When violence is “part of the job:” Effects on workers, research approaches, and researchers

Background/Objective: Patient and visitor perpetrated violence against healthcare workers (type II) is a well-recognized, growing public health concern. We describe various effects of hospital workers’ perception of type II violence as “part of the job.”

Methods: Across 6 acute-care hospitals, data were collected through surveys, telephone interviews, focus groups, and key informant interviews.

Results: Hospital workers described violence as “part of the job.” Influences of this perception on workers’ social support and job satisfaction were observed and highlighted the lack of coordinated institutional efforts to address type II violence from an occupational safety perspective. The perception influenced the research approach and interpretation of findings. Type II violent events based on the study definition were not always reported by participants who perceived them as “part of the job.” Researchers were struck by participants’ composure recounting experiences of dangerous situations, including violent encounters that researchers and other study participants found clearly traumatic. Workers’ experiences supported their concerns and recommendations for prevention, mitigation, and follow-up of violent events to ensure worker and patient well-being. However, various agendas within complex healthcare systems create barriers to making even simple, albeit urgently needed, changes to enhance workers’ safety.

Conclusions: Currently, there is a general lack of tangible, practiced, and enforced comprehensive institutional-level efforts to address type II violence from an occupational safety perspective. Such inattention, coupled with an intense focus on customer service in hospitals, perpetuates an acceptance of violence against healthcare workers, rather than appropriately ensuring it is not “part of the job.”