Practice Management

Workplace Violence: Preparing for Potential Threats Against Your Practice

Incidents of workplace violence have become all too common in today’s times. Recognizing potential threats and having a plan in place to address them is essential.

Whether it’s a news headline, an account relayed by a colleague, or a personal experience, veterinarians and staff are becoming more exposed to instances of verbal threats and/or physical violence while at work. That’s why it’s more important than ever to recognize potential triggers that can lead to a violent incident, to understand the types of violence you and your team may face, and to have a plan in place to address these situations.

Some statistics:
1 in 20 veterinary practices have experienced an act of violence against someone at their practice.
Only 57% of practices surveyed have a written policy for managing situations that involve an act of violence.
Over 55% of practices provide staff training on facility safety or awareness.

The 4 Types of Workplace Violence
The National Institute of Occupational Safety & Health (NIOSH) defines workplace violence as “violent acts (including physical assault and threats of assault) directed toward persons at work or on duty.” It’s critical to understand the different forms of workplace violence and identify the warning signs early. Violent incidents can be categorized into four types.

  • Type I: Criminal Intent. The perpetrator has no legitimate business relationship to the workplace and enters the workplace to commit a robbery or other criminal act.
  • Type II: Customer/Client Violence. The perpetrator is either the recipient or the object of a service provided by the affected workplace or victim. The assailant may be a current or former client.
  • Type III: Worker-on-Worker. The perpetrator has some employment-related involvement with the affected workplace. Usually, this type of incident involves an assault by a current or former employee, supervisor, or manager.
  • Type IV: Personal Relationship Violence. The perpetrator is someone who does not work there but has or had a personal relationship with an employee.

Safeguarding Your Practice Against Workplace Violence
The best time to develop a workplace violence prevention program for your practice is before you find yourself in need of one. Unfortunately, the AVMA Trust has observed that many veterinary practices do not have a plan in place should an active threat arise. Providing your staff with actionable steps to follow in the event of a violent or threatening incident is crucial to ensuring the best possible outcome.
Here are a few actions to consider.

  1. Create a zero-tolerance policy for verbal abuse, harassment, and general hostility. The policy should apply to employees, clients, and vendors alike, and be visible to all by posting signage in the reception area, exam rooms, and employee break rooms. Additionally, a code of conduct should be included in your practice’s employee handbook to guarantee that all staff are informed of expectations in behavior and the consequences of their actions.
  2. Recognize changes in behavior that may signal an unsafe situation and provide staff training on de-escalation techniques. According to NIOSH, certain verbal and nonverbal cues are potential warning signs of escalating anger. The verbal cues include speaking loudly or yelling, swearing, or using a threatening tone of voice. Some examples of non-verbal or behavioral cues include arms held tightly across the chest, clenched fists, pacing or agitation, heavy breathing, and a fixed stare.
  3. Increase security within and around your practice. If you haven’t done so already, add internal and external video cameras, extra lighting, motion detectors, and alarm systems to safeguard your physical space from intruders. Panic buttons may also be installed in exam rooms, treatment areas, and reception.
  4. Create an emergency escape plan from different locations within the practice. If a threat arises at the front of the practice, how will staff members working in other parts of the practice be notified? What if an intruder or assailant enters through the back door of the practice? Consider all points of entry when crafting your emergency plan and focus on creating an efficient way to spread the word.
  5. Designate a point-person who staff can turn to with concerns regarding their safety at home, with clients, or fellow employees. This point-person should be given guidelines for recording concerns, relaying them up the chain of management, and documenting how and when concerns are addressed.
  6. Instruct staff to call 911 as soon as they are safely able to do so in the event of a violent or threatening incident.
  7. Check-in with your team regularly and encourage them to voice concerns to the point-person or other practice leaders. Provide mental health resources to staff and appropriately monitor any employees who appear to be struggling

Common Triggers for Workplace Violence
In day-to-day veterinary practice, scenarios that have become common triggers for workplace violence include:
• Billing disputes with clients
• Unexpected loss of a patient
• Allegations of veterinary negligence
• Disgruntled (current or former) employees

While these scenarios are more than likely to be resolved peacefully, it is important to be aware that they can result in a negative event.

The IVMA Veterinary Practice Efficiency Working Group has also developed resources for IVMA members. Learn more at: https://invma.org/p/