If you walk into any health or social care environment , you will most likely see signs stating that abuse and harassment of health care professionals will not be tolerated. The presence and prevalence of such notices belies an uncomfortable truth: that individuals throughout the health service are frequent targets of both. In the eyes of many, it’s almost considered an inevitable part of the job.
The World Health Organization (WHO) reports that up to 38% of health workers suffer physical violence at some point in their careers – most at the hands of patients and visitors. Many more are verbally abused or threatened. It is not just workers in hospitals, care homes and GP practices that are at risk; workers who operate in disaster and conflict scenarios are vulnerable to additional forms of violence, including collective and political. Healthcare workers directly involved in patient care are among those who face the greatest risk of attacks on their human rights, including:
- Emergency room staff
But it is not just physical rights abuses that are an issue. Unsatisfactory, and often unsafe, working conditions; long shifts and insufficient pay; psychological stress, poor mental health and burnout; lack of respect, authority and autonomy; long waitlists, backlogs and budget cuts to critical resources – the list goes on. The coronavirus pandemic highlighted many global and societal issues: one such issue is that patients and others in need of medical treatment and high-quality care cannot be kept safe unless healthcare workers and caregivers themselves are kept safe.
While individual healthcare systems have their own policies and constitutions, most share similar principles.
For example, in the UK, NHS Constitution stipulates that staff across all NHS trusts should have “rewarding and worthwhile jobs, with the freedom and confidence to act in the interest of patients. To do this, they need to be trusted, actively listened to and provided with meaningful feedback. They must be treated with respect at work, have the tools, training and support to deliver compassionate care, and opportunities to develop and progress.” These rights apply to clinical, non-clinical and public health staff, wherever they are working – across private, public and voluntary healthcare services.
Enshrined in their contracts, healthcare staff have rights to:
- A good working environment with flexible working opportunities
- Fair pay and contract framework
- Involvement and representation in the workplace
- Healthy and safe working conditions and an environment free from harassment, bullying or violence
- Fair, equal and discrimination-free treatment
- Opportunities to raise complaints about employers with an employment tribunal
- Opportunities to raise concerns about public interest with their employer regarding safety, malpractice or other risks
This, however, is certainly not how it always works in practice. It poses a monumental challenge – and, therefore, monumental risks – to healthcare providers, public authorities and governing bodies in charge of maintaining public health.
Widespread, negative impacts are unavoidable where instances of violence, abuse and other indignities of healthcare workers occur. While not all employees feel appreciated and respected at work – across all sectors – at a minimum they have a right to safety. Where this need is not met, there can be significant psychological and physical effects.
Healthcare is, by nature, a fast-paced, challenging and demanding industry. Job stress can be incredibly high; whether a member of non-medical or medical staff, workers are frequently carrying out their tasks in life and death situations. At a minimum, staff are in regular contact with patients and visitors in high-stress, high-emotion scenarios – and the unwarranted harassment, degrading treatment, abuse and friction this can bring. It all adds up to making roles across health and social care incredibly demanding; both day-to-day and long-term job stresses and pain points pose severe threats to overall quality of life. As well as the very-prevalent impacts to both physical and mental health, it poses real problems for job motivation, staff retention, quality of healthcare, and financial loss for the organisation and sector.
Preserving workers’ rights is critical to operating well-functioning, resilient healthcare systems, upholding quality of care, and maintaining a productive workforce. How can the healthcare workforce be expected to protect vulnerable groups and support a nation’s health problems while they struggle with vulnerability and health threats themselves? According to the Care Quality Commission (CQC), there is much research demonstrating that supporting the human rights of staff is vital in developing a human rights approach to healthcare more generally.
The very point of human rights is that they are universal. As such, a human rights-based approach is one that recognises and upholds the rights of every individual in a situation.
Governments and healthcare leaders have a legal, moral obligation to address persistent threats to the health and safety of their staff members. So, what initiatives can be implemented to better preserve the rights of employees?
The WHO state that there are five key areas to address the safety of health workers:
- Establish synergies between health worker safety and patient safety policies and strategies.
- Develop and implement national programmes for occupational health and safety of health workers.
- Protect health workers from violence in the workplace.
- Improve mental health and psychological wellbeing.
- Protect health workers from physical and biological hazards.
In practice, this means developing better interventions to manage abusive and/or violent patients and high-risk visitors; for example, improving the physical security of healthcare facilities and working environments. It means ensuring that leaders prioritise greater advocacy and networking for strengthening the protection of workers, and ensuring widespread availability of occupational health and related support services for staff members. It means monitoring and supporting employees’ physical and mental health conditions.
Across healthcare systems, leaders and line managers must promote supportive, open workplace cultures and leaders, champion employee welfare, share information, and provide opportunities for education, training and personal and professional development opportunities. Strategic discussions need to be held to address issues of basic rights and safety in low-resource settings. Each member of staff must feel engaged and empowered in issues that affect them, and supported by clear processes and procedures for raising grievances.
These strategies are far from exhaustive, but offer options and starting points to catalyse systemic, meaningful change for healthcare staff.
Are you passionate about embedding a workplace culture that upholds the rights of both staff and those with care needs? Keen to seek the wider benefits of a human rights-based approach?
Prepare for senior roles in healthcare – and gain in-depth insight into the workings of large, complex organisations – with the University of the Commonwealth Caribbean’s online MBA Healthcare Management programme. Your combination of specialist healthcare and business expertise will make you highly valuable to future employers, with knowledge encompassing leadership, strategy and decision-making, human resource management, finance, marketing, healthcare innovation, management and delivery, and more.