Nearly one out of every two nurses experienced workplace violence last year, according to a healthcare workforce survey recently released by Vivian Health. That number is even higher — fully 55% — among long-term care nurses and nurse aids, according to further analysis of the underlying data provided to McKnight’s.
In comparison, workplace violence is experienced by an 8% larger share of the long-term care workforce than by healthcare workers overall. That mark is striking but unsurprising, said Gigi Acevedo-Parker, clinical risk consultant national leader at HUB International.
“The issue is that because of mental illness and cognitive impairments … long-term care is even more challenged,” she told McKnight’s Friday. “Workplace violence is my number one requested training from healthcare organizations across the country. It is so prevalent.”
The underlying effects of these mental challenges can directly feed into a majority of nursing home workforce violence incidents. Care providers in long-term care overwhelmingly reported experiencing workplace violence from residents (67%) or their families (29%).
Beyond the immediately painful and distressing effects of such an event, workplace violence in nursing homes is a key contributor to a “vicious cycle” of burnout and reduced quality of care, according to Acevedo-Parker.
“Workplace violence contributes to burnout,” she explained. “Burnout affects patient care. It reduces the quality of patient care … Burnout is emotional exhaustion, depersonalization and a decreased feeling of empathy for patients. All of that contributes to burnout.”
On average, the nearly 150 nursing home direct care workers surveyed rated their state of burnout at a 3.5 out of 5 and nearly half reported experiencing symptoms of clinical depression in 2023.
Ramping up regulation
According to the workforce report, almost half of healthcare workers overall reported that their employers had not implemented safety measures to protect them. Failing to take proactive steps to address and prevent workplace violence would be a mistake for long-term care providers, Acevedo-Parker told McKnight’s.
“If the [care workers] are providing treatment and they’re coming back and seeing that the care, treatment and service is not being provided in a professional and competent manner and staff is not being educated and trained as they should be — they’ll get out of there,” she explained. “The staff has to be prepared.”
Acevedo-Parker also emphasized that at least part of that training should involve real interfacing with trainers, engagement with de-escalation training and use of practical, real-world scenarios.
Perhaps counterintuitively, studies suggest that another key way of combating burnout in nurse aids and support staff is giving them more education and more involvement in the daily care process, she observed. Doing so can make them feel invested, trusted and equipped to handle developing situations.
If the impact on burnout and care quality aren’t enough incentive, state and federal regulation seems increasingly likely to be handed down in the future, Acevedo-Parker said. While current state and federal requirements are very broad, future rules will likely require increased and more specific education and training from facilities.
“Regular workplace violence training is going to be something that will be required, just period. There might be leeway to what that means and how it’s done, but it should be done relative to the patient population that an organization has at minimum.”
