violence in the work place

-jt · Aug 23, 2001

2 yrs ago at my hospital in NYC, a man came into our lobby & shot a secrurity guard.

Last yr a guy came in & stabbed another in our lobby. An off-duty police officer who happened to be visiting someone & passing thru the lobby wrestled him to the floor & disarmed him.

Last month, a woman went into the maternity & stabbed a post-partum pt - because she had just given birth to the child of this woman's boyfriend.

Workplace violence is prevalent in our profession. So much so that it is a focus for legislation that would protect us better......

See:

Workplace Violence - http://www.ana.org/dlwa/osh/violence.htm

Occupational Safety - http://www.ana.org/dlwa/osh/

"Violent behaviors toward health care workers by hospitalized medical, surgical, psychiatric and nursing home patients are well-documented. Yet, the problem is considered to be under-reported. Emergency department health care workers and those in psychiatric settings seem to be most at risk. A clearer study of the cause and impact of workplace violence is needed......"

"ANA/NursingWorld.org Launches Workplace Health and Safety Online Survey for Nurses........" http://www.ana.org/pressrel/2001/pr0711b.htm

-jt · Aug 23, 2001

"OSHA conference on Reducing Workplace Violence

Commission on Workplace Advocacy Member Key Speaker at OSHA Conference

8/16/01

Vicki Carroll, RN, MSN will be a keynote speaker at the September 25th-26th OSHA conference Reducing Workplace Violence in Psychiatric Facilities: Cost Effective Strategies That Succeed. The conference is targeted for chief executive officers, senior managers, and risk managers but all Nurses who are interested in the issue of workplace violence are encouraged to attend. The location is in Fort Lauderdale, Florida at the Embassy Suites Hotel. Registration is free, but space is limited. The deadline for registration is September 5th.

The goal of this conference is to find ways that employers and employees can develop and implement strategies to reduce worker exposure to conditions that can lead to injury and death. The conference will use real-life examples to focus on approaches for reducing worker risks and lowering costs, both human and financial.

Karen Worthington, RN, MSN, American Nurses Association Senior Occupational Health and Safety Specialist, participated in the planning of this conference. To learn more about the conference visit the OSHA website:

http:// http://www.osha.gov/as/opa/events/osha-conferences.html.

target · Aug 23, 2001

Originally posted by -jt
"OSHA conference on Reducing Workplace Violence

Commission on Workplace Advocacy Member Key Speaker at OSHA Conference
8/16/01

Vicki Carroll, RN, MSN will be a keynote speaker at the September 25th-26th OSHA conference Reducing Workplace Violence in Psychiatric Facilities: Cost Effective Strategies That Succeed. The conference is targeted for chief executive officers, senior managers, and risk managers but all Nurses who are interested in the issue of workplace violence are encouraged to attend. The location is in Fort Lauderdale, Florida at the Embassy Suites Hotel. Registration is free, but space is limited. The deadline for registration is September 5th.

The goal of this conference is to find ways that employers and employees can develop and implement strategies to reduce worker exposure to conditions that can lead to injury and death. The conference will use real-life examples to focus on approaches for reducing worker risks and lowering costs, both human and financial.

Karen Worthington, RN, MSN, American Nurses Association Senior Occupational Health and Safety Specialist, participated in the planning of this conference. To learn more about the conference visit the OSHA website:

http:// http://www.osha.gov/as/opa/events/osha-conferences.html.

I hope I am doing this right. At any rate, after perusing the materials so generously shared, I feel better. IT is obvious that my facility has read and adheres to same. I was very grateful and actually proud that all hospital members responded quickly, confidently and expertly to the crisis. I spent a lot of time with the FBI and then media. There was a debriefing meeting very soon after the crisis. I was offered couseling by a staff psychologist within a short period of time. I did not feel that I needed that and proceeded to go home and clean my house - very thoroughly. I suppose my effort to tidy things up. At any rate, it worked. The media stuff was too much but I suppose expected. It was amazing to me how angry many of patiens became that I was so closely exposed to this level of violence. I guess we mean more to them than we may appreciate all the time. It is a two way street after all. Thanks.

-jt · Aug 30, 2001

Register Now for Free Injury Prevention Conference

All nurses welcome -

NYSNA and the New York State Department of Labor are co-sponsoring a free Injury Prevention Conference to be held at NYSNA headquarters, 11 Cornell Rd., Latham, NY on Friday, September 28. The focus will be on OSHA compliance in long-term healthcare facilities. Topics will include ergonomics and Workplace Violence Reduction Strategies and the latest OSHA needlestick prevention requirements. The conference is designed for facility administrators, directors of nursing, human resource directors, infection control coordinators, purchasing agents, security personnel, and any manager responsible for reducing work-related injuries. Space is limited, so please register early by calling the Department of Labor at (518) 457-5508, or e-mailing [email protected].

