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Science Forum Index » Medicine - Nursing Forum » VIOLENCE AGAINST NURSES: "THE PUBLIC NEEDS TO KNOW...
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| redpoet... |
 Posted: Wed Jul 09, 2008 11:57 am |
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VIOLENCE AGAINST NURSES: "THE PUBLIC NEEDS TO KNOW THIS NOT OK"
Oread Daily http://oreaddaily.blogspot.com/
In the last seven years, Mercy Jaiswal has been physically assaulted
three times. She was beaten with pots filled with hot coffee. She was
kicked so powerfully that her leg was covered with a massive bruise
that would linger for months. Most recently, she was thrown "like a
rag doll," sustaining a fractured arm that required surgery and six
months of recovery time. Mercy Jaiswal is a registered nurse. All of
her injuries, says New York State Nurses Association, occurred when
she was at work in a Long Island healthcare facility, delivering
professional nursing care to the patients that she "loves so dearly."
What are nurses looking for when they head to work each day? A chance
to care for fellow human beings in their time of need, to exercise
state-of-the-art skills, to bring meaning to their own lives and to
earn a paycheck.
What are nurses not looking for? To be elbowed, slapped, punched,
kicked, verbally abused, even shot or raped.
There's no question that nurses face big risks: according to the U.S.
Bureau of Labor Statistics, nurses and other personal care workers
suffer 25 injuries annually resulting in days off from work for every
10,000 full-time workers. That's 12 times the rate of the overall
private sector.
Fifty percent of nurses surveyed by the Massachusetts Nurses
Association (MNA) and the University of Massachusetts said they had
been punched at least once in a two-year period. Some reported being
strangled, sexually assaulted or stuck with contaminated needles.
Nurses understand that they have a tough job, but getting attacked and
abused is not what former Boston area emergency room nurse Ellen
MacInnis says she signed up for.
"It was very frightening," the 18-year veteran told CNN. An angry and
frustrated patient had grabbed MacInnis' hand, dug her nails in and
made a chilling threat. "If you have children, I'll find them and I'll
kill them."
Nurses are often on the receiving end of physical assaults, because
they are typically the first and most frequent medical personnel by
the bedside of ill and sometimes angry or frustrated patients.
A recent study by the Emergency Nurses Association (ENA) showed that
86 percent of all ER nurses who responded to the survey had some form
of violence committed against them while on duty over the past three
years.
"Those are astronomical numbers," said ENA president Donna Mason, who
is in Salt Lake City this week for the group's annual conference.
Mason told the Deseret Times last fall, "The public needs to know this
is not OK. You would never kick a cop or a firefighter for putting out
a fire. Nursing is a very trusted profession. We want to take care of
people."
Those who are committing violence in emergency rooms are not typically
gang members who are brought to the hospital after a violent
confrontation with a rival gang and are looking for payback, Mason
said. Rather, it's citizens who are sometimes intoxicated, and many
times upset with having to sit for hours in the waiting room.
Violence is most frequent in psychiatric wards, emergency rooms,
waiting rooms and geriatric units, according to a National Institute
for Occupational Safety and Health report. However, no nurses are
immune from workplace violence.
“Factors contributing to workplace violence include stress, poor
staffing levels, long working hours, improper training of personnel,
and power and control issues,” writes author John Murray, Colonel,
USAF, NC, RN, PhD, CPNP, CS, FAAN, who is Director of Education,
Training & Research for Joint Task Force National Capital Region
Medical in Bethesda, MD and President of the Federal Nurses
Association. Murray encourages workplaces to create a healthy work
environment by adopting principles from organizations such as the
American Organization of Nurse Executives and the Nursing
Organizations Alliance.
“We must send a clear message that intimidation and abuse will not be
tolerated in the workplace,” says Pamela Cipriano, PhD, RN, FAAN, CNAA-
BC, Editor-in-Chief of American Nurse Today. “And, we have to provide
nurses with the skills they need to respond appropriately.”
The American Hospital Association says executives are very aware of
the problem and are taking steps to address it, including expanding
security staffing, increasing the use of surveillance cameras and
providing training on how to deal with violent situations. However,
nurses say that while some hospitals are supportive, far too many
discourage nurses from discussing these assaults and do little to
prevent them.
