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 Table of Contents  
Year : 2018  |  Volume : 23  |  Issue : 1  |  Page : 73

Workplace violence in health care

1 Department of Neuroanaesthesiology, Institute of Neurosciences, Kolkata, West Bengal, India
2 Department of Neurosurgery, Institute of Neurosciences, Kolkata, West Bengal, India

Date of Web Publication2-Nov-2018

Correspondence Address:
Indranil Ghosh
“Sudha” Flat No 4, 3rd Floor, 75/65, S N Roy Road, Kolkata, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmhhb.jmhhb_59_17

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How to cite this article:
Ghosh I, Shah DA, Das B, Pradhan DK. Workplace violence in health care. J Mental Health Hum Behav 2018;23:73

How to cite this URL:
Ghosh I, Shah DA, Das B, Pradhan DK. Workplace violence in health care. J Mental Health Hum Behav [serial online] 2018 [cited 2023 Jun 1];23:73. Available from: https://www.jmhhb.org/text.asp?2018/23/1/73/244920


Health-care workers are at an increased risk for workplace violence. Examples include verbal threats or physical attacks by patients, a distraught family member who may be abusive or even become an active shooter, gang violence in the emergency department, a domestic dispute that spills over into the workplace, or coworker bullying. Violent incidents come from a variety of sources. Many are not reported. After taking informed written consent from the sister of the patient, we present a case of severe traumatic brain injury suffered during duty hours in a health-care establishment which was managed successfully at our institute. A young female nurse who had been appointed to work in the Neuro Intensive Care Unit suffered severe traumatic brain injury at the hands of a delirious and violent patient at her workplace. She was shifted to our institute in a state of coma. Her computed tomography scan showed compound depressed fracture of the skull along with multiple hemorrhagic contusions in the brain. On examination, she was hemodynamically stable without any abdominal or thoracic injuries. After initial resuscitation, she was immediately taken up for surgery and underwent decompressive craniectomy and lax duraplasty. Postoperatively, she was ventilated for days along with general supportive care. Gradually, she was weaned off after tracheostomy and shifted to general ward in a state of severe disability. She underwent cranioplasty after a month and was discharged with an extended Glasgow outcome scale of 5 (upper moderate disability). Health care has some unique cultural factors that may contribute to underreporting or acceptance of workplace violence. Workplace violence risk factors vary by health-care setting, but common factors include the following;[1] working with people who have a history of violence or who may be delirious or under the influence of drugs; lifting, moving, and transporting patients; working alone; poor environmental design that may block vision or escape routes; poor lighting in hallways or exterior areas; lack of means of emergency communication; presence of firearms; working in neighborhoods with high crime rates; lack of training and policies for staff; understaffing in general, and especially during meal times and visiting hours, high worker turnover; inadequate security staff; long waiting times and overcrowded waiting rooms; unrestricted public access and perception that violence is tolerated; and reporting incidents will have no effect. While some data are available for other violent incidents, surveys show that many incidents go unreported even at facilities with formal incident reporting systems.[2] Workplace violence comes at a high cost. Violence can also lead to other less obvious costs. For example: Caregiver fatigue, injury, and stress are tied to a higher risk of medication errors and patient infections.[3] Studies have found higher patient satisfaction levels in hospitals where fewer nurses are dissatisfied or burned out.[3] A workplace violence prevention program can also fit effectively into a broader safety and health management system, and it can help your facility enhance employee and patient safety, improve the quality of patient care, and promote constructive labor-management relations.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Occupational Safety and Health Administration (OSHA). Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. No. 3148-04R; 2015.  Back to cited text no. 1
Findorff MJ, McGovern PM, Wall MM, Gerberich SG. Reporting violence to a health care employer: A cross-sectional study. AAOHN J 2005;53:399-406.  Back to cited text no. 2
McHugh MD, Kutney-Lee A, Cimiotti JP, Sloane DM, Aiken LH. Nurses' widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff (Millwood) 2011;30:202-10.  Back to cited text no. 3


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