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About Medical Workplace Violence

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More than Physical Assault

[By Staff Reporters]

Business Med PracticeWorkplace violence is more than physical assault.

According to trauma specialist Eugene Schmuckler; PhD, MBA, CTS opining and writing in www.BusinessofMedicalPractice.com; workplace violence is any act in which a person is abused, threatened, intimidated, harassed, or assaulted in his or her employment. Swearing, verbal abuse, playing “pranks,” spreading rumors, arguments, property damage, vandalism, sabotage, pushing, theft, physical assaults, psychological trauma, anger-related incidents, rape, arson, and murder are all examples of workplace violence.


The Registered Nurses Association of Nova Scotia [RNANS], a leading study group, defines violence as “any behavior that results in injury whether real or perceived by an individual, including, but not limited to, verbal abuse, threats of physical harm, and sexual harassment.” As such, medical workplace violence includes:

· threatening behavior — such as shaking fists, destroying property, or throwing objects;

· verbal or written threats — any expression of intent to inflict harm;

· harassment — any behavior that demeans, embarrasses, humiliates, annoys, alarms, or verbally abuses a person and that is known or would be expected to be unwelcome. This includes words, gestures, intimidation, bullying, or other inappropriate activities;

· verbal abuse — swearing, insults, or condescending language;

· muggings — aggravated assaults, usually conducted by surprise and with intent to rob; or

· physical attacks — hitting, shoving, pushing, or kicking.

Cause and Affect

Workplace violence can be brought about by a number of different actions in the workplace. It may also be the result of non-work related situations such as domestic violence or “road rage.” Workplace violence can be inflicted by an abusive employee, a manager, supervisor, co-worker, customer, family member, patient, physician, nurse, or even a stranger.


The University of Iowa – Injury Prevention Research Center [UI-IPRC] classifies most workplace violence into one of four categories.

· Type I Criminal Intent — Results while a criminal activity (e.g., robbery) is being committed and the perpetrator had no legitimate relationship to the workplace.

· Type II Customer/Client — The perpetrator is a customer or client at the workplace (e.g., healthcare patient) and becomes violent while being assisted by the worker.

· Type III Worker on Worker — Employees or past employees of the workplace are the perpetrators.

· Type IV Personal Relationship — The perpetrator usually has a personal relationship with an employee (e.g., domestic violence in the workplace).


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15 Responses

  1. More info;

    For further reading on this topic, see these two articles co-authored by Grena Porto, published in Patient Safety & Quality Healthcare:


    As well as this one:




  2. Ann and all ME-P Subscribers

    Federal Appeals Court Clarifies Doctor Conduct

    Did you know that a recent federal appeals court for the first time spelled out what constitutes an investigation under the Health Care Quality Improvement Act [HCQIA] in a decision that experts say could guide physicians in disciplinary and reporting actions?

    According to source Amy Lynn Sorrel, writing in American Medical News [2/16/09], the federal statute generally requires hospitals to report physicians to the National Practitioner Data Bank [NPDB] if they have been reprimanded for quality or conduct issues, or if they surrender privileges while under investigation.

    A panel of the 1st U.S. Circuit Court of Appeals clarified that an investigation remains ongoing until the hospital’s decision-making process runs its course, and the medical executive committee either takes final corrective action or formally closes the probe.

    PS: Keep up the good work!

    Mary Ann


  3. I was saddened to learn of Amy Bishop PhD, the biology professor at the University of Alabama in Huntsville who is accused of shooting six and killing three of her colleagues during a faculty meeting in an apparent tenure dispute.

    She had also been a key suspect in an attempted bomb plot at Harvard University, and a doctor at Boston’s Children’s Hospital, in 1993.



  4. I don’t know if my experiences are typical for a medical professional, but I have certainly seen violence in the workplace firsthand.

    Many of the episodes have occurred during my work in the emergency room setting. Patients under the influence of drugs often act out in this setting, and those seeking narcotics can be verbally and physically abusive and threatening. I have found this website, sponsored by the Illinois Department of Human Services, to be particularly useful in dealing with drug-seeking patients: http://www.ilpmp.org.

    This website provides a database of all Schedule 2, 3, 4 and 5 prescriptions dispensed by Illinois retail pharmacies. A several page print-out of all narcotic prescriptions filled by a patient over the previous six months is a powerful tool to use when I enter an exam room to deal with a drug-seeking patient.

    Brian J. Knabe, MD

    Savant Capital Management, Inc®.

    190 Buckley Drive

    Rockford, IL 61107

    Tel 815-227-0300

    Fax 815-226-2195



  5. Violence in the medical workplace is indeed an emerging safety and health issue. Its most extreme form, homicide, is the fourth-leading cause of fatal occupational injury in the United States, according to the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI).



  6. The Johns Hopkins Shooting in my Home Town

    While the shootings last week at Johns Hopkins Hospital in Baltimore serve as a frightening reminder for healthcare facilities to revisit security and response plans, the tragedy also highlights the delicate nature of physician-patient interactions, especially when delivering difficult news, wrote Keith L. Martin in a Physician’s Practice Blog post.


    Baltimore Sun: http://www.baltimoresun.com/health/bs-md-ci-shooting-hopkins-20100916,0,6535293.story

    And, of course, our textbook chapter #7 on medical workplace violence by Eugene Schmuckler PhD http://www.BusinessofMedicalPractice.com

    Dr. David E. Marcinko, MBA


  7. Gene,

    The Department of Defense and the FBI had enough information about the suspect in the 2009 Fort Hood massacre to have discharged him from the military before he killed 13 DOD employees and wounded 32 others, according to a new bipartisan Senate report.




  8. Colo. movie theater shooter is medical school dropout

    The University of Colorado Medical School just reported that the suspected movie theater gunman — earlier named as 24 year-old James Holmes — was a medical student who dropped out a month ago, The Associated Press said.


    A neuro-science PhD student with four guns on him.

    Ann Miller RN MHA


  9. Colorado Shooting Coverage On Reddit Is Better Than What You’ll See On TV




  10. Maj. Nidal Hasan MD Paid $278,000 while Awaiting Trial?

    The Department of Defense just confirmed to NBC 5 Investigates that accused Fort Hood shooter Major Nidal Hasan MD has been paid more than $278,000 since the November 5, 2009 shooting that left 13 dead 32 injured.

    The Army said under the Military Code of Justice, Hasan’s salary cannot be suspended unless he is proven guilty.


    If Hasan had been a civilian defense department employee, NBC 5 Investigates has learned, the Army could have suspended his pay after just seven days.



  11. Records Show How U.S. Government Spent Nearly $5 Million on Hasan Trial


    What would a financial advisor say about this?



  12. Stabbing at Texas hospital leaves one dead, four injured
    [Breaking NBC News]

    A stabbing at a Texas hospital this morning has killed one person and injured four others, according to the medical center.




  13. A LA Hospital

    Suspect arrested after reported shooting at Los Angeles hospital.



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