Assaults on staff

[PerfectlyNumb]

Just curious, are other EDs seeing an increase in staff assaults compared to prior years? Are people becoming more aggressive in your ED related to synthetic drug use/ETOH or untreated mental illness (or a combination of these)?

[danggirl16]

I think there probably is an increase in the violence we see in the ED. At my last job, our volume was about 30% psych and that is inclusive of drug/alcohol intoxication. The biggest issue was that many of the hospitals had closed their inpatient psychiatric units and the ones that were still in existence required some type of insurance coverage. The most violent patients we saw were a combination of some type of psychiatric disorder and ETOH abuse. We had security guards posted inside and outside the ED but it was still increasing. They started posting a sheriff's deputy in the ED in hopes that the presence of a law enforcement officer would deter the violence since they had the power to actually arrest someone.

I don't know the stats but I think a few states have passed laws making it a crime for any patient to strike a health care worker whereas in the past - and probably still in most places - facing violence was just part of the job and since the people were "sick" they couldn't be responsible.

With the synthetic drugs....bath salts, spice, etc...I haven't noticed any particular rise in the number of violent patients per se but rather in the AGE...we started seeing more of the 16+. Still most of the violence comes from ETOH abuse.

Sometimes I think the police bring people to the ED inappropriately and that has been a source of increased violence. The people are outrageously drunk and making some type of scene in public but rather than arresting them, the officers choose to bring them to the ED. Being placed on a psych hold makes them more aggressive!

[DayDreamin ER CRNP]

We have actually seen a decrease in assault. We started using the MOAB training to aid us in recognizing signs of possible threats prior to an incident and I can honestly say we don't see it too often. We also have a full-time police officer in our hospital now. For the most part the officer is in the ED but is technically assigned all over the hospital and is under the direction (sorta) of our in-house security.

I have to say that our in-house security folks do a pretty good job for us too. LOTS better than it used to be!

m

[vintagemother, BSN, CNA, LVN, RN]

I miss having in house security and police. We do have pretty good staff that help out when Pts escalate though.