Increasing Work Place Violence

  1. After reading about D. Dorsey who was killed by a gunman in the ER at Vinita Hospital in Oklahoma I thought I'd relate what happened at our hospital last week. My deepest sympathies go out to D. Dorsey's family and co-workers. Luckily no one was physically hurt in the incidents I am about to describe, Psychologically and financially are a different story.

    On Friday morning at about 0910 a member of the medical staff was about to get into his car on the ED Parking Lot when someone approached him from behind. The person told the physician that he had a weapon and wanted him to drive him somewhere. They both got in the car and the physician was directed to drive to several locations, which he did. While stopped at a traffic light in the area of XXXXXXXX and XXXXX, the suspect opened the car door and ran from the area. There was no injury to the physician and the only property taken was a cell phone and pager.

    In the early hours of the next morning, somewhere between 0300 and 0400 two cars were robbed in the ED parking Lot. The smash and grab technique was used. Smash a window and grab what ever you can reach. On car belonged to a patient being treated and the other car belonged to a staff member, neither of which were hurt.

    Although I note the I work in the Baltimore/Washington area, we are considered a community hospital, actually outside the city lines. Most of our security guards (whom most are good at what they do) are unarmed retired police and firemen with a few moonlighting prision guards thrown in.

    Several weeks ago I personally filed a police report after a mentally ill patient threatened to come back to the hospital with a gun and shot me. He was committed that visit, but we all know how long these patients stay committed. The police took a report because in their words, they have worked with me for a long time and I have never filed a report about anything patients did or said to me before. They believed me. They however could not officially file this report or take any further steps because nothing physically had actually happened. (Of course if I end up shot to death one day, at least they will have some place to start)

    I would like to hear your stories as well as things you personally or your facility has done to increase your safety.

    Thanks,
    Debbye
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  2. 10 Comments

  3. by   ERNurse752
    I think part of the problem is that people seem to expect that violence is part of the job... especially in ER or psych, violence seems to be accepted as something you just have to deal with.
    I don't think we should have to accept that risk. Certain professions do accept that risk, but they are trained and armed to handle it. Nurses are not. I do realize that there are several high risk situations healthcare workers are put in, however, measures need to be taken to prevent these situations from escalating into violence. Not just acknowledged and accepted.
  4. by   P_RN
    I haven't worked ER in a loooong time.

    However, I once had a visitor whose mother-in-law wasn't receiving the XR form of a medicine. I got it clarified and went to the room to tell them it was straight. This man grabbed me and pushed me out of the door and slammed me into the door frame. He then told me he works for the Health Dept. and would make sure the hospital was "inspected" for this medication error.

    Well, hmmmm you don't DO that to me. I called the director and then the police department. Before the cops came the visitor was long gone. Soooo after work I went down to the PD and filed a complaint. The guy wasn't about to get away with that. He called me soon afterwards and threatened me again if I didn't withdraw the complaint. Sorry Bub, you started it.

    Guess he probably now days would have come after me with a gun. BUT workplace violence is WRONG whether it's a shove, a slap or a shooting. Make out a report.
    Last edit by P_RN on Oct 13, '01
  5. by   montroyal
    You need to contact the state Of South Carolina and enquire about the law protecting ER, EMS, and Home Health personnel. I testified infront of the house sub committie when we were trying to get the law passed. What I could not believe was, I was the only RN in the state to come to testify. Most RN's were unaware of the effort of this bill. In a nut shell, this bill makes verbally threatening any of the above people a felony punishable by two years in state prison. If you physically assault any of these people, its a felony punishable by ten years in state prison. Both of these sentences have no possibilty of parole. It was about time for the government to stand up for the rights of the medical employees and I applaud them for their stand.
  6. by   schmrock
    I work in an emergency room that sees approximately 45,000 patients a year. We also have a sort of outpatient psych unit attached to the hospital. There have been isolated incidents of violence in the ED. Mostly they are drunk or emotionally disturbed patients. Our security department is very good and is quite helpful with these patients. If the nurse feels threatened or if the patient is verbally abusive, he/she can call a security watch on that patient.

    There have been many verbal threats of violence from these patients but no one has actually carried out those threats. Not yet anyways. The problem with that is that we as nurses have become complacent with the fact that nothing has ever happened. Who knows when one day one of them will follow through.

