Identifying the Public Health Response

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Table of Contents

Introduction
Definition of Violence
Workplace Violence
Workplace Violence in Healthcare
Impacts of Workplace Violence in Healthcare Context
Impact on Healthcare Organizations and Personnel
Impact on Public Health
Conclusion
Works Cited

Introduction

Violent behaviors have not been a rare case throughout the history of the mankind. Thinking of the most memorable acts of violence one may recall different forms of victimization and oppression, wars, riots, smaller and greater armed conflicts, riots, and discrimination against various groups of the population. In fact, Bloom notes that unsuccessful attempts and failures to manage and minimize the acts of violence are common cases in the human history of the past and present (vii). Violent actions have been either ignored by the people at power or responded with even more cruel practices (Bloom vii). The contemporary world is characterized by a multitude of forms of violence many of which are dealt with and addressed in more effective ways than in the past; however, this does not help to eliminate violence completely. As a result, acts of violence have massive impacts on many spheres of individual lives and the life of the society overall. Violence affects the individuals and societies by means of creating risks, criminal behaviors, and deviance (Akers, Potter, and Hill n. p.). Acts of violence may disrupt personal as well as professional lives of people. Namely, one of the forms that tend to produce a massive negative effect on the careers is workplace violence. Moreover, healthcare is one of the career fields where workplace violence is rather common (OSHA 1). This paper will explore violence as a phenomenon of social, personal, and professional type, and focus on its impacts in terms of the healthcare context in a form of workplace violence against the healthcare professionals.

Definition of Violence

When it comes to the provision of an accurate definition of violence as a social phenomenon and a term, it is best to consult the official governmental sources such as the US Code. As defined in Title 16, a crime of violence is: “(a) an offense that has as an element the use, attempted use, or threatened use of physical force against the person or property of another, or (b) any other offense that is a felony and that, by its nature, involves a substantial risk that physical force against the person or property of another may be used in the course of committing the offense” (US Code15).

The definition given above is highly practical in terms of law and criminology; it views violent behaviors as legally punishable actions that result in harm caused to one or more individuals and thus must be addressed and monitored by the law enforcement services. The protection of the population from the acts of violence is a necessity in the contemporary world as the actions of this type that lead to damage and injuries are viewed as the violations of a human right to safety and security.

However, the legal point of view on violence is not the only one. This term is also used in order to define the actions that demonstrate aggression of one individual to another that may manifest itself in a form of bullying or violent threats that create a high level of discomfort to the victimized people or groups. Due to the emotional or physical damage or discomfort caused by the acts of violence, the affected individuals or groups become limited in reference to opportunities and freedoms; for instance, a person pressurized or harassed in a certain way by another person may be forced to isolate themselves from the rest of the society, show reduced professional performance, or start having mental health problems such as stress, anxiety, depression, and other emotional disorders; and that is why violence is to be prevented (Finkel 309).

In many cases, violence may be perceived as a majorly spontaneous happening or a phenomenon of an unpredictable nature that cannot be taken under control (Rosenberg and Fenley 3). This impression is supported by the fact that regardless of the existence and constant functioning of the law enforcement agencies, the mass media report new cases of violence (such as homicide, sexual assault, robbery, or child abuse) every day (Rosenberg and Fenley 3). However, the professionals working in the spheres of criminology, law, sociology, psychology, and health care are convinced that the phenomenon of violence can be researched, studied, and understood (Rosenberg and Fenley 3). The exploration of the dynamics of violence is conducted for a purpose to find out its mechanisms and roots, and be able to create and employ effective prevention policies and practices.