And in fact 80% of actual incidents go unreported.
"Nurses need to know that violence against them will be fully
prosecuted," said Tina Gerardi, RN, chief executive officer for the
Nurses Association. "And their potential attackers need to know the
same thing."
"Each year thousands of nurses are attacked in the workplace," said
Assemblyman David Koon (D-Perinton), sponsor of a New York State bill
which would make assaulting a nurse a Class C felony. "Violence should
not be 'just part of the job' for nurses. It is important for the
state to establish that violent or abusive acts against nurses will
have severe consequences, as they do for attacks on police,
firefighters, and emergency service personnel."
New York State Assemblyman Marc Molinaro while discussing the above
proposal said, “As a volunteer fireman and the husband of a nurse, I
understand the importance of protecting those who protect us. With the
growing crisis over nurse shortages, it is all the more important we
send a message that assaulting our nursing professionals will not be
tolerated and that we support the tireless work that nurses dedicate
themselves to.”
The following is from the New York Times (you don't see that very
often).
Nurses Step Up Efforts to Protect Against Attacks
By DAVID TULLER
Karen Coughlin, a psychiatric nurse in Taunton, Mass., remembers the
evening four years ago when her 14-year-old son asked her if any
patients had tried to kill her that day.
“I was astounded, but he was serious because he’d heard about co-
workers going to the hospital for injuries,” Ms. Coughlin said. “I’ve
been hit, I’ve been kicked and spit on. I’ve had a knife pulled on me.
I love what I do and many of the patients I work with, but I don’t
love the conditions I work in.”
Three years ago, an enraged patient — 6 feet 4 inches and 275 pounds —
smacked another patient, bit a health aide, threatened to kill Ms.
Coughlin and lunged forward to strike her. He was restrained before he
reached her.
“I really thought that my life was in danger,” she said. “It was
probably the most terrified I’ve been in my 24 years of nursing.”
In recent years, nurses like Ms. Coughlin have sounded the alarm about
workplace violence, most of it committed by patients. According to the
federal Bureau of Labor Statistics, half of all nonfatal injuries
resulting from workplace assaults occur in health care and social
service settings.
Nurses and other personal care workers bear the brunt of such attacks,
with 25 injuries annually resulting in days off from work for every
10,000 full-time workers — 12 times the rate of the overall private
sector, according to the bureau. The most dangerous settings are
psychiatric units and nursing homes, where patients are often
confused, disoriented or suffering from mental ailments, as well as
emergency rooms, where long waits for care can anger patients, and the
people with them.
The level of violence may well be higher, since the government figures
include only the most serious incidents. A booklet published by the
Occupational Safety and Health Administration in 2004 noted that
violence in health facilities was “likely to be underreported, perhaps
due in part to the persistent perception within the health care
industry that assaults are part of the job.”
Nurses say the persistent nationwide nursing shortage is making
matters worse, because understaffing increases the risk of violent
incidents. And nurses cite the fear of assault as a reason for low
morale, especially if they feel that management does not share their
concern.
“Many nurses who are the victims of violence will actually leave their
position rather than fight the system,” said Evelyn Bain, coordinator
of the health and safety division of the Massachusetts Nurses
Association, a union that represents more than 20,000 nurses.
It is hard to tell whether the problem has grown more serious in
recent years or is simply receiving more attention, because
researchers differ in their study methods and their definitions of
violence. But, either way, advocates for nurses have stepped up
efforts to fight it. They are demanding that employers provide greater
protections and security for staff members, lobbying state
legislatures to increase penalties for assaults on health care workers
and urging nurses to report all incidents rather than shrug them off.
“It’s much more on the radar screen than it ever was, absolutely,”
said Diana Mason, editor in chief of The American Journal of Nursing.
“Nurses are just starting to get to the place where they’re saying, ‘I
don’t have to put up with this.’ ” She added that the problem was
international in scope.
