As a nurse, there are times where I have witnessed actions or overheard comments from RNs that I would classify as workplace violence directed towards a patient or their family. I feel I should do something however struggle with knowing how to respond. What advice can CRNS give me on my professional obligations?

This is an incredibly difficult situation and is one that requires you to intervene. The actions that you are witnessing could be a result of a lack of understanding of the professional obligations of RNs, professional or personal issues impacting the nurses’ ability to respond in an ethical manner in that moment, or they may be racially motivated. No matter what the contributing factors might be, these actions cannot be condoned.

Some of the professional expectations that specifically apply to this situation focus on nurses being accountable for identifying how their personal values, beliefs and positional power comes into play and making a conscious effort to reduce bias and influence. Nurses also must take action to support culturally-safe practice environments and to advocate for health equity for all, particularly the vulnerable and diverse clients and populations that they care for. These expectations of course, intersect with the responsibility for all nurses to conduct themselves professionally and according to the code of ethics, practice standards and entry-level competencies.

As nurses we strive to incorporate knowledge from many sources so we can continually reflect upon and improve our practice. A professional expectation for nurses is that they refuse to be complicit in any behaviors where actions are inhumane or degrading and are expected to intervene and report such behaviors when they are observed or if reasonable grounds exist to suspect their occurrence.  One of the ways nurses can do this is to develop strong conflict management skills, an ability to de-escalate volatile situations, to have a full awareness of agency policy in managing instances of workplace violence and to uphold organizational commitments that might focus on respectful environments and being courageous. One or more of these could become a learning goal in your mandatory CCP learning plan and should you find certain resources helpful, you could share those within the CRNS Facebook group to assist others with their journey.

All professional obligations matter and make the difference between ethical care and unethical treatment that can have lasting effects on all those involved in the situation. Addressing situations of workplace violence, although generally difficult, actively improves patient experience and impacts patient, health care professional and employee workplace safety. It may even prevent tragic and preventable losses of life such as Joyce Echaquan. Would the outcome have been different for her and her family and the nurses involved if someone had intervened?

One tool that can be utilized in responding is the CPR Racism card. It was specifically developed by Dr. Holly Graham with the intent of it enabling nurses and others to take action when they witness racist behaviors in health care settings. To learn more about the tool, click here.

For more information about responding to workplace violence, please see other CRNS articles within this series. They can be found here.  You can also review these resources on preventing violence in the workplace or register for a course on recognizing the risk of violence in the workplace and taking action if it occurs. You might also want to check out the resources available on the Saskatchewan Union of Nurses website.

CRNS Practice & Education nursing advisors are available to discuss scenarios similar to this one and other professional practice situations with you. They can be reached at practiceadvice@crns.ca.