Dr. Kevin Most: Workplace Violence
Recent stories on workplace violence have hit close to home. The shooting last week in Aurora is a reminder to all of us that this can happen anywhere. Probably a bigger point is that workplace violence goes well beyond the shootings that we see on the news, in fact it is the far extreme of workplace violence. Unfortunately we see workplace violence occur daily in many settings but these incidences do not hit the level of the need for national media.
Violence is actually the fourth leading cause of occupational injuries in the United States and is the Number 1 cause for death for women in the workplace. The need to understand the scope of workplace violence is very important as it can occur anytime to not only to or by employees but also to or by customers, clients and visitors, no one is immune to this.
What can we do about workplace violence, well it comes down to awareness, prevention, treatment and ongoing care. Awareness is further broken down to awareness of the environment you are in, awareness of signs to look for in coworkers or others that you engage with in the workplace.
I am sure we have all noticed a dramatic change in the safety of many public and private spots. You can’t go to a sporting event without walking thru a metal detector, you can’t enter most buildings without a security check and even some restaurants are placing their staff behind barriers to protect themselves from theft or harm. You can imagine in the hospital setting where we are thought to be a place of healing that violence is noted daily.
Employers do have a responsibility to provide their employees with a safe environment to work in. OSHA has set standards to make sure we minimize the chance of an employee getting injured while doing their job. OSHA focuses on eliminating hazards, be it machines, tools, movements or chemicals. Their focus as it should be is to provide a safe environment in normal working conditions. These laws have been in place for years and are the result of multiple unsafe workplaces where individuals were injured or killed. It may surprise many to know that OSHA has only been in place since 1971 when President Nixon signed the law. Prior to this law we had many incidents of employees being injured in non-safe work places, some included workplace fires where 100’s were killed. OSHA was put in place to set standards to make sure that employers provided the safe workplace we all expect.
That being said, workplace safety goes well beyond the immediate physical environment we work in. With workplace violence being the number 4 cause of occupational injury and the leading cause of women death in the workplace we need to place a focus on this as well. The vast majority of workplace violence does not end in the death of individuals, it often occurs with minor physical injuries. Unfortunately these occur much more than most of us realize. These injuries result in not only a difficult workplace but also often place other employees in harms was or placed in the role of a caregiver as they are placed in a role to treat an injury.
Before we discuss the employee being put in the role of the caregiver, lets discuss how we may identify the individual who is prone to violence before it occurs. Identification of that individual before a violent outburst may save many lives including the individual. In the medical field we often talk about the help we need from the family in making some diagnosis, this situation is no different except in place of the doctor is the Human Resources Department and in place of the family is the coworker. In many of these cases as doctors, police officers and psychiatrist look back there were warning signs we could have identified and if noted may have prevented the incident from occurring. These incidents are a lot like patients who commit suicide, we look back and see the signs and wish we should have acted on them. For employees to know the signs and know who to go to may save many lives and get the individual the help they need.
As in many cases of violence the start of the emotion is small and it continues to build. As the emotion builds there are signs that we should be able to identify that may allow for treatment before a violent outburst. We tell individuals to look for some signs, the first is often the worker who normally friendly and easy going is now withdrawn and curt. This may be due to a personal family issue but it may also be due to a workplace issue, it could also be a medical issue like a change in medication. Whichever the cause is it is good to make others aware of the change in behavior.
Passive aggressive actions will often start out as small, as simple as complaining to coworkers or starting rumors in the workplace. These actions are often then advanced and in this day it often will go to social media postings. Often these will advance to minor physical interactions but other employees will stay away and not report it as it was “really none of their business”, the employees will often ignore the social media posts or worse yet reply and agree with the post thus reinforcing to the individual that they are correct.
Probably one of the biggest concerns is when an employ voices a concern of hopelessness, they feel they are doomed and have no immediate power to change the situation. Now this may be a personal issue at home a financial issue or one of many other concerns. The point is the individual feels they have no hope, these individuals need help and often it is the workplace as the only option. Individuals in this situation need help and letting the HR or management team know may be very helpful and stop the next step. Having an individual receive help and insight may often give them the sense of safety again see a future.
The escalation in some individuals will often show up as unreasonable demands that are verbalized and if not acted on in their timeframe they act out with violence. The demand to meet with the Board of Directors immediately, obviously won’t be met, however having a discussion with the individual about the normal chain of action may diffuse them and show they are being listened to. Flat out saying no to the individual may be a tipping point to violence.
Probably one of the more common actions that individuals have is the individual giving a verbal threat. The concern is what verbal threats do we take seriously, how many times has someone said “you thought I was serious? I was just kidding” Verbal threats along with other signs noted above should be a huge red flag. Verbal threats need to be taken seriously, the individual is in most cases looking for help, they want to be stopped so by warning others they hope it is stopped. When it is not stopped, the verbal warning brings what is a mental plan to an actual physical plan, this is very serious. Verbal threats need to be taken seriously as they are often the last step before a violent outburst.
Each workplace should provide a safe environment, however we know that injuries occur not only in the normal workday but also from the hands of violence in the workplace. All employees should be trained in basic first aid. Basic First Aid, may stop a minor injury from advancing and in some cases minor first aid will save a life. It is sad that we need to teach our staff how to treat injuries due to workplace violence but it is truly a reality today. Basic first aid may need teach individuals how to control bleeding, it may teach them how to protect an airway in many cases now it is going beyond basic first aid.
Another large concern is the concept of the “second victim” in workplace violence it is the survivors or the individuals who witness the act of violence. In the extreme cases of a death the surviving workers are often placed back into the workplace where the violence occurred. The importance of having an Employee Assistance Program in place cannot be overlooked, this is often an outside company who has individuals who are specially trained to assist in the psychological side of these incidents. They work with individuals about feelings of guilt and safety, they are important for the mental wellbeing of the survivors.