Here's How CNOs Can Prevent Workplace Violence and Keep Nurses Psychologically Safe

Physical and psychological safety should be key focuses for CNOs.

With rising workplace violence and burnout rates, it's important for CNOs and other nurse leaders to be aware of the safety and wellbeing of their nurses.

Safety goes beyond just the physical. Nurses must feel psychologically safe as well—they should be able to voice their feelings and concerns without fear.

During the HealthLeaders’ Nurse Labor and Compensation NOW Summit, Jennifer Croland, vice president and chief nursing officer at OSF HealthCare Saint Francis Medical Center, and Dr. Marie Giordano-Mulligan, vice president for nursing and chief nursing officer at Huntington Hospital Northwell Health, both spoke about how CNOs can help their nurses feel physically and psychologically safe at work.

Workplace violence prevention

There are several investments that health systems can make toward workplace violence prevention. According to Giordano-Mulligan, at Huntington Hospital Northwell Health, they have technology that boosts security, including quick badge alerts, metal detectors, and drones that fly around the campus, which remains well-lit at all hours.

Giordano-Mulligan also said they have signage that displays how respect from patients, family, and visitors is a requirement, and that the hospital does not tolerate violence toward the nursing staff or other healthcare workers.

"[For] any patient that is considered a high risk, we do have enhanced safety measures, and there [are] workplace violence processes in place," Giordano-Mulligan said, "and the staff is very appreciative knowing that they are supported in those processes."

Support is also provided to nurses after incidents occur, in the form of both employee assistance programs and employee health services if injuries are sustained.

"They're also given the option to file a police report as well and press charges," Giordano-Mulligan said, "and we will support them in that because they have that right."

In terms of mental health and psychological safety, Giordano-Mulligan said Huntington Hospital has processes in place for helping nurses improve wellbeing.

"If they need support for any other concerns…there is a process in place to help them with employee support services," Giordano-Mulligan said, "and there's a committee that is very active working with…executive leadership and with team inputs to enhance those processes in the future."

Psychological safety

Burnout is a huge contributing factor to mental health in the workplace, and according to Croland, one of the subgroups that has the highest degree of burnout is nurses who have under three years of experience.

"I've seen lots more people who are only working for a year and then they're choosing to leave the nursing profession," Croland said.

CNOs are also concerned with the public perception of nursing, and how that contributes to participation in the industry and potentially the culture of a health system.

"If you're on social media at all, you've probably seen the TikTok [videos] that are disparaging to the profession," Croland said, "so we have some accountability, I think, in changing that image of nursing." 

Croland recommends implementing more transition to practice programs that go beyond orientation and onboarding. Nurses need to develop a sense of belonging in their units and learn the necessary communication skills.

"How do you work in a culture where you can respectfully escalate a concern to another nurse who's working, who may be shutting you down?" Croland said, "and I think transition to practice programs are gaining a lot more traction."

The ANCC has criteria for transition to practice programs that Croland recommended. The criteria exist to help nurses acclimatize better to the profession and become more equipped to deal with the stressors that accompany the job.

"When you think about what we do, it requires high reliability, really high stakes outcomes, [it's] life and death, and that's a lot to put on a young person who's new in their role," Croland said.

CNOs must create environments where nurses can come forward and admit that they are not sure whether they did something right or wrong, or that they made a mistake that affected the patient.

"I think those programs are worth their weight in gold," Croland said, "they have demonstrated successes with reducing turnover, increasing retention, and really keeping people within the profession of nursing."