|
Abstract
|
In order to provide effective care and service to those in need, the safety and well-being of health care workers must be guaranteed. The physical and emotional safety of health care workers is nonnegotiable. Violence directed at nurses and other health care workers cannot be allowed. Verbal and emotional abuse cannot be tolerated. Practices that place both patients and providers at risk, including unsafe staffing levels, are unacceptable. As we begin a new year, it is time to move to action in improving the environments in which health care is delivered to acknowledge and address the needs of nurses, physicians, and all members of the health care team.
Health care providers seek to improve outcomes for the people, families, and communities they serve. Health care has historically been anchored in altruism, illustrated by the Nightingale Pledge in nursing and the Hippocratic Oath in medicine. The original 1893 Nightingale Pledge ends with a promise that the nurse will "devote myself to the welfare of those committed to my care."1 A 1935 version updated this phrase to state, "as a 'missioner of health' I will dedicate myself to devoted service to human welfare." A modern (1964) version of the Hippocratic Oath expresses altruism in this sentence: "I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm."...
...
However, the mutual understandings embodied in nursing's social contract appear to be fraying. Nurses, who make up the majority of providers and spend the most time with patients and families, bear the brunt of a recent rise in violence and abuse that undermines the social contract and the ability of nurses to provide care.
Two shocking and disturbing illustrations of the risks that nurses face in the workplace occurred in October 2022. In 2 separate incidents, nurses were murdered at their workplaces while providing care. On October 18, 2022, June Onkundi, a psychiatric/mental health nurse practitioner at an outpatient clinic in Durham, North Carolina, was stabbed to death by a patient.6 Four days later, on October 22, 2022, Jacqueline Ama Pokuaa and Katie Annette Flowers were fatally shot by a visitor on a maternity ward in Dallas, Texas, following his assault of a patient who had just given birth.7,8
Nurses are often the target for violence and abuse. Since 2006, the American Association of Critical-Care Nurses (AACN) has periodically conducted national surveys of the critical care nurse work environment. The most recent AACN study,9 completed in October 2021, showed dramatic declines in all aspects of the health of nurse work environments since the 2018 study. In response to a question about experience with workplace violence and abuse, 72% of the nurses reported that they had experienced at least 1 negative incident in the last year. Verbal abuse was reported by 65%, and 28% had experienced at least 1 episode of physical violence. Perpetrators were most often patients or family members but also included other members of the health care team...
Language: en |