REPORTING, DOCUMENTING, AND RESPONSE • Is the process for reporting workplace violence simple, efficient, and quick? • Is an immediate response team available to help de-escalate and resolve workplace violence incidents? • Is there a follow-up plan after workplace violence events that includes safety plans, behavioral contracts, and increased security? COLLEGE OF NURSING |
