ANA Sets ‘Zero Tolerance’ Policy for Workplace Violence, Bullying

The nursing profession “will no longer tolerate violence of any kind from any source,” the American Nurses Association (ANA) declared in a new position statement on violence in health care workplaces released in August.

 “Taking this clear and strong position is critical to ensure the safety of patients, nurses and other healthcare workers,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Enduring physical or verbal abuse must no longer be accepted as part of a nurse’s job.”

ANA’s position statement, developed by a panel of registered nurses (RNs) representing clinicians, executives, and educators, addresses a continuum of harmful workplace actions and inactions ranging from incivility to bullying to physical violence. The statement defines bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress,” such as hostile remarks, verbal attacks, threats, intimidation and withholding support.

The statement calls on RNs and employers to share responsibility to create a culture of respect and to implement evidence-based strategies. The statement cites research showing that some form of incivility, bullying or violence affects every nursing specialty, occurs in virtually every practice and academic setting, and extends into all educational and organizational levels of the nursing profession.

A recent ANA survey of 3,765 RNs found that nearly one-quarter of respondents had been physically assaulted while at work by a patient or a patient’s family member, and up to half had been bullied in some manner, either by a peer (50%) or a person in a higher level of authority (42%).

Among the position statement’s recommendations to prevent and mitigate violence, in addition to setting a “zero tolerance” policy, are:

• Establishing a shared and sustained commitment by nurses and their employers to a safe and trustworthy environment that promotes respect and dignity
• Encouraging employees to report incidents of violence, and never blaming employees for violence perpetrated by non-employees
• Encouraging RNs to participate in educational programs, learn organizational policies and procedures, and use “situational awareness” to anticipate the potential for violence
• Developing a comprehensive violence prevention program aligned with federal health and safety guidelines, with RNs’ input

To prevent bullying, among ANA’s recommendations are that RNs commit to “promoting healthy interpersonal relationships” and become “cognizant of their own interactions, including actions taken and not taken.” Among recommendations for employers are to:

• Provide a mechanism for RNs to seek support when feeling threatened
• Inform employees about available strategies for conflict resolution and respectful communication
• Offer education sessions on incivility and bullying, including prevention strategies

ANA has several resources to help RNs and employers address and prevent bullying in the workplace, including the booklet, Bullying in the Workplace: Reversing a Culture, and a bullying “tip card.”