-jt · Aug 31, 2001

Michigan Nurse Attacked on the Job -

Testifies to State Legislature: "Being in an unsafe work environment nearly took my life that night and the life of others.

if adequate staffing had been provided .... this attack could have been prevented..."

Brenda Maynard, RN

ORAL TESTIMONY

For the Subcommittee on Appropriate Supply and Utilization of Michigan's Health Care Workforce of the Standing Committee on HEALTH POLICY

Re: Safe Staffing - Bedside Nurse Shortage

Monday, August 27, 2001

My name is Brenda Maynard. I am the mother of three adult children and the wife of a supportive and devoted husband. I am a Registered nurse and licensed with the State of Michigan. I received my Associate Degree in Nursing in 1990 and completed my Bachelor of Science of Nursing this month.

I have worked for the same hospital the last ten years.

On June 28, 2001 I reported to work for my routine PM tour of duty that starts at 3:30 PM. I was assigned by my head nurse to cover the psychiatric NEST. The NEST is a unit that is set up to care for patients who pose a threat to themselves or to others. The acuity rating of patients in the NEST are number 4, which is the highest rating and classifies the amount of care the patient needs. The NEST was at maximum level, three patients' that evening.

When assigned to the NEST, nursing staff is not to leave the area unless a nurse can cover you for lunch and bathroom breaks. The nurse working down team II is your primary relief.

After receiving report from the daytime nurse I started my nursing duties. The patient in bed one was a right hip replacement with short-term memory loss, with no reported history of violence. Bed two was a dialysis patient, legally blind, a total care patient, and a full code. Bed three was delirious, in restraints, and a total care patient.

The milieu was extremely busy that evening, total patient census was 15. Two RN's were down team two for seven patients and three RN's and a nursing assistant were down team one for eight patients. Early in the evening our nursing coordinator informed our charge nurse that a staff RN on our floor was getting pulled to another floor. Both my charge nurse and the nursing coordinator were aware of the high acuity of the patients in the NEST, yet our

staff was pulled and I was not given any staff to assist me in this high acuity area.

The patient in bed one had his daughter and grandson to visit in the evening, but after they left he became more fidgety and wanting to get out of bed. I was very concerned he would injure his hip replacement and instructed him he could not get up without assistance. While assisting the patient in bed two with a diaper change due to loose stools, I looked over and saw that the patient in bed one was out of bed and stating "I am going to leave the

hospital". I went over to this patient and encouraged him to get back in bed, but he would not get in bed. I had my hands on his arm to support him to keep him from falling, but he jerked away from me, grabbed his duffle bag and started to run down the hall attempting to leave against medical advice.

With the assistance of two maintance workers and myself this patient was brought back to the NEST, placed in bed and a poesy restraint vest was placed to his chest area. All four siderails were up. I notified the orthopedic doctor, the nursing coordinator, and my charge nurse. Both my charge nurse and the nursing coordinator were in the NEST and saw this patient at this time. In fact my charge nurse helped to restrain him. He was medicated to help decrease the anxiety, per another RN, as I secured his hand and arm. He settled down and appeared to be resting. This patient did not speak another word to me until the attack.

Approximately 45 minutes later while hanging an antibiotic intravenously on the patient in bed two I was attacked from behind. I felt hands grasping my neck and soon learned that it was the restrained patient in bed one that was attacking me. I heard no sound of siderails being released and heard no footsteps. I heard no sound at all. He used sexual and racial overtones the entire time of this attack "Woman you will never put me to bed again, you will never put me down again. I'm going to kill you White *****, I'm going to kill you now."

I was finally able to break his neck grasp by flexing my knees using all forces of energy and the weight of my body and jumped as high as I could, while at the same time using the full force of my hands, arms, and elbows to bring them backward while I was jumping upward. I tried to get away from him many times, but each time he would grab my shirt and pull me back trying to get his hands back to my neck and throw me to the floor hitting the table and the wheel chair. I was fighting for my life; I was blocking his punches and watching every move he made for I knew my life depended on it. I was screaming and praying for help, but no one came to assist me. The last time I broke free from him I made it to the door when he grabbed my shirt again and threw me across the room and I hit the wheelchair and table

very hard this time. At this point I was unconscious for a few seconds and was not able to physically get back on my feet. He then picked up a metal air pump used to inflate an air mattresses and was swinging the pump at my head. He had my right hand trying to pull me to my feet and I kept resisting. At this point I knew I was facing death if someone didn't hear me soon; I was terrified. I was crying and praying for help and for my life. The entire time he kept saying he would kill me lying on the floor or standing, but he was going to kill the ***** that had put him to bed.

