Violence in Nursing - page 2

Violence in Nursing When Ashley became a nurse, she dreamed about helping patients and relieving suffering. She never thought she’d be hurt, much less attacked. Her second day on the job, a... Read More

  1. by   albert_636
    I've heard stories of patients assaulting a nurse and if another nurse stepped in to defend (such as push the patient off or physically hold the patient down) they get sued and the nurse loses their license. I think its BS considering how some of these patients can really hurt even kill a staff member. What are we supposed to do, just watch and yell for security?
  2. by   Ruby Vee
    Quote from JKL33
    I've thought of a practical suggestion for this part of the problem: Those tasked with incorporating Patient Satisfaction initiatives should probably be required to spend significant time, regularly, on the front lines in order to stay informed about the kinds of issues that lead to dissatisfaction the different ways that patients respond. When we hear about patient satisfaction (such as through inservices, for example), we are often told about rather compelling stories and there is a lot of collective murmuring about how that [bad thing nursing did] shouldn't have happened. We don't hear as much about patients becoming dissatisfied or even abusive about more mundane things - - which happens quite frequently. We can't continue to pretend that it doesn't happen. "Appearances" and patient satisfaction concerns have been things that have inhibited progress on this issue. I think spending time in EDs especially would help advance initiatives to empower staff. All different types of units, really.
    That's a wonderful suggestion. I remember being called into the office to talk about a abjectly negative survey I'd been tied to. As we were talking about why I had been rated so badly, my manager opened up the patient's chart from the day specified. Lo and behold, it was a day when three call-off's necessitated her to do charge for 12 hours. She had had multiple conversations with the patient and family involved. In fact, the wife had demanded to see the "*&^(( manager because that charge (bad word meaning female dog) you brought in here had a nasty attitude" -- all documented as direct quotes in my charting.

    "Oh," she said. "THEM. There was no way anyone could have made THEM happy." And the survey went directly into the circular file. Not to worry. HER boss had a copy. And when Marilyn (my manager's boss) was drawn into the conversation, she said "That's the family berating you for ice water that was too cold when I came by with the staffing reports, wasn't it?" HER copy went into the circular file as well. The next departmental meeting I went to addressed the series of bad surveys we'd had from a certain family -- and both my boss and HER boss spoke up and said "There are some people that you just can't make happy. Best to forget about them and concentrate on the ones we CAN make make happy."
  3. by   Froggybelly
    Excellent article, Beth. It's sad that nurses feel workplace violence comes with the job. I cannot imagine a financial advisor thinking it's okay to be punched by his client.
  4. by   FlyingJoey
    Thanks for the great article.
    Someone mentioned about pressing charges and I was wondering if it's okay to call local police to a hospital unit to get a police report? Or is there any better way to handle this type of situation when I want to pursue legal action?
  5. by   Laurean
    Wow this article is long overdue! The reason, I believe that violence is condoned towards nursing is because ADMINISTRATION does not hold the patient and the individauls chain of command accountable. It is directly given to the one who is attacked. This is so prevelent that even the nurse who was attacked is not even supported by their co workers! The co worker is afraid of retalliation(really?! you say) from their managers. We work in an age of computers and video and still the nurse is blamed for being attacked. This will not change until accountability to the correct individauls is held. And that means the suits who have no idea how the attack started in the first place. Myself, I was sexually assaulted at my job. When I went to my admi istratiin I heard the following, 'it's part of your job,we all go home with bruises every now and then' oh and my favorite from a cop' if I didn't think he was truly sick I would be the first to arrest him'. Yeah to say I am jaded is an understatement. Oh and juat because a person works in psych is not a free for all. Nursing is nursing, we all care.
  6. by   Beatlefan
    Took an "escalating behavior" class at the hospital where I work. The instructor was very surprised and angry to hear us nurses tell him about what we endure on the floor. I think he was shocked to know that the hospital security and/or VA police do little with violent patients. MDs accept them for admission, but rarely are around to deal with the horrible behavior. I will never forget being a new RN, having a box of haldol powder come up from pharmacy, and asking for help from my coworkers to; mix and draw up the medication, and get it into the patient. Health care and all the games people play to get out of doing work has really changed me.
  7. by   JinnSchlajfertig
    The stories by the other nurses break my heart and make my blood boil. That clinical instructor, especially,sounds like a self-serving idiot.
    I want to shout off the rooftops: EARTH TO MANAGEMENT! PEOPLE ARE VIOLENT! There are tons of people who we care for who are capable of incredible violence. Some may not be in their right mind. But many are just waiting for their opportunity to hurt others. It's just in their nature. We need to stop serving up victims to these cretins on a platter.
    That's why I'm glad (yep GLAD) I work in a prison. Safety is ALWAYS ALWAYS #1. The custody officers are professional, supportive, skilled and ready to respond to any nonsense. Inmates are infracted for verbally and physically abusive behavior. People coached me on how to position myself to avoid a head-butt or spit attack.
    Most inmates are fine and not particularly violent. But we use a "universal precautions" approach to keep people safe. Can someone slip by and get a hit in? Sure. But I feel safer by far than when I worked inpt psych or detox with little support, no security personnel and patients wandering all over.
    I won't work in corrections forever. But I will take the skills I learned with me wherever I go and strongly advocate for staff safety.
    P.S. I did clinical training in an E.D. If someone was violent the staff responded immediately. We have a sign in the waiting room warning of our no tolerance policy. We are more that happy to restrain a violent who needs urgent treatment and bar those who don't. And we had no problem calling the police. Do not be afraid to make a complaint to OSHA or your state worker safety agency. That's what they are there for.
  8. by   herring_RN
    I was told this story be several nurses I met in a CE class. I'll attack links to newspaper stories. The papers didn't tell the whole story.
    Ventura County, CA ER nurses were attending meetings with their management regarding violence in the ER. Attempted or actual assault by visitors or patients happened an average of twice day. Police were called to the ER more than twice a week. The last straw was when police responding to a call regarding a patient who was threatening staff with scissors drew their firearms in the nurses station.
    The patient had come to the nurse's station bleeding.
    Although the officer didn't shoot nurses knew they had to do more than meet with management. One RN led the campaign for ER safety. No more keeping such incidents secret.

