Violence in the workplace

[Pudnluv, ASN, RN]

Recently, there has been an increased amount of violence against the nurses in my department. Our hospital was recently acquired by a larger hospital in the area and many policies have changed. Since that time, the number of violent episodes has also changed. I do not work in a big city, level 1 trauma center. We are a smaller community type hospital on the edge of a medium sized city, yet we are experiencing more and more violence than the larger hospitals in the area. Back before the acquisition, we had our own trained security team that did all the watches on psych or potentially dangerous individuals. Now we have contracted security that does not do any watches, and instead we have techs, (many are small or older women) sit on the watches. We were told there would be a police presence in the department, but we have yet to see it. The response from management is less than optimal. We are be encouraged to press charges, but find resistance when the police arrive. Meanwhile, staff is dwindling due to injuries. It is a second degree felony to assault a health care worker. I think management needs to take this more seriously. How do you deal with violence in your EDs? How does management react when someone is assaulted? I think we need to put posters in all the rooms that say it is a felony to assault a nurse. I also think it should be listed exactly what would constitute assault, (such as throwing your water at the nurse). People hesitate to talk back to police officers or to throw empty containers at cops because they know they will be arrested. Maybe we should make the public aware that the same thing could happen if they assault a nurse. Just needed to vent and hopefully hear from others about how they handle this situation.

[Sassy5d]

I am not aware of anyone pressing charges on pts in my ER. The violent ones are usually fired up on drugs or alcohol. Occasionally they try to smack us around, but they end up restrained and medicated to keep them safe.

I have yet to see a sober person come in and just start attacking staff, but I'm sure it's coming

[SweetMelissaRN]

I'm sorry about your management not backing you. I had to press charges on a pt who pushed me down, I wasn't going to, but the police officer who tazed him "strongly suggested" it lol. Our officers ALWAYS ask us to press charges if a pt puts their hands on us in anyway... Don't know what to tell you other than go directly to management about your concerns?

[traumaRUs, MSN, APRN]

I was hit in the face by a drunk individual one night, pressed charges, went to court, he got 6 months in jail.

Press charges!

Report to management

Write everything up

[SweetMelissaRN]

I was hit in the face by a drunk individual one night, pressed charges, went to court, he got 6 months in jail.

Press charges!

Report to management

Write everything up

Please tell me you hit them back?? Or that they at least got tackled and/or tazed!

[Pudnluv, ASN, RN]

Everyone has been pressing charges. Pressing charges only happens after the fact. I think something should be done before it gets to the point where someone gets hurt. So far, we have a nurse who took a chop to the larynx and then received several broken ribs, another who received a broken nose and broken wrist and another nurse who had a weapon pulled on her in triage. All these acts were perpertrated by psych pts and one on bath salts. All happened in split seconds upon the pt entering the room. If it were up to me, anyone who presented via ambulance under the influence should be immediately restrained until their cooperation is assured. I also think metal detectors should be in place for all persons who enter the department. Guards should be in place by the detectors and any one setting off the alarm should be searched, prior to entering the department. Pysch patients should be immediately searched, belongings removed and placed on security watch by trained security personnel. It should also be made clear to each and everyone entering the department that assaulting a health care worker is a felony. I know that my views may not be the most popular and some will say why punish everyone for a few bad apples, but policies should be in place that will prevent harm to both workers and patients. trying to judge on a case to case basis is too hard, as things can change in an instant. Unfortunately, this is the world we live in. Policies have to be in place before someone gets hurt. Pressing charges only helps after the fact.

[emtb2rn, BSN, RN, EMT-B]

Psych pt's are met by security, searched and clothing must be removed. We believe in a "show of force" and overwhelming odds. That said, punches still get thrown. We press charges. I will neither confirm or deny that counter jabs and elbow strikes have occurred.