One of the largest studies on the issue was a 2004 survey of 6,300
randomly selected nurses in Minnesota, in which 13 percent of
respondents reported having been physically attacked during the
previous year and 39 percent reported having been threatened, verbally
abused or sexually harassed. Patients committed almost all of the
physical assaults and two-thirds of the verbal ones, with visitors as
well as physicians and other staff members responsible for the rest.
The study appeared in the journal Occupational and Environmental
Medicine.
Its lead author, Susan G. Gerberich, a professor of public health at
the University of Minnesota, said nurses frequently felt pressure not
to report violence incidents. “Nurses find different kinds of
responses from their administrations and different levels of support,”
she said. “Everything from ‘This is not tolerated at our institution’
all the way to ‘If you don’t like it, people, you can leave your job.’
”
In a 2006 survey by the Emergency Nurses Association, a national
group, 86 percent of respondents said they had experienced violence in
the previous three years, and a fifth said they encountered it
frequently.
Emergency room nurses say they also face the potential for violence
from patients’ family members. “If you have families come in and their
loved one has been in a traumatic accident, and their anxiety levels
are so high, it can overwhelm their coping skills,” said Nancy Hughes,
the director for occupational and environmental health at the American
Nurses Association, another professional organization.
Ms. Hughes recalled an emergency room incident in which she escorted a
woman who was high on drugs to the bathroom. Although the two women
had a security escort, the patient managed to punch her so hard in the
chest that she needed surgery.
“It was quite a traumatic event, but I didn’t get much support where I
worked,” she said. “The doctor I was working with said don’t be a
wimp, sort of take your lumps and don’t worry about it.”
Richard Wade, a spokesman for the American Hospital Association, said
health care facilities should not necessarily be blamed for patient
violence. “These things don’t happen because of breaches of security,”
he said, “but because something happens that you can’t predict, and
nurses are on the front lines.”
But Mr. Wade added that hospitals were very much aware of the issue
and were addressing safety concerns in a variety of ways, among them
increasing camera surveillance, expanding the security staff and
training employees to deal with potentially violent situations.
“You want to have good security, but you don’t want it to feel like
going through an airport screening or like a place in lockdown,” he
said. “Hospitals are by their very nature supposed to be open, caring
places where patients and families feel safe and don’t feel
imprisoned.”
Tammy Peterman, the chief operating officer at University of Kansas
Hospital in Kansas City, said it had stepped up its security efforts
in recent years. It now keeps certain units locked at all times,
funnels late-night visitors through a single entrance with a metal
detector and mandates violence prevention training for all staff
members.
The state Highway Patrol maintains a round-the-clock post at the
hospital, and officers make rounds to enhance their visibility and
reduce the risk of violence, Ms. Peterman said, adding, “When you’re
driving down the interstate and you see the police, you don’t speed.”
Nursing organizations and unions have been the most active in drawing
public attention to the issue. The Massachusetts Nurses Association,
for example, has conducted member surveys on violence and lobbied for
legislation to increase penalties against perpetrators and require
employers to improve worker protections. (Ms. Coughlin, the Boston-
area nurse, testified before the State Legislature on violence against
nurses.)
The organization has dubbed Brockton Hospital, in the suburbs south of
Boston, the “poster child” for workplace violence. Last year, in
response to complaints, OSHA investigated the hospital and found,
according to its report, that “the types of physical assaults include,
but are not limited to, punching, kicking, biting, scratching and
pulling hair.”
The agency recommended that the hospital analyze the workplace
hazards, solicit extensive comments from employees, and develop a
comprehensive violence-protection plan. The nurses’ association says
the hospital has done little to carry out the recommendations, which
are voluntary.
Rob Brogna, a spokesman for Signature Healthcare, which owns the
hospital, said that even before the investigation, the company had an
“ongoing initiative” for workplace safety. “Many of the suggestions
raised by OSHA had already been put in place at the hospital before
they even came out,” he said, declining to comment further about the
union’s complaints.
Other states are also looking at legislative fixes. Last year New
Jersey and Oregon passed legislation that requires health care
facilities to assess the dangers of workplace assault and develop
programs to address it. Liz Jacobs, a spokeswoman for the California
Nurses Association, said improved nurse-to-patient ratios mandated by
the State Legislature had helped reduce violence.
