violence in the work place

hanna-beacon · Mar 22, 2007

We did a 'violence in the workplace' training session during orientation, went on a bit about personal space and making sure that you are in a public area of the ward should you encounter an aggressive patient/relative etc...

I personally feel quite safe in the workplace, we generally have good staffing on the ward and security are very good at night. Doors are locked and it is only swipe card access. The main entrance in manned all night should anyone need to get in.

I've had confused aggressive male patients draw fists at me, but never been physically attacked. Verbal abuse is part of everyday nursing!

Would I press charges? That would depend on who had attacked me. A confused patient then I wouldn't, no. I would just ensure measures were taken to ensure it didn't happen to any of my colleagues.

Someone who would know full well what they were at I would press charges in a heartbeat. 'Nurse' is not another name for 'I'm a Mug'!

gonzo1, ASN, RN · Mar 22, 2007

I do feel safe in our ER. I am very impressed with our security. Our unit is supportive of pressing charges. I am lucky

bill4745, RN · Mar 22, 2007

WE (ER) have good, close-by security (they are in our waiting room), panic buttons for both security and our local police, who respond quickly. We have docs who are quick to order restraints and sedation, and a hospital that doesn't argue with us about pressing charges when appropriate. We have had very few incidents.

shearernurse · Mar 22, 2007

Yes, I have been hit and punched many times. We just got security a couple of weeks ago for our rural hospital. Our management have not been very supportive of pressing charges.

About 13 years ago, I had a lady come to the emergency room via ambulance from the dentist's office with anxiety.I quickly assessed her. This was in the D.C area, a very busy ER, so she was seen quickly and then discharged. I was standing against a counter and I heard running footsteps and next thing you know I get whacked over the head with the wooden handle of an umbrella. Luckily my co-worker's stopped her. I did press charges and she was charged with assault and got community service.

emmycRN · Mar 22, 2007

The only time I do not feel safe is when the police deliver out of control psych patients to our ICU and expect us to deal with them. Several times officers have stayed with violent patients, but only until their shift ends, and then they're gone wether or not another officer is there to replace them. I do not know what makes them think that we can handle them if they can't. They have badges and guns for goodness sake! I don't know of any policies that are in place at my facility to protect the nurse but there is a policy to protect the patient which says that all psych patients have to be 1 on 1.

CRNI-ICU20 · Mar 22, 2007

Incidence rates for nonfatal assaults and violent acts by industry, 2000

Incidence rate per 10,000 full-time workers Private Sector OverallHealth Services OverallSocial ServicesNursing & Personal Care Facilities Source: U.S. Department of Labor, Bureau of Labor Statistics. (2001). Survey of Occupational Injuries and Illnesses, 2000.

The above graph, which is seven years old, tells you something...doesn't it?

And this is only the REPORTED incidents that are included in the graph....

Many hospitals, from my research, refuse to document incidents...as to some nursing homes...they are concerned about their IMAGE....that the population at large will believe that they are not a safe place to be cared for when illness or surgery is required.

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The Department of Justice's (DOJ) National Crime Victimization Survey for 1993 to 1999 lists average annual rates of non-fatal violent crime by occupation. The average annual rate for non-fatal violent crime for all occupations is 12.6 per 1,000 workers. The average annual rate for physicians is 16.2; for nurses, 21.9; for mental health professionals, 68.2; and for mental health custodial workers, 69. (Note: These data do not compare directly to the BLS figures because DOJ presents violent incidents per 1,000 workers and BLS displays injuries involving days away from work per 10,000 workers. Both sources, however, reveal the same high risk for health care and soical service workers.)

The above is taken from the OSHA website:http://www.osha.gov/Publications/OSHA3148/osha3148.html

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It's quite sobering to realize that as nurses we are over double the national average for being a victim of violence....

and while some hospitals offer violence in the workplace seminars, or have a few more security guards on staff, the vast majority are underreporting or not reporting at all the DAILY incidents that occur with nurses, therapists, doctors, and ancillary staff by patients, outsiders, or fellow co-workers.

