Aggression against healthcare workers is increasing

According to the WHO, 38% of health workers experience physical violence at some point in their careers. Many more are threatened or exposed to verbal aggression. The Covid-19 pandemic sems to have caused an increase of aggression against healthcare professionals. This can put healthcare provision at risk. OLVG, a hospital with two locations in Amsterdam, recently released a press release about the increase of aggression against healthcare professionals. Incidents of aggression against OLVG staff were reported 234 times in the first quarter of 2022; 154 involved verbal aggression, 31 physical violence and 23 threats. For the whole of 2021 OLVG reported a total of 764 incidents of aggression and violence against its healthcare staff.

Limited visits cause frustration
Stella Salden, director of NU’91, an organization that stands up for the interests of healthcare professionals in the Netherlands, says that aggression against healthcare workers has always been high, but increased significantly during the Covid-19 pandemic. “We see an increase of what we call “frustration aggression”,” said Salden, explaining that a lot of people were upset about the safety measures limiting the possibilities to visit patients in hospitals or demanding them to keep a safe distance. “When people don’t comply with those measures, the nurses warn them. This often causes irritation or even aggression.”

Mike Wijngaarden, coordinator for aggression and violence at OLVG, explained the problem further:

“There was a lot of anger and incomprehension about the number of visits allowed to a patient per day, while outside the hospital almost all measures had already been scrapped. It is often forgotten that we do this to protect our vulnerable patients.”

“We understand that it can be difficult when you or a loved one is in hospital. But that should never lead to aggression or physical violence against our healthcare workers. We do not tolerate violence in OLVG and we report it when we can ,” added Maurice van den Bosch, CEO at OLVG.

Just the tip of the iceberg
However, only a fraction of all aggression incidents in healthcare gets reported. “If a visitor pushes me, I see it as aggression. But if I have no pain or injury, then that visitor is not criminally liable. In addition, it is often difficult to prove anything and it is not possible to report such incidents anonymously. This sometimes prevents employees from reporting aggression or going through with a report,” says Mike Wijngaarden, stating that the latest figures do not provide a complete picture of aggression at OLVG: “This is just the tip of the iceberg.”

It is not only legal qualification that contributes to the underreporting of aggression against medical professionals. Stella Salden says that aggression against healthcare workers is a taboo. “We see that nurses are ashamed to report these incidents to the police or even hesitant to discuss them with their colleagues or employers. We have to change this, because if the problem is not discussed, we cannot solve it.”

The problem needs to be addressed because, as the WHO states, violence against health workers not only has a negative impact on their psychological and physical well-being, but also on their job motivation. In the end, this results in lower quality of care and puts healthcare provision at risk. Increasing aggression can be one of the factors causing healthcare professionals to leave their jobs, which is a big problem for countries like the Netherlands that already struggle with a shortage of nurses.

OLVG offers information and training to make employees more resilient to aggression and violence. Training courses help them learn how to deal with aggression. Moreover, to draw attention to the growing problem, OLVG is starting a campaign with photos of healthcare workers who have experienced violence. Some of them are labelled with the words they heard from patients or their families such as “I am waiting for you outside” or “I will remember your name”. After all, it’s not the staff who need to change, but the visitors who have to restrain themselves.

Written by Zuzanna Kuffel