    When the DON attended a county board of supervisors meeting to present a routine report that RN leader had requested to be on the agenda. Most off duty ER nurses and RNs from other departments attended too.
    After the DON barely mentions that a problem was being worked on the RN leader gave her presentation.
    She had a print out of each date and time police were called to the ER. She presented a petition signed by all ER RNs, ER physicians, most other ER staff, and hundreds of nurses from other units demanding a police officer be present in the ER.
    For the first few months it was part time, but nurses made it clear that an officer was needed 24/7.

    More than a year later I heard from those nurses again. They said they worked with officers who came and stood by when called by a nurse.
    When a visitor or patient threatened violence, or even loudly expressed anger, the officer would ask for ID. If the person had any outstanding warrants he or she would be arrested and taken in by another officer the ER officer called in.
    The probation or parole officer was called if that person was under that supervision.
    A public health nurse said, "The word on the street is that you have to behave in the ER or go to jail."
    Patients and staff continue to be safer with an officer on duty.
    Ventura County Medical Center will pay for police officer in emergency room
    Ventura County Medical Center will pay for police officer in emergency room
  9. by   Timbal
    Unfortunately violence is all too common for nurses.
    I have worked with mental health patients who can be very violent, at multiple facilities. The workers have always been told to run away or call for help if a patient becomes violent and attacks. That leaves us in a dilemma if we are cornered and cannot get away without putting hands on the patient. We have no legal defense. Just the very real threat of A) allow the patient to injure us or someone else, or B) defend yourself and loose your license.
    At some facilities security is very good, and gets there fast. But I was still body-slammed into a wall. I still had a food tray thrown at me (it missed). I still have been sexually assaulted and had my butt grabbed. I was still cornered in a hallway (near a staff meeting), and when I loudly stated, "do not touch me", I was reprimanded for talking to the patient like that (BTW, no one came out of said meeting to see what was happening, and this was on a locked psych unit). Anywhere other than in the hospital where I worked, I would have pushed at or struck the individual threatening me in the corner, in an attempt to get away. I did not touch him, and STILL got in trouble for my tone of voice!
    We NEED to be able to protect ourselves, to be safe, without feeling like our license is on the line. We NEED to set clear boundaries and be able to enforce them.
    Now, I am working in corrections. When a patient (inmate) becomes verbally abusive or threatening in any way, security personnel immediately remove them from the room. I feel imminently safer working in a jail than in a hospital!
  10. by   karrikon
    I worked as a psych tech in a hospital. A male and female nurse brought charges against a violent patient. Most patients have enough knowledge to know right from wrong when they are not having a psychotic episode. I also have a nurse friend whose wife is permanently disable from a patient who came in for medical reasons. He was having a delerium episode and PTSD. He attacked her and broke her back. She sued the hospital and one due to lack of support and safety issues.
  11. by   herring_RN
    I searched for an article about my state's new workplace violence law. I think it should be Federal or made law in every state.
    That would be a start. It will require staff insisting the guidelines are implemented and reporting if they are not.
    Prevention Is Key (Er…Required): Will Your State Soon Mandate Workplace Violence Prevention Programs?
    It is no secret to hospital and other healthcare employees that their workplace is no longer a guaranteed safe zone. In fact, recent statistics released by the Occupational Safety and Health Administration (OSHA) indicate that workplace violence is four times more prevalent in the healthcare and social services industries than in other private industries...

