Health care workers must routinely handle patients who are delirious, agitated and even aggressive, especially on psychiatric units, in EDs and nursing homes.
Sometimes when these conditions escalate they become full scale assault – and nurses are often the victims.
The September 2006 issue of the Journal of Advanced Nursing reported that in 2002, almost 64% of 2400 Tasmanian nurses said they had suffered either verbal or physical abuse during the four weeks prior to the survey.
Psychiatric and emergency settings show the highest levels of abuse. Patients perpetrated the vast majority of instances of physical (97%) and verbal (74%) abuse; other sources were visitors and colleagues. The studies show that of those physically assaulted on the job, 38% talked with a colleague afterward and only 19% filed a formal report.
There are numerous reports in the media of nurses being injured, or worse, by patients.
Just last week the death of a Filipina nurse working in a California jail raised concerns over the “disturbing trend of violence” faced by medical care professionals in potentially violent workplaces.
On October 28, registered nurse Cynthia Palomata, 55, succumbed to the head injuries she sustained when she was attacked by an inmate at the Martinez county jail, where she had been working since 2005. The prisoner faked a seizure attack to get out of the waiting room, then, without provocation, hit Palomata on the head with a table lamp.
Surely there must be some warning signs – so what are the indicators of workplace violence?
The USDA Handbook on Workplace Violence Prevention and Response outlines the following as potential signals for general workplace violence prevention (not specifically hospitals)
- Intimidating, harassing, bullying, belligerent or other inappropriate and aggressive behavior.
- Numerous conflicts with customers, co-workers or supervisors.
- Bringing a weapon to the workplace (unless necessary for the job), making inappropriate references to guns or making idle threats about using a weapon to harm someone.
- Statements showing fascination with incidents of workplace violence, statements indicating approval of the use of violence to resolve a problem or statements indicating identification with perpetrators of workplace homicides.
- Statements indicating desperation (over family, financial and other personal problems) to the point of contemplating suicide.
- Direct or veiled threats of harm.
- Substance abuse.
- Extreme changes in normal behaviors.
Have you experienced violence in the workplace? How do you deal with it?
What indicators are there from patients who may be a threat?
Image credit: European Parliment
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