Workplace Violence

Acts of violence that occur in the professional settings and work environments are defined as workplace violence (“OSHA Fact Sheet” 1). Moreover, the United States Department of Labor notifies that in most situations, speaking about the acts of violence that happen at the workplace one should keep in mind that the range of such behaviors is rather wide and includes both verbal abuse, threats, and offensive statements and physical attacks or assaults (par. 2). Besides, the acts of workplace violence may affect and include different groups of people such as the employees, customers, visitors; in other words, all of these individuals are at risk of getting harmed. All in all, workplace violence has a broad definition and is characterized as involving all attempted behaviors that result in physical damage and non-physical abuse of the individuals or groups in the workplace environments; to be more precise, the definition of workplace violence provided by the World’s Health Organization is the following: “The intentional use of power, threatened or actual, against another person or against a group, in work-related circumstances, that either results in or has a high degree of likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation” (Cooper and Swanson iv).

According to multiple research results, there are a number of aspects and factors that contribute to the likeliness of the acts of violence happening at various workplaces; for instance, the employees who operate in the settings where alcohol is served, and there are many people under its influence, are at risk of becoming the victims of violent behaviors (The United States Department of Labor par. 3). Some more contributors to the potential cases of violence at work include operations with money exchange, working in isolated areas, or dealing with psychologically unstable or aggressive individuals (The United States Department of Labor par. 3).

When it comes to the intervention and prevention practices, different workplaces handle their challenges individually studying the threats and employing measures that would minimize the risks. For instance, banks and stores, whose operations with money make them vulnerable to the acts of violence, hire guards who watch the premises and people on the daily and nightly basis. A workplace with more complicated problems may create specialized programs helping to prevent violence and injuries training the workers how to act in versatile dangerous scenarios (The United States Department of Labor par. 4). In case if the risky duties and tasks are a part of the job description, the necessary safety trainings, tests, and procedures would be involved in the employee handbooks and workplace codes.

Workplace Violence in Healthcare

As specified by OSHA, health care sector is one of the industries that have the highest rates of workplace violence in comparison to private industry in general (1). To be more precise, the research conducted by the organization showed that the average rate of workplace violence cases in the health care sector is 7.8 cases per 10000 employees working full-time between 2002 and 2013; this number is higher than those of the other professional fields deemed risky in terms of occupations violence (such as retail, manufacturing, and construction) (OSHA 1). In healthcare institutions such as hospitals, medical centers, nursing homes the major risks of violence come from the patients, co-workers, and visitors; also, there may be intruders with criminal intentions (OSHA 1). For instance, a medical professional (such as a nurse, a paramedic, or a doctor) may be exposed to the acts of violence performed by the mentally unstable patients, aggressive patients (criminals, inmates, or suspects), gang members, relatives and friends of the patients who may displace their frustration and anger caused by the loss of a close one on the medical personnel (OSHA 1). Statistically, the highest percentage of all the violence acts is inflicted by the patients (80%), other clients or visitors may be responsible for the damage as often as 12% of the time, also, there is 3% likelihood for the act of violence to be caused by a co-worker or a student (OSHA 2).

The issue of workplace violence in healthcare is complicated by the fact that many of the medical institutions either lack a sufficient protocol for reporting violence or let such cases be overlooked and remain unreported (OSHA 2). Besides, the traditional approach of doing no harm usually clashes with the need to report the cases of violence against medical personnel; that way, the practitioners make the wrong choices preferring to remain silent about the risks and stresses they undergo created by the patients and other clients (Stathopoulou 3).

Impacts of Workplace Violence in Healthcare Context

It goes without saying that violence targeting healthcare personnel has immediate and long-lasting consequences. There are two primary types of effects occupations violence may produce; they may be distinguished based on their focus of influence – the ones that impact healthcare organizations and personnel and the ones that affect public health.