    We are required as part of our yearly competencies to attend a "ninja" class. This class originally was called BMT - behavioral modification technique class. They have since renamed it but it remains the same. It is a full day class with lecture about violent patients and then hands on techniques to subdue the patient. The problem with this is that I as a nurse don't necessarily feel I am qualified to "bring someone down" who happens to be having a violent outburst. Although the thought pattern here is to diffuse the situation before it becomes an issue where the patient must be subdued.
  7. by   lpnandloveit1
    here's the thing. We have to realize that any shove push slap etc. is assualt. this is a crime. We have to bring nursing out of the dark ages. We are not servants who can be treated anyway anyone wants to treat us. I realize that often stressful situations bring out the bad in people but there is never an excuse for violence.
  8. by   cannie
    Our hospital recently called a mtg to announce a lucrative contract they had just picked up with the Dept. of Corrections. Needless to say not many of us were thrilled no matter how "lucrative" it may be. We are now expected to provide care for inmates. They are chained to the bed and have a sheriff at the bedside at all times. Except, of course if they need the restroom or more coffee. I recently had an inmate with leg shackles on and undergoing a golytely prep. It was a poopy situation for us both. He became upset that I wouldn't request that the shackles be removed. He made some threatening comments and within 3min. I had 4 security guards and an order for 4pt leather restraints. At our mtg we were told that we were not legally able to question why these people were incarcerated but that if they told us we were to "pass it on without making an entry on report sheet or charts". The whole situation stinks. However some security changes were made for the nurses and other personel. Everyone was issued new badges without our last names and last names are no longer used in any documentation that might be seen by patients. Phone number lists are now locked up and only accessible by the charge nurses. Security patrols on bikes through our parking lots 24/7 and they are always available to walk nurses to their cars. It's a given that we deal with sick people and sick people are usually not happy. We are going to run into some nasty ones so prepare yourself, do what you can to prevent violent interaction and keep being the best nurse you can.
  9. by   fergus51
    I think it's terrible that some people think assault is just a part of the job. Debbyed, we had a patient in our hospital a few years ago whose husband threatenned to come back with a shot gun and kill some staff members. Most of the staff just laughed it off, but one did call the police. They arrived as he was walking towards the door... with his shotgun. Luckily nothing happened because this nurse followed her gut instinct. I can't tell you how glad I am that you are willing to follow your gut too.

    The worst I have seen (I work L&D and we get our share of loonies) was a father to be who was threatenning and intimidating one nurse. He was saying he was going to kick her ass and kept walking closer to her. The doctor on (who happens to be 6'3 and BIG) slammed him into the wall and told him he would not be threaten any of the nurses again. One of the nicest things I have ever seen a doc do for us nurses. The father to be wound up leaving shortly after and coming back 4 hours later completely drunk so the cops took him.
  10. by   Aerolizing
    I had clinicals for psych at our local state mental facility. A male patient had caught my attention as he left his penis sticking out of his pj bottoms for some unknown reason. He later asked if I had seen his wife driving a brown van from West Va. I told him no, I had not. That night on the news, I heard a man had escaped from the state mental hospital in a brown van with West Va plates. The next day when I went back, I asked staff if it was him and sure enough, it was. I heard the whole story from the other patients and the nurse. Seems his wife had smuggled in a gun and he held it to the nurse's head and told her if she did not hand over the right keys, he would shoot her. He locked her in a closet and a paranoid schizophrenic patient showed him how to get out quickly but did not want to be his hostage as he thought that guy was in enough trouble already.
    Now, there is a sign posted at the entrance asking that everyone check their weapons.
  11. by   tonchitoRN
    I think we are too complacent about workplace violence. Any verbal threats should be taken seriously. I think even police reports should be done on a regular basis regardless what admin. has to say. In my hospital they did not want us to report violence to the police. Guess, they did not want a rep. However, I do not believe they had the employees best interest in mind. Luckily, we do not get too many incidences of violence but things can and do happen.
    This is an issue that staff should ban together and say "we are not gonna take this anymore. If you are not gonna protect me then it is up to me."
    I do believe that the public knows they can get away with a lot and push the limits.
  12. by   semstr
    Hi,

    During my last year in nursingschool I was attacked by an alcoholic.
    Well up till there nobody knew he was, but as I entered his room for the last round on the late shift, he wasn't in his room. As I called him, he was in the bathroom, I thought his voice was a bit strange, but heh, so what?
    Well that's the last thing I really know, till I came round in the ER with 5 stiches in my head!
    Apparently the patient came out of the bathroom and hit me with a glass flowervase from behind.

    He was admitted to the psych. ward immediately afterwards.

    The best thing though: doctors and nurses on the psych. ward knew this guy from other "visits". (This was years before we used computers!) and knew he could be very aggressiv!

    The doctor admitting him this time, didn't consult with a psychiatrist, because he thought it wasn't necessary!
    (My attacker was admitted with a pancreatitis directly from his "livingroom" in the central station of Amsterdam and looked and smelled that way)

    The good thing for me though, a week paid sick leave, that didn't have influence on my practical hours on this ward.

    Since that time (and this happened 22 years ago) I am very careful when streetpeople are admitted!
    -Renee

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