It’s no secret that our health care workers have faced unprecedented challenges over the past few years, from caring for the sick through the pandemic to staffing shortages to high rates of burnout. An Oct. 12 story in The Colorado Sun detailed yet another challenge — the troubling rise in violence against health care workers in Colorado.
Data specific to the true incidence of workplace incivility, bullying and violence is limited due to challenges in consistent reporting. However, a 2022 survey from the American Nurses Association Foundation of more than 11,000 nurses nationwide found that 60% of nurses experienced incivility and bullying, and 29% reported incidents of violence.
As executive director of the Colorado Nurses Association (CNA), I work every day to advocate on behalf of nurses, the largest and most trusted group of professionals in our health care system. Our work on behalf of all Colorado nurses is to assure that these academically and clinically prepared professionals are able to provide the care that each of us needs and deserves when illness strikes.
That’s why CNA is supporting a bill during Colorado’s upcoming legislative session that is laser-focused on reducing the risk and preventing workplace violence.
Nurses choose this profession because they have a strong desire to help people and make a positive impact in patients’ lives. They want to love their jobs, and they want nothing more than to be able to do their jobs safely and effectively. Health care workers deserve dignity, respect and safety on the job. They should not be afraid to go to work.
Without a doubt, we need action to keep health care workers safe. A CNA member and nonmember survey in August indicated that nurses’ priorities for workplace safety are adequate staffing, education and professional development in de-escalation techniques, and consistent and reliable response teams to incidents of incivility, bullying and violence.
The proposal before state lawmakers will require hospitals to create violence prevention plans based on recommendations from frontline workers and the most up-to-date data on how and why violence is occurring in their facility. It will also require hospitals to give workplace violence training to workers, which includes proven de-escalation tactics to help workers protect themselves. Finally, it will ensure health care workers are taken care of in the aftermath of an incident by requiring facilities to offer a variety of resources, including mental health care.
According to the Sun’s reporting, there are some current efforts to curb workplace violence in health care facilities by increasing criminal penalties for assaults on health care workers. While these efforts may be well-intentioned, they’re not likely to prevent violence. Assaults are already a crime, and we know of no data that confirms that increased sentencing reduces incidents of workplace violence.
Not only is there no evidence basis for policies that increase criminal penalties when a health care worker is assaulted, but these policies disproportionately impact those with behavioral health issues, people with disabilities, and people with neurological conditions like epilepsy, dementia and others. In addition, racism and implicit bias in our criminal justice system will disproportionately impact people of color. Black Coloradans constitute 5% of state residents but 17% of people in jail and 18% of people in prison. This legislation will only exacerbate this crisis.
Further penalizing these already-vulnerable populations after an incident doesn’t make us any safer, and these kinds of policies put health care providers who have a duty to first and foremost do no harm to their patients in an ethically compromised position. Many health care workers might feel uncomfortable threatening legal action against their patients knowing it could result in a felony charge that would have a negative impact on their patient’s overall health and potentially lead to their condition worsening. We need to give these workers tools to keep their workplace safe that don’t involve anyone going to jail.
Though some may be tempted to threaten punitive action, it is more important to us that any legislative action taken makes meaningful changes to the work environment to prevent violence in the first place.
We need a research-backed, prevention-focused solution to protect health care workers. Health care workers have been working hard to keep us healthy and safe amid unprecedented challenges, often risking their health while battling burnout in high-intensity environments. They deserve real solutions to keep them safe on the job.
Colleen Casper, DNP, RN, MS, is the executive director of Colorado Nurses Association and a long-time nurse leader and hospital administrator in Colorado. Her work has always been about increasing the voice of nursing in organizational policy and quality improvement.
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