Impact on Healthcare Organizations and Personnel

The impacts violence has on its victims (medical workers, namely) are profound. To be more precise, a professional exposed to violence may or may not suffer physical injuries of different level of seriousness; as to the emotional consequences – they are present regardless of the type of violence one undergoes. Namely, a practitioner under attack may be left with the damaged self-esteem and professional confidence (which would directly impact their ability to perform as a professional), their level of job satisfaction may fall and turnover intention may increase (Stathopoulou 4). The latter effects are likely to impact the organization in general and result in financial costs (loss of the human capital) as well as damage to the reputation arising from the high rates of turnover. In addition, understaffed medical institutions are likely to underserve the patients and have unfair workloads for the employees which, in turn, leads to more dissatisfaction from both sides and a higher risk of the additional acts of violence. Besides, even the victimized employees who do not turnover would be likely to have a higher level of absenteeism due to avoidance behaviors, anxiety, and depression that are the logical outcomes of the workers’ exposure to violence (Stathopoulou 4). Finally, the programs of violence and injury prevention, as well as the employers’ legal responsibility for the wellbeing of the workers makes the cases of violence in the workplace settings a financial liability for the organizations due to the need to compensate the affected employees for their traumas and injuries.

Impact on Public Health

As noted by the World’s Health Organization, occupational violence in the health care sector “compromises the quality of care and puts health-care provision at risk. It also leads to immense financial loss in the health sector” (par. 2). In other words, the public health impact of the workplace violence in healthcare is secondary to the effects it produces on the providers of the medical care and services. Logically, injured and scared medical personnel tends to grow discouraged in their profession and either leave it contributing to skills shortage or continue doing the job without full dedication and thus putting the patients at risk of being underserved with their needs unresponded. This tendency creates situation that could be called a “cursed circle” where the dissatisfied patients cause dissatisfaction among the workers, and then the workers’ deteriorating professional performance aggravates the patients’ dissatisfaction of the patients even more and so forth.

The danger of occupational violence in the health care sector is well-known to the leaders of the industry and the researchers who realize the need to work on solutions and prevent the cases of violence minimizing the threats to the medical personnel and thus breaking the vicious cycle. If left unattended, this problem may evolve into a massive threat to public health due to the lack of trust between the patients and medical workers that causes many different issues such as unreported medical errors, patients’ lack of desire to cooperate and provide full information on their health conditions, the population’s refusal to consult medical specialists in cases of emergencies and diseases, and overall deterioration of public health accompanied with the medical staff’s diminished capability of affecting it and turning things around.

Conclusion

As shown in the paper, workplace violence directed at the health care providers may result in a multitude of highly dangerous outcomes affecting the performance of healthcare in general and the quality of public health as a consequence. As a result, occupational violence in healthcare is officially referred to as unacceptable (WHO par. 2). However, there are many challenges to the prevention of this type of violence such as the medical professionals’ reluctance to report the issue, the spontaneous and often unpredictable nature of the phenomenon, the organization’s willingness to keep such cases secret to protect their reputation, and the overall working conditions and the professional situations typical for healthcare (work with drugs and alcohol, dealing with emotionally unstable people, confrontations between the patients and medical personnel, insufficient security, close interactions with a large number of individuals, shortage of staff) that make its institutions more vulnerable to workplace violence than the facilities of the other sectors (Stathopoulou 2).

Works Cited

Akers, Timothy, Roberto Hugh Potter, and Carl V. Hill. Epidemiological Criminology: A Public Health Approach to Crime and Violence. San Francisco, California: Jossey-Bass, A Wiley Imprint, 2013. Print.

Bloom, Sandra L. Violence: A Public Health Menace and a Public Health Approach. London, United Kingdom: Karnac Books, 2001. Print.

Cooper, Cary L. and Naomi Swanson. Workplace violence in the health sector. n. d. Web.

Finkel, Madelon Lubin. Public Health in the 21st Century. Santa Barbara, California: Praeger, 2011. Print.

OSHA. Workplace Violence in Healthcare. 2013. Web.

OSHA Fact Sheet. 2002. Web.

Rosenberg, Mark L. and Mary Ann Fenley. Violence in America. New York, New York: Oxford University Press, 2001. Print.

Stathopoulou, H. G. “Violence and aggression towards health care professionals.” Health Science Journal 2 (2014): 1-7. Print.

The United States Department of Labor. Safety and health Topics. n. d. Web.

US Code. Title 16. n. d. Web.

WHO. Violence against health workers. 2016. Web.

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