Working in a long-term care facility can be challenging, and nurses and support workers often endure significant sexual harassment and physical and verbal abuse at the hands of patients with dementia, cognitive impairment, and mental illness. What’s more, that violence has become normalized, and when it comes from patients, staff don’t get the support they need, according to a report in the journal, New Solutions.

‍What Did The Study Find?

“This study adds new evidence and confirms previous scientific investigations that suggest violence is a significant risk factor in the day-to-day experience of long-term care staff,” said one of the study’s authors, Jim Brophy of the University of Stirling, in a statement. “We found that physical and verbal abuse, as well as sexual harassment, have been allowed to become normalized within these work environments.”

The researchers interviewed 56 workers at seven long-term care facilities in Ontario, Canada, between 2016 and 2018. The group interviews included four to eight participants with various healthcare occupations, including aids, registered practical nurses, personal support workers, dietary staff, clerical staff, cleaners, and housekeepers. They were a variety of ages, genders, and ethnicities.

The participants reported injuries and episodes that included burns, bruises, scratches, fractures, verbal abuse, and sexual assault. 

Descriptions of their experiences include:

• On a daily basis, I am hit, punched, spat at, sworn at, slapped, bitten.

• I had a fractured tailbone after being run over by an electric wheelchair.

• He had me backed up in a corner, punching me, and I was blowing the whistle over and over, and it was in his face, and it didn’t even have any reaction.

The participants felt like a number of factors contributed to the problem, including inadequate resources and training, understaffing, underfunding, and a lack of recognition of the severity and pervasiveness of the problem.

They also noted an increase in patients who were younger, more mobile, and more likely to have a mental illness, which facilities were ill-equipped to cope with. When violence did happen, employees felt like they didn’t get the psychological support they needed in the short- or long-term. 

For example:

• There’s no follow-up with management. They don’t ask you if you’re okay. They ask, “Can you take a Tylenol and stay here?”

• We’re not allowed to discuss what happens in our workplace because it could cost us our employment.

‍What Must Be Done?

“The study concludes, first and foremost, that there needs to be an increase in staffing levels to ensure adequate relational care for long-term care residents,” said another author, Michael Hurley, president of the Ontario Council of Hospital Unions. “There is also a need for immediate legal and regulatory measures to create violence-free facilities for everyone within the jurisdiction.”