Registed Nurses' Association of Ontario

Nurses launch guideline to tackle violence in the workplace

Nurses launch guideline to tackle violence in the workplace


TORONTO, Dec. 4, 2008 – The Registered Nurses’ Association of Ontario (RNAO) has taken a critical step in tackling violence in workplaces and educational settings by issuing comprehensive recommendations to promote violence-free environments.

Aimed at governments, employers, educators, professional bodies, regulators and unions, as well as individual nurses and those from other disciplines, the new guideline - titled Preventing and Managing Violence in the Workplace -  was announced at St. Michael’s Hospital in Toronto this morning, two days ahead of Canada’s National Day of Remembrance and Action on Violence Against Women. A team of nurses and other health experts spent the past two years identifying the strongest research evidence and developing recommendations to address verbal, emotional and physical acts of aggression and violence that could be perpetrated by health-care professionals, patients or patients’ family members.

“We’re in a profession where there’s a greater risk of violence. Having said that, when people say ‘it’s part of the job,’ that assumes it okay and that it’s going to happen,” explains RN Margaret Keatings, co-chair of the panel that developed the guideline and the Chief of Interprofessional Practice, Chief Nurse Executive at The Hospital for Sick Children in Toronto. She stresses that violence must not be tolerated and should be prevented from occurring. Governments, organizations, nurses and all health professionals need to understand preventive measures, know how to recognize risks early to prevent escalation, and know how to respond swiftly to prevent re-occurrences. “You can minimize occurrences and risk by intervening right up front,” Keatings explains.

For years, violence against health professionals was rarely discussed; but cases such as the tragic death of Lori Dupont, an RN at Windsor’s Hotel Dieu Grace Hospital who was murdered while on duty by her former boyfriend, an anaesthesiologist at the same hospital, brought the issue poignantly to the forefront. While the public only hears about a small number of incidents, statistics show that they are not that unusual. Twenty-eight per cent of Ontario nurses who responded to a Statistics Canada survey released in 2006 said that they had been physically assaulted by a patient in the previous 12 months. The report also found that 19 per cent of Ontario nurses had experienced emotional abuse at the hands of physicians and nurse co-workers. Many nurses who experience violence don’t talk about their experiences for fear of losing their jobs or enduring retaliation and further confrontation.

Doris Grinspun, the Executive Director of RNAO, says some organizations don’t acknowledge they have a problem with violence until they find themselves involved in a very serious incident. As more and more employers begin to implement policies to address violence, Grinspun urges them to follow RNAO’s guideline, keeping one fundamental principle in mind: “It’s got to be clear to everyone associated with the organization - from the chair of the board of directors and the CEO, to the chief of medical staff and the chief of nursing right down to patients and their families - that the policy applies to everyone and there are no exceptions.” Grinspun adds that if implemented, the guideline’s recommendations will empower health-care providers to speak out and stand up for violence-free workplaces.

The following are some of the recommendations included in the guideline:

  • Governments should enact and enforce legislation that promotes a violence-free workplace. This legislation should include mandatory reporting and whistle-blower protection for those who report violence in the workplace. Adequate funding should be provided for staffing, mandatory education and leadership development to prevent, identify and respond to violence in the workplace.

  • Organizations should ensure that the safety of patients, staff, physicians, volunteers and students is a strategic priority. They must develop and implement a violence prevention policy and program that addresses all forms of violence in the workplace.

  • Individual members of the health-care team should collaborate with team members in a manner that fosters respect and trust and prevents violence. This includes refraining from actions such as gossiping, bullying, harassment, socially isolating others, pushing, throwing things, or any other aggressive behaviours.  

RNAO’s ambitious Best Practice Guidelines Program, funded by the Ministry of Health and Long-Term Care, was launched in 1999 to provide the best available evidence for patient care across a wide spectrum of health-care areas. The 38 guidelines developed to date are a substantive contribution towards building excellence in Ontario’s health-care system. They are available to nurses and other health care professionals across Canada and abroad. To learn more about RNAO’s Nursing Best Guidelines Program or to view these resources, please visit

The Registered Nurses’ Association of Ontario is the professional association representing registered nurses in Ontario. Since 1925, RNAO has lobbied for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve.


For more information:
Marion Zych, Director of Communications
Registered Nurses’ Association of Ontario
Ph: 416-408-5605
Cell: 647-406-5605