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A well known hospital in LA recently put in metal detectors in their main entry way. Their study showed that over 75% of the women visitors and 60% of the men visitors were carrying some sort of contrabanded weaponry!

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If ever there was a need to address the REAL issues of nurses and doctors at the bedside, it is now.

It seems that many of the national organizations are focused on minutia, while there are tangible issues that go unaddressed.

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Emmy mentioned that occassionally an out of control psyche patient delivered by a policeman is left in the nurses' hands while they go about their duties elsewhere....

Why isn't the hospital protecting these nurses?

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Rural and small hospitals are often the worst, which is counter to what many people would think....it is falsely believed that inner city hosp. would be the mecca for violence...but rural hosp. rarely have a security guard, or if they do, only on one shift....and management of those rural hosp. are anxious to support nurses, because they worry about the bottom line....it's a small community, where everybody "knows your name."

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JUST SO YOU KNOW:

UNDER OSHA GUIDLINES AND FEDERAL LAW, IT IS THE EMPLOYER'S RESPONSIBILITY TO KEEP THEIR WORKERS SAFE WHILE AT WORK....

If, say, a nurse is fatally injured from violence in the workplace, and the employer failed to maintain a safe environment that is reasonable, they can be named as co-respondents in a wrongful death lawsuit.

It is my opinion, that much of the head in the sand attitude about this is because once this issue is addressed with accompanying policies in place, it requires documentation of the subsequent incidents and what was done about it....ie a paper trail....if there is nothing done, and all is ignored, it leaves less evidenciary tools to work with, when something does happen.

(notice, I said WHEN)

Please, all of you, be very aware of your surroundings, and always place yourself in a position that does not block your exit from a potentially violent situation...walk in pairs...(whether you are male or female..it doesn't matter) when going to parking areas...or down stair wells...

Don't wear your stethoscope around your neck....and be careful of lanyards that do not break away....

The stats show that violence is climbing....

If our administrations refuse to address this, then we have to do it ourselves, as best we can.

Be safe.

Gromit · Mar 22, 2007

I do feel safe in our ER. I am very impressed with our security. Our unit is supportive of pressing charges. I am lucky

Same here. Our security not only roams the hospital, but are always close at hand -they also have a force that is sufficiently large enough to deal with the facility, and is staffed with VERY capable individuals.

Elvish, BSN, DNP, RN, NP · Mar 22, 2007

I feel safe in our hospital, knock on wood. Our units are locked and people have to sign in with the security officer sitting right in their way. We have closed circuit cameras in all public/common areas that are monitored by security 24/7. Security makes rounds and we call them if there is even a potential situation. They are very good about defusing situations before they turn violent, which is key. So yeah, I feel good about where I am.

CHATSDALE · Mar 22, 2007

i worked at a mental health ltc at my last job and got punched several times..no serious injuries to me but i have known of co-workers who got bit by hiv+and hep a/b/c pts it was considered a hazardous duty place

these patients who 'didn't know what they were doing' never hit a large orderly but a short older guy was hit on several occasions, women were fair game

CRNI-ICU20 · Mar 22, 2007

Chatsdale,

What was the facilities' response or action taken for those who were injured by an out of control patient?

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Are all the units that you work in ,(those of you who mention units) a 'swipe in ' type of unit, or are you completely open to the public?

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New2ER · Mar 23, 2007

Speaking of out of control psych patients, I work in a psych ER in Florida. The hospital I work at does not seem to put much stock in the safety of the staff and staffs our section of the ER with 3 people during the day (sometimes) and 2 at night (the nurse and one tech). I have an ongoing arguement with the main ER about overflowing our area with patients. We have 4 rooms in a corridor that is about 50 feet long. They have allowed up to 12 psych patients in this area. The ER doctors are sometimes slow to allow for medication although nurses do have the authority to place patients in restriants then call for orders, but 2 against 1 (especially with a psychotic male patient) is not always the best odds.

I worked in critical care/ER for a year before moving into psych. I really enjoy my job but I want to get out of South Florida as it seems that staff safety is not a major concern for hospitals down here.