How prevalent is violence in the workplace for nurses?

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Ruby Vee, BSN

17 Articles; 14,030 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Originally posted by LPNtoBSNstudent

I have been kicked and hit and pinched by patients but usually they have some sort of dementia. Most of the time I just brush it off but one time when I was pregnant I got kicked HARD in the stomach, when I was trying to protect a helpless patient from a BIG farmer man who had Alzheimers. He was super strong too. It was me and two CNA's in the whole building, (NOC shift) and we could barely get him away from this other patient. He kept going in her room and trying to move stuff around. One time I walked past and he was trying to set her 19 inch television set on top of her! She was bedridden. I was horrified. We had to be very careful with how we approached him. We couldn't get him to let go of the TV for the longest time and then we couldn't get him to get out of her room! He was huge and very agile. We were not pulling and tugging on him, but rather trying to be very nice and persuade him to come to the hallway and sort of steering him toward the hall. He was mad as could be at us and was very suspicious, as many Alzheimer's patients can be. I was standing in front of him and his leg came up and kicked me right in the abdomen.

Later on that night after I thought he was calmed down (and asleep), I came around the corner and he was STANDING on the nurses station! There was a half wall sort of area that enclosed the nurses station and he was standing up there trying to change an imaginary light bulb. And this was AFTER the IM Ativan was given.

Anyway,

Even if they have dementia, it still "feels" like you've been abused.

I would like some ideas of how people cope with things like this? I ended up quiting my job over this because I felt I had no support in dealing with this from management. What are some things that management can do to help nurses in these types situations?

Was there some kind of security person at your facility? If not, there should be!

Nope, no security. Just the 3 of us. Two CNA's (a male and a female) and me. It was a small rural nursing home.

-jt

2,709 Posts

some current research on the topic:

FROM THE NEW YORK STATE NURSES ASSOCIATION REPORT: February 2004

Violence in the Workplace: NYSNA Survey Results Examined

by Ann Purchase

Two years of discussions between elected members of the clinical and functional practice units culminated last fall in the creation of a survey to identify incidents of violence in the workplaces of NYSNA members. The qualitative data are currently under review and will be reported in the spring. What follows are highlights from the quantitative results, which were recently shared with the expanded Council on Nursing Practice.

The federal Occupational Safety and Health Administration (OSHA) has developed guidelines aimed at protecting healthcare workers from workplace violence, but since these guidelines are voluntary, many employers have not implemented policies and programs to protect their nursing staff. NYSNA supports state legislation that would require employers to develop and implement programs to prevent workplace violence. This approach would ensure that employers are committed to a zero tolerance policy to protect all employees from violence.

The results detailed in the charts on this page demonstrate the need for such policies.

The results of the 229 surveys received to date show that the majority of the violence takes the form of verbal insults or threats (46.9%), followed by physical assaults without a weapon (20.7%). The incidents are reported as occurring primarily between patients and nurses (34.2%), yet an alarmingly high number of incidents, almost 10%, were incidents occurring between nurses.

The analysis of the qualitative data may shed light on the reasons why nurses are reacting violently toward each other.

The survey results showed that 42.5% of the incidents occurred during the summer months and that most violence occurred during the late night or evening shifts. Lost work time after violent incidents was reported by 26% of the respondents, statistics that, in this time of staffing shortages, employers should heed. A preliminary look at the written comments suggests the need for follow-up care for individuals involved in workplace violence. Stay tuned for more detailed information in Report about nurses' written responses to the survey.

{Ann Purchase is Associate Director of NYSNA's Practice and Governmental Affairs Program.}

Who Answered the Survey?

Member Type Responses % of Total

NYSNA member 164 --- 71.6%

Non-member 26 --- 11.4%

Status unknown 39 --- 17.0%

Total number of surveys received so far: 229 --- 100.0%

Q.: Describe the type of violence you have experienced or witnessed in your workplace. (Check all that apply)

Type of violence Responses % of 443

Verbal insults or threats 208 --- 46.90%

Physical assault without a weapon 92 --- 20.70%

Sexual comments/innuendoes 78 --- 17.60%

Inappropriate touching 44 --- 9.90%

Physical assault with a weapon 18 --- 4.00%

Other 3 --- 0.67%

Total reported incidents 443 --- 100.00%

NOTE: Total responses (443) represent both experienced and/or witnessed incidents of violence.

Q.: Please indicate the setting and location of the workplace violence. (Check all that apply)

Setting Responses % of 221

Hospital/acute care 150 --- 67.8%

Ambulatory care 22 --- 9.9%

School/college health --- 15 6.7%

Long term care 14 --- 6.3%

Office-based practice 8 --- 3.6%

Other 8 --- 3.6%

Home care 4 --- 1.8%

Total number of settings 221 --- 100.00%

Location Responses % of 195

Patient's Room 98 --- 50.2%

Hallway 69 --- 35.3%

Parking Lot/ Garage 15 --- 7.6%

Bathroom 10 --- 5.1%

Cafeteria 3 --- 1.5%

Total responses 195 --- 100.0%

NOTE: Responses indicating PACU, ICU, and ED as settings are included in the "Hospital/acute care" setting.

