what are you doing with violence in ed?

Specialties Emergency


we are seeing an increase in violence in our ed. we are a 450 bed tertiary medical center in maine where this has not been a problem. the administration says that they care, but nothing seems to be getting done. we have had some injuries, 2 requiring surgery. what protocols do you have in place? are there ways to file complaints to have them heard? we have a union, but few are reluctant to file a grievance with them. i want to know how to broach this to make a statement and make the administration know that this will not be tolerated.




401 Posts

Have the staff who were injured filed criminal complaints? Hospitals have gotten away with dealing with such violence INTERNALLY and therefore, pretending it does not happen and not being held accountable for security.

Specializes in ED staff.

I'm the triage nurse, I often have disgruntled patients due to wait time or someone going ahead of them that is sicker. Last week I had a woman waiting to be triaged, but I had a couple of wheezers and a chest pain come in and had to go back before I could even talk to her. Her hubby got in my face and told me that she would be seen next, she was not next on my list and she was NOT seen next. I finally got to triage her and had no room to put her in, so again she had to wait. After she went into the ED, her husband came out, went outside. Security has an office right next to mine, the guy walks by and throws his jacket open just enough to expose a pistol. The security guard was new and wasn't sure how to handle this (duh, call the police!!)he called his supervisor who talked to the man and the man put his gun back in his vehicle. This man should have been arrested, he'd been drinking and had a gun. It's scary. I am not sure what the answers are. As long as the US public believes that the ED means instant service and that we can cure whatever you've already seen 10 doctors for, I'm afraid that this will remain kinda commonplace. :/

ps the terrible illness that this man's wife HAD to be seen next for because she was so sick? she had a UTI!


48 Posts

I also say CALL THE POLICE! We do not tolerate violence against staff. We have had several patients taken away in cuffs. I don't know why the public, or staff for that matter, think that just because the act of violence occurs in a hospital you can't prosecute. If a drunk comes into our ER and is abusive to staff, we clear them medically and then have their butts hauled to jail. Just because we are in the business of taking care of people doesn't mean we have the be abused verbally or physically.

Trauma Columnist

traumaRUs, MSN, APRN

97 Articles; 21,237 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

In Illinois it is a felony if a healthcare worker feels "threatened either physically or verbally." Believe me in our level one trauma center - lots of people go out in handcuffs.


258 Posts

Specializes in Emergency Nursing Advanced Practice.

My administration says you are pretty much on your own if you are assaulted and want to pursue criminal charges. They want nothing to do with it. Pretty much try to make you feel like it is your fault.

Too much touchy-feely psych BS at all levels of admin.

It is not a good night until someone goes away in handcuffs.


32 Posts

In my ER, we don't hesitate to call the police if a patient or visitor becomes abusive, refuses to leave the premises (provided we are not State mandated to care - drunk, overdose, suicidal, medical problem) or hits a health care worker. Nor do we hesitate to make use of 4point leathers, when we are State mandated to provide care. We have a great security team and couple of large male nurses who have been known to not-so-gently take down patients who care to take a swing or a punch at a female nurse. The potential for violence is inherent to ER nursing, especially in high volume urban settings. I wouldn't do what I do unless I was willing to live with a certain amount of risk.


450 Posts

Specializes in Emergency Room/corrections.

we have "panic buttons" a silent alarm direct to the police dept. One in the triage area and two in the back at the nurses desk.

Our administration has told our staff to use them if necessary. About 2 months ago, a patient put his fist through the wall in triage because he (or his family member) had to wait to be seen. Oh well.... the boys in blue took his sorry a** away.

Our security guards are barely traffic control, they do not carry weapons and do not give the impression of being intimidating at all. LOL

harry Krishna

67 Posts

a few years back I was on a travel assignment and I was told that this hospital had poor security. Well I was attempting to d/c a psych eval pt when he jumped me and started to choke me, I struggled against this rather large person and reached the "panic button" a few seconds later I could hear over the ER overhead speakers "will someone turn off the panic button in room 19".....

Got to love it.......


ps; turns out the guy did not want to be d/c'd. I did manage to put the pt. in a "strategic hold" until another RN came to help me out then we called the local P.D. for this jerk's disposition.

allnurses Guide

JBudd, MSN

1 Article; 3,836 Posts

Specializes in Trauma, Teaching.

Our security guys are great, they don't tolerate anything towards the nurses (or docs). No hassle about getting a doctor's order for restraints first either.

In triage, I sit in the "fishbowl", locked door to my left, bulletproof glass in front of me. Yes, you have to pick up the phone to talk to me! and if I call, security will go out the door first if someone runs in wanting help getting a patient out of the car.

And PD's pepper spray has been banned in the ER! Turned out the patient wasn't quite wide enough to catch all of it and my buddy got half of it.:eek: yeah, she looked like that:)


25 Posts

Where in Maine.....???? I have worked and lived in the area for all my life...i guess i am just curoius.

Specializes in Emergency room, med/surg, UR/CSR.

In our ER we have what is called Non-violent Crisis Intervention training. It's a class designed to teach the staff how to get out of a situation before it gets to the point of violence.

I took the whole class, including the instructor's course, so I teach this class. In the full class we learned how to do non-violent restraint techniques that allows the patient to be physically restrained but not harmed.

I don't teach my staff that as I don't feel like it is our job to restrain someone; all I want us to know how to do is to nip the situation in the bud, and if it gets to the point of violence, then I want our staff to know how to get out of the situation and get away from anyone that is attempting to harm them.

If anyone is interested in this training you can get information at:



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