Workforce Readiness | Page 13

Technology may also offer a solution to predicting and preventing violence. New Hampshire Hospital’s “Project Pause” is a smartphone app for predicting patient violence in the behavioral health setting. Patients answer self-assessment questions every two hours, and researchers compare the data with violent incident reports. For example, the app asks, “Since the last time we asked, have you been physically aggressive toward anyone?” Most violence perpetrated by patients is unintentional. Dementia, psychosis, and sudden or unexpected pain can all be reasons a patient might become violent. Danger from belligerent patients includes punching, biting, and hurling objects. Violence toward nurses is certainly not limited to patients. Nurses must also deal with angry family members, the perpetrators of domestic violence against their patients, and even violent criminals. One nurse reports being cornered in a room by a violent man brandishing two knives. “I yelled for the security officer, and he had to call for more help from deputies who were luckily just a few rooms away. One of the deputies tased the man and disarmed him. You need to remain alert, constantly assessing patients and being prepared to de-escalate the situation.” Nurses in emergency departments are disproportionately victims of workplace violence, according to the Emergency Department Violence Surveillance Study, published by the Emergency Nurses Association. The study found that 55.6% of nurses reported they had experienced physical violence, verbal violence or both. Furthermore, the study found that 57.6% of nurses surveyed rated the safety of their ED as a 5 out of 10 or lower (Emergency Nurses Association, 2011). Sadly, the majority of survey participants who were victims of workplace violence did not file a formal report for the physical violence or the verbal abuse they experienced. Writing for Hospitals & Health Networks, Pamela Thompson, RN says, “There is an underlying cultural problem within the healthcare setting regarding workplace violence—workers tend not to report incidents, specifically in the ED. Recent research indicates that many healthcare workers underreport violence because it is inconvenient, and they accept such conditions as part of the job” (Thompson, 2015). How can we protect nurses? A frequent answer is simply safety in numbers through adequate staffing, but thoughtful design of the patient care environment is also a key to prevention. Facilities should provide adequate lighting and visibility, physical barriers and escape routes, and, some sources say, patient care areas with limited furnishings and other items that could become projectiles. Authorities say training should offer both instruction and hands-on experience to be effective. The nursing shortage in this country must be faced head-on, not only by attracting more people to the profession, but by retaining nurses for the long-term. Increasing their one-on- one time with patients, ensuring appropriate breaks within and between shifts, addressing nurse behavioral issues, and protecting nurses from violence at work will be a good start. References: Brown, T. (2010). “When the Nurse Is a Bully,” The New York Times. Retrieved from https://well.blogs.nytimes. com/2010/02/11/when-the-nurse-is-a-bully/ Colduvell, K. (2017). “Nurse Bullying: Stand Up and Speak Out,” Nurse.org. Retrieved from https://nurse.org/ articles/how-to-deal-with-nurse-bullying/ Dressner, M. A. (2017). “Hospital workers: An assessment of occupational injuries and illnesses,” Monthly Labor Review, Bureau of Labor Statistics. https://www.bls.gov/ opub/mlr/2017/article/hospital-workers-an-assessment- of-occupational-injuries-and-illnesses.htm Emergency Nurses Association (2011). Emergency Department Violence Surveillance Study. Retrieved from https://www.ena.org/docs/default-source/resource- library/practice-resources/workplace-violence/2011- emergency-department-violence-surveillance-report. pdf?sfvrsn=5ad81911_4 Esposito, L. (2017). “Nurses Face More Violence from Hospital Patients,” US News. Retrieved from https:// health.usnews.com/wellness/articles/2017-01-18/ nurses-face-more-violence-from-hospital-patients Meissner, J. (1999). “Nurses Are We Still Eating Our Young?” Nursing. Retrieved from http://journals.lww. com/nursing/Citation/1999/02000/Nurses_are_we_ still_eating_our_young__.18.aspx Nolte, A. (2017). “Compassion Fatigue in Nurses: A Metasynthesis,” Journal of Clinical Nursing. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/jocn.13766/full Occupational Health and Safety Administration (OHSA), (2017). Preventing Workplace Violence: A Road Map for Healthcare Facilities 2015. Retrieved from https://www. osha.gov/Publications/OSHA3827.pdf Safety+Health, The Official Magazine of the National Safety Council Congress and Expo. (2017). “Survey of nurses shows fatigue causing many to consider leaving current job.” Retrieved from http://www.safetyandhealthmagazine. com/articles/15838-its-time-to-care-for-the-caregivers- survey-of-nurses-shows Smokler, L. P. and Malecha, A. (2011). “The impact of workplace incivility on the work environment, manager skill, and productivity,” Journal of Nursing Administration. Retrieved from https://www.ncbi.nlm.nih.gov/ pubmed/21799351 Sullivan, K. (2014). “US must produce 1.1 million nurses by 2022 to meet demand,” FierceHealthcare. Retrieved from https://www.fiercehealthcare.com/healthcare/ us-must-produce-1-1-million-nurses-by-2022-to-meet- demand Thompson, P. (2015). “Addressing Violence in the Health Care Workplace,” Hospitals & Health Networks. Retrieved from https://www.hhnmag.com/articles/3365- addressing-violence-in-the-health-care-workplace Woelfle, C. and McCaffrey, R. (2007). “Nurse on Nurse,” Nursing Forum. Retrieved from https://www.ncbi.nlm.nih. gov/pubmed/17661804 13 HealthStream.com/contact • 800.521.0574 • A-40007-0519