At this time my charge nurse and a staff RN appeared in the doorway; I will never forget the fear in their eyes. My charge nurse did not speak, but the staff RN said "don't you kill her Mr. ----" He kept saying, "I will kill you too, *****, I'm going to kill you both." The staff RN stepped forward and handed me her hand and pulled me loose from his grasp and threw me across the room out into the hallway and I hit the med cart and the computer

terminal. She told me to get up and start running and I did. We were all running in a single file, me first, the staff RN, and the patient with the metal pump was running after us shouting he was going to kill us. I made it to the first set of elevators, but the doors were not opening fast enough, so I ran to the thoracic intensive care unit (TICU) and pushed the big silver button to make it in the unit. I kept running toward the nurse's station

shouting he's going to kill me when everything got black and I couldn't see. The next thing I remember was being on the floor in TICU being placed into a neck collar and onto a backboard. I was treated in ER and transferred to the University of Michigan for trauma and further evaluation.

This patient tried to get into TICU but was unsuccessful, he continued on down the hall attempting to attack a visitor in the waiting area, and then continued on to break window panels near the elevator.

I believe on the night of my attack if adequate staffing had been provided in the NEST this attack could have been prevented or not escalated to this level. I believe if only one staff person had been available in the hall and heard me screaming the attack could have been minimized. My unit supervisor told me that the two patients across the hall heard my death screams, but were unable to assist me. Both of these patients verbalized feelings of quilt

because they were unable to help me.

Inadequate staff and the use of mandatory overtime that is used in this facility places both the nurse and the patient in unsafe conditions. Just two weeks prior to this attack I was mandated to work a midnight shift after working my scheduled PM shift. I would be responsible for 19 patients with one scheduled LPN and one Nursing Assistant. Being in an unsafe work environment nearly took my life that night and the life of others. I believe other

nurses would be here with me today to give testimony if they were not afraid of reporting unsafe work conditions. I believe violence is not acceptable at any level, and no human being deserves what I went through that night. Thank you for listening."

Submitted by Brenda Maynard, RN

http://www.minurses.org

target · Sep 3, 2001

Dear Brenda,

I am so sorry this has happened to you. What a harrowing experience. I agree, something must be done to safeguard staff and as you mentioned others such as the visitor he was trying to attack. This has gotten awful. I am so glad that you survived and realize how close it was that you did not. How did your hospital react to this occurance??

In my situation, the hospital CEO held a very productive meeting where suggestions were taken from the staff audience about how to avoid this in the future. However, when I suffested that our facility should have a visitor pass system like everyother hospital in the WNY area, he stated he did not want to interfere with "access". "Access" too much of it, is what contributed to the problem. Everyone knows you can just walk in the VA and wander where ever you wish without being quesitoned, watched or anything. This has contributed to robberies in the past and now this violence. I am not sure what it will take ot wake some folks up. I do not want to consider how far the administrators will let things go. Of course, they are safely hidden on the 11th floor - the farthest point fromt he entrances.........

Brenda, are you able to still practice?? What actions did you or your family take on your behalf?? I imagine they were appalled and frightened terribly by what happened to you.

Thanks for sharing.

:)

-jt · Sep 5, 2001

>

Same situation where I work in NYC. For over 4 yrs the nurses have been fighting with the administration over the no-pass "sysytem" to no avail. Its a management right to set its business operations policies but we contend that this policy (or lack of one) interfers with our practice (too many people all over the place) & also is a safety hazard for the reasons you mention. The hospital disagreed & nothing was done - until a visitor walked onto the postpartum unit & stabbed a new mother for having the baby of the woman's boyfriend (personally I would have stabbed the boyfriend). She was caught because the unit is a lock-in unit so no one can get out stealing a baby but the press publicized it as a lock-out unit & made a big deal about how did this person get on a locked unit without a pass anyway. The hospital couldnt answer the questions about why do you have people walking all over theplace & you have no idea who they are or where they are going & you have helpless vulnerable sick people lying like sitting ducks in their beds. Good question. It was all over the news & the hospitals lack of a visitors pass policy made the papers. We are suddenly being notified to remember to wear our IDs because the hospital is insituting a new pass system to "better serve the visitiors". Big surprise.

By the way, the post about Brenda Maynard was a copy of the text of her actual testimony to the Michigan State Legislature on the problems nurses are facing & why we need them to pass state laws to protect us. You can send your comments about her testimony to the Michigan State Nurses Assoc. at http://www.Minurses.org