Employers wanting to retain top nurses should be aware of factors that can cause nurses to leave their workplace, including violence and bullying.
Job stress has long been an issue in nursing and nurse retention. In a recent study of hospital-based nurses, researchers linked job stress to intention to leave the hospital, which preceded intention to leave the profession.
To put workplace violence in the spotlight, the American Hospital Association designated June 8 as Hospitals Against Violence Hope (#HAVhope) Friday. The day is meant to encourage hospitals, health systems, nurses, physicians and other healthcare professionals, as well as local and national organizations, to unite and combat violence through the use of digital media.
Fourteen percent of the more than 4,500 nurses surveyed in Nurse.com’s latest salary survey report indicated they’re considering leaving the profession. Baby boomers were the most likely of the generations to exit nursing, most likely to retire. But millennials and Generation X were only 4% less likely than the older generation to consider saying goodbye to nursing.
Those findings, according to the report, send a clear message that employers and others need to find out why nurses are leaving their jobs and might be considering leaving the profession. They then need to address those issues to retain nurses in the workforce.
Workplace violence and bullying contribute to nursing turnover
Among the issues that impact nurses’ decision to leave are two big stressors: workplace violence and bullying.
About three-quarters of workplace assaults reported each year occurred in healthcare and social service settings, according to The Joint Commission’s Sentinel Event Alert published April 17, 2018.
The alert makes specific recommendations for preventing and dealing with workplace violence in healthcare settings. Those start with clearly defining workplace violence and putting systems into place that allow staff to report workplace violence experiences.
Bullying behavior is at epidemic levels in environments where nurses provide care, according to the June 2016 Quick Safety newsletter published by The Joint Commission titled, “Bullying has no place in healthcare.”
“A recent Occupational Safety and Health Administration (OSHA) report on workplace violence in healthcare highlights the magnitude of the problem: while 21% of registered nurses and nursing students reported being physically assaulted, over 50% were verbally abused (a category that included bullying) in a 12-month period. In addition, 12% of emergency nurses experienced physical violence, and 59% experienced verbal abuse during a seven-day period,” according to The Joint Commission.
Workplace bullying, also called lateral or horizontal violence, takes many forms, from verbal abuse and intimidation to humiliation and sabotage. Among the solutions to decrease bullying in healthcare facilities: Establish a safety system and culture that does not tolerate bullying behaviors and make this a core value of all leaders in the organization, the newsletter states.
Why nurses leave the profession and how to address those issues
The stressful, demanding nature of nursing can result in nurses leaving the profession, said Ginger C. Hanson, PhD, assistant professor of community public health nursing at Johns Hopkins School of Nursing.
“Nurses have a variety of options to work in jobs with better benefits outside the hospital or nursing home setting,” she said. “We know that many trained nurses — more than 30% — have left nursing to work in other occupations, citing the stressful work environment and burnout as the primary reason.”
One employer focused on reducing workplace violence is RWJ Barnabas Health System, said Nancy E. Holecek, MAS, MHA, BSN, RN, senior vice president and chief nursing officer for health system’s Northern New Jersey region.
The numbers of nurses experiencing workplace violence might be higher than reported because nurses are among the healthcare workers who tend to under report workplace violence. That’s because they might see it as part of the job, Holecek said.
“To that end, we are working on creating more awareness among our healthcare workers that workplace violence should not be tolerated, and it’s something that we need to report, so we can trend it, and we can respond to the trends that we uncover,” she said.
The health system has formed a committee charged with minimizing risks of threats or violence. To help keep staff and patients safe, RWJ Barnabas Health System conducts walk-throughs of facility interiors and exteriors to make sure security cameras are up to date, entry points are properly guarded, visitor access systems are updated and more.
Staff, including nurses, are educated in ways to de-escalate threatening, physically assaulting or violent patients, family members, coworkers and others.
“Unfortunately, in the hospital environment, people often make excuses for patients’ behavior, but we really do have a responsibility to make sure we identify the violent or aggressive behavior, report it and trend it,” Holecek said. “We’ve installed an icon on our computer system, which makes it very easy for staff to report potential or actual workplace violence. They just have to go on the computer, hit the icon and enter their reports. Then, we follow up.”