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Introducing #SilentNoMore

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What happened the first time you witnessed or experienced an assault in the workplace?

Introducing #SilentNoMore

Warning: graphic content contained in the beginning of this article. To avoid it but still read the main part of the article, scroll to below the quote box.

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Jessica went to work, like any other day. It was Thanksgiving of 2016. She worked as a psych tech in triage at a walk-in clinic connected to both inpatient and outpatient services. It was a special time for her family. She just found out two days prior that her 6-year old was about to have a baby brother. She was nineteen weeks pregnant. 

No other techs were scheduled to work with her that day, probably due to it being a holiday. Jessica received only one patient in the morning: a male who had been previously assessed and sent home the day before. His discharge had included instructions to come back if anything got worse. He decided to come back, and he brought his father. They waited for paperwork to be completed and for him to be admitted inpatient. During this wait, the crisis worker assigned to the patient stepped out of the office to get something to drink, leaving Jessica alone. 

This is when the patient began to stab Jessica 105 times. 

When he began the attack, Jessica attempted to reach a phone to call for help. He grabbed her and threw her to the ground instead. At one point, he stepped back to look her over, as if in surprise - how had she not died yet? Jessica was taken over by a mothers' instinct and her military training, which told her to curl into the fetal position. She knew to protect her baby and her vital organs. Jessica screamed for someone to call 911. The patient's father called, and the stabbing continued.

Police arrived, and they ordered the patient to drop the knife. The patient resisted all commands. When it became apparent he was not going to stop for anything, they shot him. His lifeless body fell to the floor next to Jessica. The assault ended.

EMS transported Jessica to the ED, where she was stabilized and transferred to a trauma center's ICU for eight days. She then spent two weeks closer to home for rehab. Her injuries were extensive. In addition to scars that cover her back, neck, head, and face, she is blind in her right eye. Her spinal cord had been severed, leaving her with inability to feel one side of her body and inability to feel temperature on the other. Other motor and sensory deficits remain.
When she describes the injuries that still affect her, she says they are too numerous to list. Her physical and mental health have prevented returning to work. She remains in intense physical therapy. She hopes to see things get easier, but understands the injuries that still remain are permanent.
One incredible miracle, besides Jessica herself, is her son. He was born full-term, months after the attack, and turned two last month. She has relished in this time they have had together. Of course, that isn't always easy. The road to recovery has been long and arduous. There is still far more to come.

 

{End of graphic content.}

You’ve probably noticed that violence happens a lot where we work. Healthcare, in general, has the highest incidence of non-fatal workplace violence out of any other industry (almost combined), including law enforcement. In Jessica’s case, psychiatric technicians and aids are at a higher risk of violence than any other role. Data gathered by BLS paints a grim picture of what we face when we go to work: it is dangerous there. In state-run hospitals, assault is the number one cause of injury requiring time away from work. In private and local hospitals, assault is the third leading cause of injury leading to time away from work. 

Let’s bring this back home, though. The statistics are staggering. The evidence is there. We know this; we’ve experienced this.

Let’s talk about what is right in front of us now. Let’s talk about YOU.

Have you experienced violence while working in healthcare? What happened the first time you were assaulted at work or witnessed violence? Was it the patient who assaulted you? Were you injured? Did you contact the police? 

How well were you treated by your employer after? Did you receive workers compensation? Did you take time off? 

More importantly, how are you? Have you healed? Not just physically, but psychologically — are you better now? 

I am Angela, and I am the National Director of Silent No More Foundation. We are working on elevating this conversation in meaningful ways. We hope that by being #SilentNoMore, we can build a movement that ensures violence is actively prevented, the severity of assaults are reduced, and the victims receive adequate support and protection from employers after. This is our first of hopefully many posts and articles to come. We’re looking forward to getting to know you all! 

Silent No More Foundation is on a mission to protect healthcare workers before, during, and after an assault in the workplace through education, awareness, and legislation.

1 Article; 652 Visitors; 3 Posts

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River&MountainRN has 4 years experience as a RN.

1,987 Visitors; 206 Posts

I forget my very first time, but the message has consistently been the same from my coworkers AND superiors: "It happens, you knew what you were getting into when you chose nursing [especially in my first couple of years after licensure], suck it up, and get over it". Something needs to change drastically, but if you try to speak up then you're labeled a "problem".

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adventure_rn is a BSN and specializes in NICU, PICU.

1 Article; 16,346 Visitors; 997 Posts

That story is horrifying. Working primarily in NICU and peds, I feel fortunate that I've had minimal exposure to workplace violence.

I do wonder: as nurses, is it ever really possible to avoid the risk of violence? I understand that leadership and admin could do a lot more to back up nurses against patients who chronically assault staff. The situation described above could have been ameliorated (although perhaps not entirely prevented) with improved security and more staff. However...

It seems as though there will always be a certain subset of patients who are violent (especially within the dementia and psychiatric crisis populations). No matter how supportive admin is, those patients will still exist, and they'll still require hands-on, up-close-and-personal care. It's like being a lion-tamer and asking how you can protect yourself with absolute certainty against a lion attack.

I think of my own grandfather who had Alzheimer's. He was an incredibly kind, thoughtful, decent guy throughout most his life. Unfortunately, through his disease progression, his mind deteriorated while his body remained surprisingly limber and strong. We had to move him to a SNF once he started wandering out of the house. Every day he needed to be bathed, and every day, he'd yell and kick and swat at the staff. Like I said, he remained surprisingly strong; I'm sure his actions put people's personal safety at risk. As sad as it makes me feel, he probably injured some of his nurses and CNAs. And if he were of sound mind, I'm sure he'd be horrified by his actions.

Unfortunately, I'd imagine that there are tons of patients and nurses in our country who face that exact same predicament. In cases like my grandfather's (as well as other dementia and certain psychiatric patients), is it even possible to provide quality care while keeping staff safe? In practice, what does that look like?

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68 Visitors; 1 Post

This is so sad that we as RNs passionately to help others have to go true nightmares...

I worked 9 months in a hospital and decided to quit not because of the patients but because of coworker's and management; they were extremely unprofessional, bullies and rude; i had a ex coworker who one morning decided to start pulling and pushing the reclining chair that the patient was going to use for the treatment just because i said that the patient port was in the opposite side of the chair; let me tell you it was 6am and the patient's parents were scared because not only that ex coworker was pushing and pulling, loud words were coming out of the mouth. I reported it and they didn't do absolutely nothing. I got stuck in a harassment scenario were i reported as well and nothing was done. I decided to quit.

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