Getting Hurt in the Units

Dan McFeeley · May 20, 2012

Questions like this, and others, are good to bring up in the hiring interview, but you've already started the job and have prior experience? Try checking with Human Resources and asking what their policies are. At my place of employment we have a task force on hospital violence -- is there anything similar at your hospital? It could also help to ask discretely if anyone at work has been injured in the past, and what the response was, including Workmen's Compensation.

Another good question to ask -- does the facility have a policy of prosecuting criminal assaults against staff members?

Staffing can also be a contribution to injuries. You need to have sufficient staff, and the staff you do have on the floor have to be the kind of people who are proactive in spotting potential situations where aggression can occur, and intervene beforehand. Insufficient staffing can lead to minor injuries, such as chronic back pain or lumbar area injuries.

Quite some time ago, there was an item in the news about a nurse who was severely injured by a patient at a state facility. The patient was being admitted to the hospital unit, had a record of violence. He erupted unpredictably and slammed the nurse's head into a door frame. She suffered brain damage from the injury. Afterwards, news reports indicated that a factor in the incident was insufficient staffing. What took us aback was, the staffing on the floor of that hospital unit which they did have, reported as inadequate, was more than the staffing on our own hospital unit.

The figures for injury in the mental health field are high -- mental health professionals lead the pack with a rate of 69.9 out of 1,000 (National Crime Victimization Survey (199) and The Bureau of Labor Statistics Data). The risks are high, but with good staffing and experience people, they can be minimized.

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Kooky Korky, BSN, RN · May 21, 2012

Didn't your orientation cover this?

Workers' Comp should be available. You can always make a police report yourself.

Are you allowed to defend yourself? Can you take someone down alone? Or does your place require 2 people or more?

Read your policy manual.

HolyPeas · May 21, 2012

Havent started yet, sorry guys.

Midwest4me · May 21, 2012

There isn't any recourse at our facility. It's understood that we hire on with the understanding of the "potential"(which is actual, not potential) violence(which includes assault, rape, etc); because these criminally ill patients are mentally ill; they've committed horrid crimes and are not responsible for their actions...so how can we possibly place police charges against them? And when most of the patients have 30+ years to serve, what difference does it make? It's frustrating to say the least. Some staff have lost their jobs trying to stop patients from injuring other staff, despite the fact that these staff have been cleared of wrong doing by the police. It doesn't speak highly of those in administration lending us the support we need, does it? You must expect injuries..it's so sad...but with this economy, at least it's a job.

HolyPeas · May 21, 2012

I do expect it in a way, I just dont know how serious things are on a day to day basis

chevyv, BSN, RN · May 22, 2012

Security is poor in many places. Where I work, if you are injured Workmans Comp kicks in after 3days out. I think you may be asking about pts though so please excuse me if I'm on the wrong track here. When a pt assaults staff on my unit, the pt may be taken off of the unit, but most likely, the pt will be placed on 72 hr restriction and told to 'say your sorry'. The sheriff is called and a ticket possibly given. Fact is, its frustrating for the staff as well as the sheriffs. Pts are not competent so the ticket will be thrown out, no charges will be filed, and the pt is already where they need to be. I work in a county facility and we do the best we can, but many times there just doesn't seem to be good support for the floor. Still, I love my job :)

marydc · Jun 2, 2012

The voice of experience here. I've spent 24 years working an inpatient psychiatric unit. 5 years ago I became a statistic when I was assaulted and seriously injured by a patient. Left with hair pulled out, a black eye, broken nose, herniated disc in my neck, and chronic pain I'll always deal with.

The incident was reported by security to the local police department. That same evening I was called by a detective who wanted a full report. I was given the option to press charges. I refused but only because the patient was truly psychotic and thinking was not reality based. If it been someone well aware of right from wrong I wouldn't have hesitated and my hospital would have backed me 100% In some states it is a felony to assault a healthcare worker while on duty. It currently is not in my state, however my hospital is fighting to get the legislation changed.

I was off work almost 5 months. Workman's Comp did cover all of my medical expenses and my time off. The employee health nurse was very supportive and worked hard to save my job and get me back to work.

The fact that people do not stay would concern me. I work in a great place and we rarely have openings. As someone else said experience means a lot in preventing injuries. Most of us have been here for years.

We do not have security staffed on the unit, but we can call them at anytime to assist or just do a walk through. We have a panic button to use in an emergency which brings immediate help.

HolyPeas · Jun 3, 2012

Great. We dont even have panic buttons, although supposedly security can get anywhere in the units in 90 seconds. but thats if we can get to the phone....

I am considering taking out some sort of workplace hazard insurance..... surely there must be such a thing right?

algebra_demystified · Jun 3, 2012

If I were in your shoes I would think hard about a few topics before taking a position on the floor. Here's a short list.

1. Power tripping

2. Drawing a line in the sand

3. Hospital policies and procedures

4. Why should anyone help me if I dig myself into a hole?

5. Conflict deescalation

6. Respect

7. What can I realistically do if a patient shoves me into a corner and pulls out a shank? Please think about this question as though there was nobody to help you. What could you personally do on your own? Can you fight your way out? How willing are you to get stuck with a sharp object in a vital organ? Consider the possibility that this might happen in a psych setting and that you could be killed if you choose incorrectly.

8. How much money is worth my safety?

9. Do I like working with the criminally insane? Why?

10. Do you believe you have the right to defend yourself from an attack?

11. Are there cameras at this facility? Do they record?

Lots more to ask yourself.

HolyPeas · Jun 3, 2012

Thanks! Most things I am not so worried about, I feel like I am basically capable of handling myself, I'm no small lady, but I didn't think to ask about the camera situation.

algebra_demystified · Jun 3, 2012

You might have gotten me wrong. I'm not a tough guy. It's not about whether you could do any of a number of things on your own, except in the final defense of your life or serious disability/loss of limbs. The rest of it matters whether there are cameras there or not.

I think you'll understand more once you have a couple years under your belt. I'm not sure my list would have made much sense to me on my first day.

There were morbidly obese elderly women who worked maximum security with me. They had a grandmotherly crook to their pointer finger and could back down the most violent offenders when they would have taken my head off.