(Editor's note: The following is an essay written by Heather Ryner, an occupational safety nurse based in Ontario. This essay was one of three winners of this year’s Dick Martin Scholarship Award by the Canadian Centre of Occupational Health and Safety.)  [Watch Ryner talk about the essay]

 
Workplace violence is a large problem in workplaces, but even more  so in health care facilities.  

The Ontario Nurses Association defines workplace violence as “Violence, also known as abuse, can be defined as any act of violence, including physical, verbal and sexual abuse, harassment, including sexual harassment, threats, intimidation or anything that offends or humiliates etc.” (ONA, 2003, p.3)   Workplace violence can also include rumours, swearing, pranks, arguments, vandalism, sabotage, pushing, rape, arson, anger related incidents and murder.
    

In 2004, 20% of all reported workplace incidents were related to workplace violence. (COS, 2007). These violent acts are more common in certain industries; one third involved someone working in social assistance or health care services such as hospitals, residential care or the nursing field.   

The international council of nurses states that two million people die each year as a result of violence and nurses are three times more likely to experience violence than any other professional group (ONA, 2003).  Health sector makes up only 10% of the workforce yet account for 40% of accepted WSIB violence claims.
Incidence of violence can be greater at certain times of the day, month or year. 

There is a remarkable increase in assaults during the Late hours of the night and early morning due to decreased activity and lower staffing levels.  Annual events such as Tax return season or Christmas can cause increased stress.  People faced with debt, struggling to pay the bills, or faced with utilities being shut off for none payment can be overcome by stress.  Pay days can cause people to act unusual , perhaps by increased intake of alcohol or drugs or other harmful practices.  Performance appraisals at work, if negative, can cause people to act out.   

Any one or a combination of these factors can cause a change in a person’s behaviour that may result in violence.

Nurses are working under stress due to nursing shortages, higher patient acuity, and staffing changes. These factors can lead to an increased incidence in burn out, which can cause nurses to act out in a negative fashion towards other nurses and staff members. 

Nurses are viewed by society as having a lower status in the medical profession.  Many nurses are also subject to daily verbal abuse from physicians.   Nursing is a female dominated profession in a society that devalues and sexualizes women which can cause oppression in nurses. 
When people are oppressed, they feel a lack of control and use desperate measures to try and regain control.  This may be expressed by intimidation or abuse of their co-workers.