Nurse’s Role in a Changing Healthcare Environment and the Image of Nursing

The Professional Nurse's Role in Recognition:

Active Surveillance: The nurse is positioned to recognize the early warning signs of WPV—such as escalating patient or visitor behavior, environmental stressors (long wait times, understaffing), or unaddressed lateral incivility—before they become overt incidents.

Non-Physical Harm: The professional nurse must recognize that WPV extends beyond physical harm to include psychological aggression (e.g., threats, bullying, racial slurs), which contributes to moral distress and burnout. This recognition is vital because non-physical abuse often goes unreported.

II. Addressing the Issue: Reporting and Advocacy

Addressing WPV requires a shift from viewing incidents as isolated events to recognizing them as systemic failures. The professional nurse is central to this shift through proactive reporting and policy advocacy.

A. Data Integrity Through Reporting

Reporting is the cornerstone of mitigation. Nurses must overcome the culture of silence or normalization ("It's just part of the job").

Mandatory Reporting: The professional nurse has an ethical and professional duty to utilize established organizational channels to report all incidents, including verbal abuse. This provides the evidence base needed for administration to allocate resources.

Root Cause Analysis (RCA): The nurse participates in RCAs following severe incidents, shifting the focus from individual blame to systemic factors. For example, identifying that a physical assault occurred during shift change due to inadequate security staffing is critical evidence for change.

B. Unit-Level Intervention

Nurses are responsible for implementing de-escalation techniques and ensuring immediate staff safety.

Sample Answer

The Professional Nurse's Role in Mitigating Workplace Violence: An Evidence-Based Position

The professional nurse is the largest component of the healthcare workforce and the primary guardian of patient safety. Therefore, the nurse plays a crucial, multifaceted role in recognizing, addressing, and mitigating the most common and pervasive issues within the profession. One of the most critical current challenges is workplace violence (WPV). Nurses face WPV at significantly higher rates than other occupations, yet its persistence profoundly threatens staff retention, patient care quality, and the ethical integrity of the healthcare environment.

I. Recognizing and Understanding the Scope of Workplace Violence

Workplace violence, as defined by the Occupational Safety and Health Administration (OSHA), includes any act or threat of physical violence, harassment, intimidation, or other disruptive behavior that occurs at the work site. In nursing, WPV often takes the form of physical assault, verbal abuse, or lateral (nurse-to-nurse) violence.