Increase in violence at work in the health care sector

The rise in physical and psychological violence in the health care sector in Finland is due in part to increased time pressures and employment insecurity in the workplace, according to a Finnish study. However, another study finds that the majority of nurses in 10 European countries are willing to stay in the sector.

One third of all care workers in Finland have been faced with physical violence or the threat of violence at work. Two thirds had encountered verbal threatening, criticism or verbal abuse during the previous year. Employees of old people’s homes, health centres and hospitals experienced the threat of physical abuse most often.

These findings are outlined in a study, Name calling, bullying, kicking - nurses’ daily work. Report on violence and the threat of violence experienced by health care personnel in the workplace, which was conducted in the health care sector in Finland in 1999. The study analyses 2,688 responses from all occupational groups belonging to the trade union TEHY (Union of Health and Social Care Services).

Young and less experienced employees seem to run a higher risk of becoming the target of intimidation than those who have worked for a longer time. Half of those under the age of 30 and one third of those over 50 reported that they had experienced verbal abuse and criticism at work.

Fixed-term employment seems to increase vulnerability to all types of violence. Shift workers are a particularly high risk category, experiencing violent incidents two to three times more often than regular day workers. According to occupational safety representatives, the number of personnel on shifts is inadequate, which exposes employees to greater risk.

The study concludes that serious attention must be paid to address the threat of violence and especially to ensure the safety of employees who work alone. Violent events in the workplace should be documented and systematically dealt with. The situation for young employees and employees with fixed-term contracts in particular needs to be considered. The employer and supervisor should be responsible for ensuring a sufficient number of personnel on shifts.

Working conditions

According to the Finnish Quality of Work Life Surveys (1977-1997), the health care sector has experienced an increase in many working conditions problems, such as time pressure, employment insecurity, and violence and harassment. (Lehto and Sutela, 1999- pdf file ) These pressures may find expression in forms of intimidation and psychological violence, particularly in hierarchical organisations, such as within the health care field. The Quality of Work Life Survey further revealed that those working in health care were most vulnerable to the threat of physical violence. The figures indicate that 58% of employees in this sector mentioned the threat of violence, compared with a figure of 23% for all sectors.

Staffing

Another survey Working conditions and plans to leave the profession among nursing staff in Europe (pdf file) was carried out in 10 European countries (Belgium, Finland, France, Germany, Italy, the Netherlands, Poland, Slovakia, Sweden and the United Kingdom) by the NEXT study group at the University of Wuppertal. In Finland, 4,000 nurses working in hospitals, long-term care institutions, municipal health centres and in private out-patient organisations took part in this survey. According to the survey results, the majority of nurses are willing to stay in the health care service, despite the stress factors.

The results of the questionnaire in autumn 2002 reveal that 15% of Finnish respondents thought about giving up nursing at least once a month. This figure compares with the United Kingdom (36%), Italy (21%), Germany (19%), Poland (12%), Belgium (10%), and the Netherlands (9%).

Nurses in the under 30 age category were most willing to leave. Temporary employees (mostly young workers) considered leaving more often than permanent staff. Nurses suffering high levels of fatigue due to workload indicated that they had considered changing their profession nearly five times more often than others.

Many employees in the health care sector will reach retirement age in the near future. At the same time, there will be an increased demand for nursing staff, especially to provide care services for older persons. It is important to continue to attract young people into the sector, and to support the working conditions of those already working in the field.