“Staffing levels really affect what happens in terms of safety on the
unit,” said Barbara Williams, a psychiatric and emergency room nurse
who retired last year from Dominican Hospital in Santa Cruz, Calif.
“If people’s needs don’t get met in a timely manner, that level of
frustration builds. When people become angry, the nurses become the
focus of the anger when they really had nothing to do with it.” |
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| Andrew Heenan... |
| Posted: Wed Jul 09, 2008 5:42 pm |
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"redpoet" <redpoet at (no spam) sbcglobal.net> wrote ...
Quote: And in fact 80% of actual incidents go unreported.
Maybe that's why the public does not already know?
Don't whinge - prosecute.
Granted, some may not stick due to mental illness or the circumstances.
That still leaves 70%+ that should have been reported.
--
Andrew
http://www.realnurse.net/ |
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| ironjustice... |
| Posted: Thu Jul 10, 2008 4:17 am |
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On Jul 9, 3:42 pm, "Andrew Heenan" <f... at (no spam) will.com> wrote: attacked at
work <<
Nurses can scream out .. "help" ..
In a situation of a couple of guys attempting to reset your clock in a
secluded space where no amount of .. screaming .. is gonna help ..
a .. tall .. 'assisted living' takes on a whole .. new .. meaning.
'Heroic efforts' endorsed:
Knee to the nads ..
Thumbnail to the eye ..
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/4rq595
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk
Quote: "redpoet" <redp... at (no spam) sbcglobal.net> wrote ...
And in fact 80% of actual incidents go unreported.
Maybe that's why the public does not already know?
Don't whinge - prosecute.
Granted, some may not stick due to mental illness or the circumstances.
That still leaves 70%+ that should have been reported.
--
Andrewhttp://www.realnurse.net/ |
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| cat... |
| Posted: Thu Jul 10, 2008 10:06 am |
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Guest
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"Andrew Heenan" <fire at (no spam) will.com> wrote in message
Quote: "redpoet" <redpoet at (no spam) sbcglobal.net> wrote ...
And in fact 80% of actual incidents go unreported.
Maybe that's why the public does not already know?
Don't whinge - prosecute.
Granted, some may not stick due to mental illness or the circumstances.
That still leaves 70%+ that should have been reported.
We had three assaults in one shift in our ICU not long ago. Two were
attributable to acute delirium, but the other one was just an asshole. We
had to push the poor nurse (who was blaming herself) to press charges, just
to validate that it was not her fault. The asshole and his SO never
apologized and never took responsibility, and continued to blame the nurse.
I think if he had just said he was sorry, she would have let it go.
Suddenly, the media cares?
July 8, 2008
NY Times
Nurses Step Up Efforts to Protect Against Workplace Assaults
Karen Coughlin, a psychiatric nurse in Taunton, Mass., remembers the evening
four years ago when her 14-year-old son asked her if any patients had tried
to kill her that day.
"I was astounded, but he was serious because he'd heard about co-workers
going to the hospital for injuries," Ms. Coughlin said. "I've been hit, I've
been kicked and spit on. I've had a knife pulled on me. I love what I do and
many of the patients I work with, but I don't love the conditions I work
in."
Three years ago, an enraged patient - 6 feet 4 inches and 275 pounds -
smacked another patient, bit a health aide, threatened to kill Ms. Coughlin
and lunged forward to strike her. He was restrained before he reached her.
"I really thought that my life was in danger," she said. "It was probably
the most terrified I've been in my 24 years of nursing."
In recent years, nurses like Ms. Coughlin have sounded the alarm about
workplace violence, most of it committed by patients. According to the
federal Bureau of Labor Statistics, half of all nonfatal injuries resulting
from workplace assaults occur in health care and social service settings.
Nurses and other personal care workers bear the brunt of such attacks, with
25 injuries annually resulting in days off from work for every 10,000
full-time workers - 12 times the rate of the overall private sector,
according to the bureau. The most dangerous settings are psychiatric units
and nursing homes, where patients are often confused, disoriented or
suffering from mental ailments, as well as emergency rooms, where long waits
for care can anger patients, and the people with them.