[NO50FRANNY]

If someone is assaulted in our department (a common occurrence), and by this I refer to intentional and unprovoked acts of violence against staff members charged with duty of care, they are encouraged to press charges and the police get involved. Our police officers are always patient and encouraging, albeit realistic. Alcohol / intoxicants are almost always a factor but it's no longer a reason "not to bother" as our laws move toward a "no excuse" policy. A few years ago legislation was passed in my state that raised the penalty for assaulting a care provider (nurse, doctor etc.) to carry the same gravity as assaulting a police officer. We are slowly moving toward a zero tolerance policy but obviously, nurses are reluctant to press charges in cases of acute genuine organic psychosis (rarely do these people assault us anyway). When someone is assaulted in my ER EVERYONE knows. From our paramedics to support / admin staff, everyone knows, gives you a cuddle and commiserates.

Our security guards are amazing, they are always ready to protect us, and are excellent at keeping patients calm. I've often seen our guards talk down psych patients very cleverly. It sounds to me that your workplace security really needs some sort of overhaul (to put it mildly). We have panic buttons and a response time of less than 30 seconds in most cases but we are a large facility. The injuries you speak of are COMPLETELY and off the charts unacceptable. I will say however that the security measures in place in my neck of the woods only came about (several years ago) after a triage nurse was chased and almost stabbed to death in a waiting room (elsewhere) with about 40 patients to witness. Prior to this event, security process across the country were fairly relaxed. We have a guard in the department at all times. Why punish everyone for a few bad apples?. Well, because the bad apples in an emergency department often outweigh the good ones and care providers have a right to not be frightened to earn their living. Sick patients also have a right not to be exposed to this kind of fear either. I don't know how to help out but I totally agree with you. They tried to bring in contract security at our hospital and it was squashed very quickly because nursing and medical staff refused flatly and protested vehemently against it.

[goshennurse]

Nurses are way too busy and needed in the hospitals to have to put up with any of that . it only takes the care and attention away from people who need your expertise today I don't think management cARES OR THEIR HANDS IOR TIED BECAUSE THEY ARE OWNED BY BIG PEOPLE OWNLY WORRYING ABOUT THEIR PROFITSI THINK NURSES SHOULD HAVE UNIONS TO PROTECT US AND KEEP OUR JOBS SAFE PSYCH PTS CAN BE VERY SCARY I CANT IMAGINE WHAT THEY WOULD BE LIKE TO OTHER PEOPLE WHO DONT KNOW HOW TO HANDLE THEM DONT PUT YOURSELF IN DANGER IF SOMETHING HAPPENS TO YOU AND YOU CANT WORK THEY WONT TAKE CARE OF YOU FIND A SAFER PLACE TO WORK GOD BLESS YOU AND STAY SAFE

[SweetMelissaRN]

Tonight there was a psych pt (not my pt), who walked up to one of my coworkers and (with a straight face) asked "hey can I get a knife? That gypsy (pointing to me) stole my lucky charm and I think she's hiding it in her appendix"... Now that I think about it, that's totally terrifying, but at the time I started laughing and informed him that I had my appendix removed so I could not be the holder of his lucky charm! Lol... I can't make this stuff up!

[TopazLover, BSN, RN]

A union would immediately file hostile work environment charges to management. They would support staff not being injured and would show the difference under new management. I suspect you might be in a "right to work" state. As can easily be seen "Right to Work" is a euphemism for "right to be abused".

Document, Document, and more papers! Contact previous workers and ask them to write letters expressing the love of their job while working there and the flip side of that coin of love of quality of life that was endangered to the point where they had to leave. Create a committee to take copies of these letters and your documentation to all involved. If nothing is done call OSHA. Ask for an immediate inspection to include interviewing both workers on and off shift when they do the inspection.

As much as management has the ability to hide the facts some of the time if good documentation is in place they will have to change or be fined. I suspect there may be whistle blower status available if progressive reporting is needed.

[Esme12, ASN, BSN, RN]

Psych pt's are met by security, searched and clothing must be removed. We believe in a "show of force" and overwhelming odds. That said, punches still get thrown. We press charges. I will neither confirm or deny that counter jabs and elbow strikes have occurred.

Unfortunately patients will still throw punches, kick, scream obscenities, spit, bite and throw feces and urine at staff....drugs and alcohol always makes one very brave....But I personally have not seen elbows and counter jabs occur........although physical force is used to restrain patients until they can make better decisions for themselves.