Voice of the President | January 2024
Nursing is my passion and I am honored to serve as president of AONL. Now is the time to amplify the voice and influence of nurses. Our collective impact is greatest when nurses speak with a unified voice. AONL is uniquely positioned to convene and collaborate with others on a common agenda. The nursing profession is now 5 million strong. As president, I will work to bolster collaboration with national nursing and specialty organizations, academia, regulating agencies and industry, to enhance nurses’ roles as change agents and facilitators in transforming our health care system.
I am the eldest of four children and the daughter of a registered nurse. I knew from a young age that nursing was my calling. I regularly talked to my mother about her patients, the many specialties within the profession and the impact of advances in bedside technology on her critical care practice. With four children, my family could provide moral, but no financial support for college. When women were first admitted into the military academies, they were offered ROTC (Reserve Officers’ Training Corps) scholarships. I accepted a scholarship, and upon graduation, began my nursing career as an army nurse. The military was foundational to both my nursing practice and leadership development. As a young officer, I was given opportunities to lead and advance my practice.
I witnessed firsthand the power of nursing and professional nursing associations in shaping policy when I became actively engaged with the regional and state chapters of AONL more than 30 years ago. From the greats, I learned the power and collective influence of nurses through efforts to obtain prescriptive authority for nurse practitioners and years later when advocating for advanced nursing education standards. In AONL, I found mentors and colleagues who were passionate about strengthening the development and influence of nurses, the creation of collaborative interprofessional care models and quantifying the nurse contributions in improving health outcomes. I am humbled by our AONL members who so generously share their expertise to set standards, drive excellence and transform health care. Their passion for nursing, leadership and improving the health of individuals is inspiring.
Creating safety
Urgency surrounds the need for sustainable solutions that address the underlying causes of stress and burnout. Given the complexity of the challenges, creating a safe and healthy work environment is essential for patients and clinicians. Addressing workplace violence is paramount for clinicians’ well-being and for fostering a healing environment for patients. With health care leaders, caregivers, policymakers, law enforcement and communities, we will systematically address workplace violence. This month’s issue of Voice of Nursing Leadership focuses on the work of nurse leaders to make health care environments safer for everyone –staff, patients and visitors.
A few months ago, I asked a conference room full of nurse leaders how many of them had been a victim of verbal or physical violence in the workplace. Nearly three-quarters of the audience raised their hands. I then asked how many had reported the violence. As expected, the raised hands were too few. Many of us, myself included, rationalized that violence was related to our patients’ substance abuse, psychiatric illness or dementia.
We know better and need to do better. The U.S. Department of Labor reported that compared to private industry, workers in hospital settings are eight times more likely to experience nonfatal violence-related injuries from other persons (22.8 vs. 2.9 incidents per 10,000 full-time workers). Nurses experienced verbal and nonverbal aggression from authority figures (23%) and peers (31%), as well as verbal and/or physical threats by a patient or patient’s family member (35%).
As leaders, we are responsible for protecting our clinical teams and our patients. It is essential nurse leaders recognize workplace violence and institute a comprehensive approach addressing all forms of violence. We need to build a foundation supporting a culture of safety where health care professionals, patients and visitors feel safe. AONL and the Emergency Nurses Association developed guiding principles to assist nurse leaders in implementing measures to decrease and mitigate violence within the health care environment. These guidelines are outlined on the AONL website.
It is our responsibility to protect our patients and teams in our own organizations, but our voice is needed to enact federal change. Last year, U.S. Reps. Madeleine Dean, D-Penn., and Larry Bucshon, MD, R-Ind., reintroduced the Safety from Violence for Healthcare Employees (SAVE) Act. This bill, which is modeled after current protections for aircraft and airport workers such as flight crews and attendants, would create legal penalties for individuals who knowingly and intentionally assault or intimidate hospital employees.
Currently, no federal law protects hospital employees from assault and intimidation. This bill would criminalize assault or intimidation of hospital employees – with protections for individuals who may be mentally incapacitated due to illness or substance use. Enhanced penalties for those who knowingly assault and intimidate hospital employees will deter further violence and ensure future offenders are given proper punishments for their crimes.
This quest for a violence-free environment is a collective journey, demanding the unwavering commitment and concerted efforts of interprofessional teams spanning leadership, in addition to staff, patients and visitors alike. Regardless of position or discipline, accountability for upholding nonviolent standards is a universal imperative. Encouraging health care teams to proactively identify and address violence in the workplace is key to building a healthy workplace.
Ultimately, addressing workplace violence serves as a linchpin for ensuring a robust and healthy profession. Nursing is valued for its specialized knowledge, skill and caring; it is based on a social contract from which the nurse is granted privileges and in turn held accountable to the public. Therefore, we need to establish the standards for a safe and healthy care environment for our clinicians and for the patients we serve.
"Ultimately, addressing workplace violence serves as a linchpin for ensuring a robust and healthy profession."
As your president, I will keep safety and a violence-free work environment a priority and look forward to the year ahead.