The level of violence may well be higher, since the government figures
include only the most serious incidents. A booklet published by OSHA in 2004
noted that violence in health facilities was "likely to be underreported,
perhaps due in part to the persistent perception within the health care
industry that assaults are part of the job."
Nurses say the persistent nationwide nursing shortage is making matters
worse, because understaffing increases the risk of violent incidents. And
nurses cite the fear of assault as a reason for low morale, especially if
they feel that management does not share their concern.
"Many nurses who are the victims of violence will actually leave their
position rather than fight the system," said Evelyn Bain, coordinator of the
health and safety division of the Massachusetts Nurses Association, a union
that represents more than 20,000 nurses.
It is hard to tell whether the problem has grown more serious in recent
years or is simply receiving more attention, because researchers differ in
their study methods and their definitions of violence. But, either way,
advocates for nurses have stepped up efforts to fight it. They are demanding
that employers provide greater protections and security for staff members,
lobbying state legislatures to increase penalties for assaults on health
care workers and urging nurses to report all incidents rather than shrug
them off.
"It's much more on the radar screen than it ever was, absolutely," said
Diana Mason, editor in chief of The American Journal of Nursing. "Nurses are
just starting to get to the place where they're saying, 'I don't have to put
up with this.' " She added that the problem was international in scope.
One of the largest studies on the issue was a 2004 survey of 6,300 randomly
selected nurses in Minnesota, in which 13 percent of respondents reported
having been physically attacked during the previous year and 39 percent
reported having been threatened, verbally abused or sexually harassed.
Patients committed almost all of the physical assaults and two-thirds of the
verbal ones, with visitors as well as physicians and other staff members
responsible for the rest. The study appeared in the journal Occupational and
Environmental Medicine.
Its lead author, Susan G. Gerberich, a professor of public health at the
University of Minnesota, said nurses frequently felt pressure not to report
violence incidents. "Nurses find different kinds of responses from their
administrations and different levels of support," she said. "Everything from
'This is not tolerated at our institution' all the way to 'If you don't like
it, people, you can leave your job.' "
In a 2006 survey by the Emergency Nurses Association, a national group, 86
percent of respondents said they had experienced violence in the previous
three years, and a fifth said they encountered it frequently.
Emergency room nurses say they also face the potential for violence from
patients' family members. "If you have families come in and their loved one
has been in a traumatic accident, and their anxiety levels are so high, it
can overwhelm their coping skills," said Nancy Hughes, the director for
occupational and environmental health at the American Nurses Association,
another professional organization.
Ms. Hughes recalled an emergency room incident in which she escorted a woman
who was high on drugs to the bathroom. Although the two women had a security
escort, the patient managed to punch her so hard in the chest that she
needed surgery.
"It was quite a traumatic event, but I didn't get much support where I
worked," she said. "The doctor I was working with said don't be a wimp, sort
of take your lumps and don't worry about it."
Richard Wade, a spokesman for the American Hospital Association, said health
care facilities should not necessarily be blamed for patient violence.
"These things don't happen because of breaches of security," he said, "but
because something happens that you can't predict, and nurses are on the
front lines."
But Mr. Wade added that hospitals were very much aware of the issue and were
addressing safety concerns in a variety of ways, among them increasing
camera surveillance, expanding the security staff and training employees to
deal with potentially violent situations.
"You want to have good security, but you don't want it to feel like going
through an airport screening or like a place in lockdown," he said.
"Hospitals are by their very nature supposed to be open, caring places where
patients and families feel safe and don't feel imprisoned."
Tammy Peterman, the chief operating officer at University of Kansas Hospital
in Kansas City, said it had stepped up its security efforts in recent years.
It now keeps certain units locked at all times, funnels late-night visitors
through a single entrance with a metal detector and mandates violence
prevention training for all staff members.
The state Highway Patrol maintains a round-the-clock post at the hospital,
and officers make rounds to enhance their visibility and reduce the risk of
violence, Ms. Peterman said, adding, "When you're driving down the
interstate and you see the police, you don't speed."
