One of the many challenges that exist for organisations within health, community or social welfare based services are individual clients who use aggressive behaviours. Organisations within those sectors can have a tendency to dismiss the behaviour as being caused by the client’s physical or mental health condition, or just daily life creating stress for that individual. To some degree, it is behaviour that is normalised and accepted. That being said, often the behaviours aren’t extreme enough to be labelled violence.
However, the behaviour by the client (to keep it simple I will use the term client) creates a significant risk to health and safety. The risk to employees in these workplaces is often coined by the phrase burn out.
The question to be asked is, should the client’s behaviour be classed as occupational violence, or is it more of a variation of workplace bullying?
What is Occupational Violence
It is our safe work authorities who provide our guide to understanding occupational violence, or as they also name it workplace violence. Safe Work Australia (other authorities are consistent with this) define it as a situation “where a person is abused, threatened or assaulted in circumstances arising out of, or in the course of their work”.
Some examples include:
- biting, spitting, scratching, hitting, kicking
- punching, pushing, shoving, tripping, grabbing
- throwing objects
- verbal threats
- aggravated assault
- any form of indecent physical contact
- threatening someone with a weapon or armed robbery.
It is clear in some cases, that occupational violence is an appropriate term for some client behaviours who are supported by health, community or social welfare based services.
Understanding How the Term “Bullying” Fits
Within health, community or social welfare based services there are many instances of behaviour that don’t fit the definition of occupational violence. There are many others that more closely resemble workplace bullying.
Workplace bullying is defined as unreasonable behaviour that is repeated and creates a risk to health and safety.
The following is an example of where a client’s behaviour matches workplace bullying.
One service provider had a client who received monthly garden maintenance. Each time the gardener attended the client’s property, he invariably did not complete the job to the client’s expected standard. As a result, the service would receive repeated calls each time the gardener had attended and the client would present as being angry and verbally abusive. She would make comments about how useless the gardener was and how bad he was at his job. The client would use similar words describing the quality and competence of both the service provider and her case manager. She would not listen to reasonable arguments. Inevitably, the service arranged a different gardener, but her behaviours were repeated with each replacement.
Throughout this, the organisation continued to provide services to the client because they knew she had a range of both physical and mental health problems. She never threatened to harm staff or physically assaulted anyone. However, they found that as time progressed, case managers struggled to continue to work with the client due to her aggressive nature. Therefore, they swapped case managers regularly. This only aggravated the situation as the client became upset when her case manager changed. The case managers often were stressed and anxious due to the client’s aggressive approach.
This situation resembles bullying as it involved repeated, unreasonable behaviour resulting in a risk to, in this case, psychological health and safety. It should also be noted that the signs of injury mimic workplace bullying injury. On top of stress and anxiety, recurring comments in the form of attacking ability and competence undermined self belief and self confidence. Not responding to calls from that client, while a sign of managing the clients behaviour, may also indicate potential injury.
Implications for health, community or social welfare based services
Under work health and safety legislation, Australian organisations and companies are required to provide a safe workplace. Psychological health and safety sits firmly within this obligation.
The following are five key strategies for you to employ to minimise your risk of psychological injury from client based, work-related bullying.
Health, community or social welfare based organisations are going to work with difficult and challenging clients with difficult behaviours. It has to be acknowledged that these behaviours, like all workplace bullying, create a risk to health and safety. We need to move beyond the acceptance that this is just the way that client behaves and push on.
- Assess the Risk
It is not unusual for organisations complete regular assessments to identify risk to the client or the risk to the employees. The assessment doesn’t usually include psychological risk to employees.
- Plan and Manage the Risk
Ensure that the risks identified have an associated planned response. If you can, set up the boundaries and expectations with the client so they know what to expect. Reward the client where things go well. Where appropriate, you may need to include behavioural experts to advise on appropriate strategies.
- Review the Plan
Knowing that your plan is working or not is vital. Check each strategy and adjust or trying something new when elements don’t work. Don’t loose sight of the things that do work and continue to do them if you can.
- Educate your employees
Educate your employees to identify the bullying type behaviours, their impact and potential management strategies. Their health and safety is not only your responsibility, but theirs as well!
Managing aggressive clients is never easy. That being said, you can minimise the risk of client to employee workplace bullying injury and ensure your employees go home at the end of the day safe and well. That is good for your employees and your organisation!