Q.: Please indicate the parties involved in the workplace violence incidents.

Parties involved Responses % of 514

Patient to nurse 176 --- 34.20%

Patient to patient 68 --- 13.20%

Nurse to nurse 50 --- 9.70%

*Visitor to nurse 50 --- 9.70%

*Physician to nurse 46 --- 8.90%

Visitor to patient 37 --- 7.10%

Nurse to patient 26 --- 5.00%

Patient to visitor 26 --- 5.00%

*UAP to nurse 8 --- 1.50%

*Student to faculty 5 --- 0.97%

Other 22 --- 4.20%

Total parties involved 514 --- 100.00%

*Categories added by survey participants.

NOTE: Respondents could choose more than one category.

Q.: Please indicate the amount of lost work time as a result of the violent episode.

Amount of Lost Work Responses % of 207

*No work absences 153 --- 73.9%

1 absence 16 --- 7.7%

Less than 1 week 16 --- 7.7%

More than 1 week 15 --- 7.2%

Continue to experience residual lost time 7 --- 3.4%

Total responses 207 --- 100.0%

Amount of lost work* Responses % of 54

1 absence 16 --- 29.6%

Less than 1 week 16 --- 29.6%

More than 1 week 15 --- 27.7%

Continue to experience residual lost time 7 --- 12.9%

Total responses 54 --- 100.0%

*For those who reported lost work time.

NOTE: 73.9% of the total 207 respondents did not have work absences. See table above for the 26% (54 out of 207) who reported lost work time.

What was the season and time of day of the workplace violence occurrence and discuss the staffing or numbers of individuals on duty at the time of the occurrence.(include yourself)

Season Responses % of 108

Summer 46 --- 42.5%

Winter 27 --- 25.0%

Fall 20 --- 18.5%

Spring 15 --- 13.8%

Total responses 108 --- 100.0%

Time of Day Responses % of 124

Late night shift 45 --- 36.2%

Evening 22 --- 17.7%

Afternoon 20 --- 16.1%

Midday 19 --- 15.3%

Early Morning 18 --- 14.5%

Total responses 124 --- 100.0%

NOTE: Respondents who chose more than one season were not included in this total.

NOTE: Several participants chose more than one time and were not included in this total.

Q.: Outcome of my experience with the violence episode.

Outcome Responses % of 296

Emotional reactions (anger, sadness) 125 --- 42.2%

Psychological care 49 --- 16.5%

Decreased productivity 37 --- 12.5%

Medical care 31 --- 10.4%

Self-blame 28 --- 9.4%

Increased absenteeism 15 --- 5.0%

Disruption of work environment 3 --- 1.0%

Left facility 2 --- 0.6%

Other 6 --- 2.0%

Total responses 296 --- 100.0%

NOTE: Respondents could choose more than one category.

The qualitative data are currently under review and will be reported in the spring.

:: Publications | :: Departments and Services Home | :: NYSNA Home

http://www.nysna.org/departments/communications/publications/report/2004/feb/survey.htm

Ruby Vee, BSN

17 Articles; 14,030 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

What amazes me is that nurse-to-nurse violence is as prevelent as visitor-to-nurse and MORE prevelent than physician to nurse. That doesn't mesh with my experiences!

mattsmom81

4,516 Posts

its that the facility will not back a nurse when she is abused. They want to cover it up, minimize it, or blame the nurse for it. I've seen too many coworkers treated this way over the years.

Last week I had a doctor yell at me on the phone for waking him up about a critical patient. When I cut him off, telling him he was being innappropriate and abusive, he told me he would have my job. I'm tired of listening to this crap, so I said " Oh yeah? Well, I have an excellent attorney..." . He was speechless for a moment, then gave me the orders I needed. I guess he was disappointed I didn't cry or apologise, nor take his crap.....:(

Cops and lawyers will be my recourse from now on when I've had enough, whether its verbal or physical violence.. I won't waste time with facility politics anymore. They don't care...not about us anyway. We don't bring $$$$ into the facility, we are only their workhorses. Disposable and dispensable. We gotta look out for ourselves and I also look forward to the day nurses will look out for one another. Too many of us won't stand together and this weakens us. :o

I was working in a nursing home where our charge nurse

got mad at a patient who was distracting us from our

charting after all the others had gone to bed.

She went up and started pushing on the chair she was in

and demanding that she go to her room. She got the patient

crying and someone on her wing had to take her to her room.

It took her a while to calm down.

I just want some feedback. If someone on you floor did this

and you were a witness to it what would you do? Would

you write an abuse report?

Yes, this was abuse. Write it up but expect some back-handed actions.

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