Nursing organizations and unions have been the most active in drawing public
attention to the issue. The Massachusetts Nurses Association, for example,
has conducted member surveys on violence and lobbied for legislation to
increase penalties against perpetrators and require employers to improve
worker protections. (Ms. Coughlin, the Boston-area nurse, testified before
the State Legislature on violence against nurses.)
The organization has dubbed Brockton Hospital, in the suburbs south of
Boston, the "poster child" for workplace violence. Last year, in response to
complaints, OSHA investigated the hospital and found, according to its
report, that "the types of physical assaults include, but are not limited
to, punching, kicking, biting, scratching and pulling hair."
The agency recommended that the hospital analyze the workplace hazards,
solicit extensive comments from employees, and develop a comprehensive
violence-protection plan. The nurses' association says the hospital has done
little to carry out the recommendations, which are voluntary.
Rob Brogna, a spokesman for Signature Healthcare, which owns the hospital,
said that even before the investigation, the company had an "ongoing
initiative" for workplace safety. "Many of the suggestions raised by OSHA
had already been put in place at the hospital before they even came out," he
said, declining to comment further about the union's complaints.
Other states are also looking at legislative fixes. Last year New Jersey and
Oregon passed legislation that requires health care facilities to assess the
dangers of workplace assault and develop programs to address it. Liz Jacobs,
a spokeswoman for the California Nurses Association, said improved
nurse-to-patient ratios mandated by the State Legislature had helped reduce
violence.
"Staffing levels really affect what happens in terms of safety on the unit,"
said Barbara Williams, a psychiatric and emergency room nurse who retired
last year from Dominican Hospital in Santa Cruz, Calif. "If people's needs
don't get met in a timely manner, that level of frustration builds. When
people become angry, the nurses become the focus of the anger when they
really had nothing to do with it." |
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| Kurt Ullman... |
| Posted: Thu Jul 10, 2008 10:39 am |
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Guest
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In article <bzpdk.20094$%q.4917 at (no spam) newsfe24.lga>,
"cat" <catsandcanaries at (no spam) nospammeowmeow.com> wrote:
Quote: Suddenly, the media cares?
I did an article for the Late and Lamented Trends in Nursing at
helix.com in 1998. Better late than never, I guess.
Kurt (one concussion, one separated shoulder, two broken ribs, numerous
sprains and strains, and too many human bites to count) Ullman |
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| cat... |
| Posted: Thu Jul 10, 2008 1:43 pm |
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"Kurt Ullman" <kurtullman at (no spam) yahoo.com> wrote in message
Quote: "cat" <catsandcanaries at (no spam) nospammeowmeow.com> wrote:
Suddenly, the media cares?
I did an article for the Late and Lamented Trends in Nursing at
helix.com in 1998. Better late than never, I guess.
I'm sorry...I meant the media that people have heard of. <g/d/r>
Quote: Kurt (one concussion, one separated shoulder, two broken ribs, numerous
sprains and strains, and too many human bites to count) Ullman
Ouch. Remind me never to work in psych. As if I needed reminding.
Nurses have been punching bags too long. My first hit was as a new grad on
a med/surg floor. The patient ripped out his central line and hit me
because he wanted a 1:1 nurse/patient ratio. I would say that
administration didn't care, but that would be giving them too much credit.
The most recent hit was the three in one shift incident I mentioned. This
poor woman became progressively more agitated and violent due to an acute
medical decline, and even in 4-points, managed to take out two of us at the
same time, one with each leg. We got bills from the emergency room. Those
should never have left the billing office. |
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| Kurt Ullman... |
| Posted: Thu Jul 10, 2008 2:58 pm |
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Guest
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In article <0Lsdk.17619$3q7.5754 at (no spam) newsfe15.lga>,
"cat" <catsandcanaries at (no spam) nospammeowmeow.com> wrote:
Quote:
The most recent hit was the three in one shift incident I mentioned. This
poor woman became progressively more agitated and violent due to an acute
medical decline, and even in 4-points, managed to take out two of us at the
same time, one with each leg. We got bills from the emergency room. Those
should never have left the billing office.
That isn't all that unusual, at least in my rather wide ranging
experience (g). You are assuming competence that is not exhibited in
other aspects of their job, so why should this be any different. I have
never, however, got a second bill. |
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