    ... Responding to an outcry from nurses’ unions and patients’ rights groups, and following the lead of seven other states, the California Occupational Safety and Health Administration (CalOSHA) recently enacted a new law (effective April 1, 2017) creating a standard for workplace violence prevention in the healthcare industry. While the breadth of coverage and depth of action required of employers in California now exceeds what can be found in any other state, it could be a sign of things to come for other states...

    ... California employers should immediately look to the following list of tasks to ensure
    compliance, while healthcare organizations in other states should consider using the same list as a step-by-step guide:
    Compile all records of workplace violence incidents from the previous year;
    Develop a recordkeeping system for incidents and training sessions;
    Analyze existing policies and training programs (whether or not part of an IIPP);
    Assess each workplace for environmental risk factors;
    Draft (with employee input) and implement a plan; and
    Develop (with employee input) and provide a training program on workplace violence and your Workplace Violence Prevention Plan
    ...
    [B]]Prevention Is Key (Er…Required): Will Your State Soon Mandate Workplace Violence Prevention Programs? | Fisher Phillips - JDSupra
    Current federal OSHA Guidelines:
    https://www.osha.gov/Publications/osha3148.pdf
  12. by   JKL33
    Quote from Ruby Vee
    I remember being called into the office to talk about a abjectly negative survey I'd been tied to. As we were talking about why I had been rated so badly, my manager opened up the patient's chart from the day specified. Lo and behold, it was a day when three call-off's necessitated her to do charge for 12 hours. She had had multiple conversations with the patient and family involved. In fact, the wife had demanded to see the "*&^(( manager because that charge (bad word meaning female dog) you brought in here had a nasty attitude" -- all documented as direct quotes in my charting.

    "Oh," she said. "THEM. There was no way anyone could have made THEM happy." And the survey went directly into the circular file. Not to worry. HER boss had a copy. And when Marilyn (my manager's boss) was drawn into the conversation, she said "That's the family berating you for ice water that was too cold when I came by with the staffing reports, wasn't it?" HER copy went into the circular file as well. The next departmental meeting I went to addressed the series of bad surveys we'd had from a certain family -- and both my boss and HER boss spoke up and said "There are some people that you just can't make happy. Best to forget about them and concentrate on the ones we CAN make make happy."
    Wonderful. It's good to be reminded there are level-headed people out there.

    I have been commended in the past on careful/neutral documentation of such things because doing so is very helpful when patients end up make complaints later. It would be most fair if, by an algorithm of some sort, satisfaction surveys associated with such events/people would be disqualified. I simply can't imagine how one can sit in an office and realistically believe that there is *anything* (ethical) that can be done about this particular segment of the complaints received.
  13. by   maporcrn1
    Nurses need to feel safe in the work environment. Deescalating training and Security support is essential, especially in the Emergency Departments. Defense training may not be a bad idea as well.

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