Ensuring Nurses’ Safety in the Workplace

Violence in the workplace is one of the most complicated and dangerous occupational risks facing nurses working in today’s health care environment. The U.S. Occupational Safety and Health Administration (OSHA) and the U.S. Centers for Disease Control National Institute for Occupational Safety and (CDC/NIOSH) define workplace violence as behaviors including physical force and threats of assault directed toward persons in the workplace.1 According to OSHA, each year, some 2 million American workers are victims of workplace violence.How to prevent these occurrences from happening is vital.

A zero tolerance policy should be utilized in the prevention of workplace violence. According to McPhaul and Lipscomb, although reviews have been done of the rising problem of violence in the workplace, few intervention studies are reported.3 In addition, employers should acknowledge that attacks are possible and consider ways to deescalate them.

Root Causes of Frustration

More often than people realize, nurses deal with family members of their patients who are angry, upset, and frustrated. The reasons for such behaviors are due to fact that their loved one is in the hospital and they may not know the severity of the patient’s illness. Although it is difficult for families, it is equally troublesome for nurses to cope with such behaviors. It is important not only to tend to the patients and their family’s needs, but also the nurses’ needs.

Why are patient’s family members angry? We are all human beings. Hostility is often that breaking point and results from fear. That can be fear of the unknown, fear of being out of control, fear of loss and even fear of death

Seeking Solutions

How do you identify family members that may be difficult to manage? You want to be aware of the signs and symptoms of the typical situation. Hartford Hospital incorporates the acronym S.T.A.M.P. in the workplace violence prevention and awareness training to help all professionals.

  • Staring
  • Tone: Raising their voice, tension in their voice
  • Anxiety: Tapping of the feet, clinched fist
  • Mumbling: Saying things under their breath
  • Pacing: In the waiting area or the halls

Some signs of atypical behavior from family members may be silence and isolation. It is essential to know the signs and act accordingly before the situation escalates.

When you know that a patient’s family member is out of control, what’s the best way to handle the situation? You want to recognize the signs early and respond. In addition to S.T.A.M.P., Hartford Hospital also utilizes the acronym A.I.D.

  • Attend: Don’t ignore and acknowledge the person and their issue. Listen carefully and get to the root of the problem. It is essential to catch it early to avoid escalation.
  • Inform: Keep the patient or family member informed. Adhere to policies consistently so that mixed information is not being provided.
  • Defend: Call public safety or call 911. Always know your exit strategy.

Protect Yourself

Never let an aggressive person come between you and your personal space. Stand at a side angle. Whenever possible with someone who is escalating, remove anything that can be used against you such as scissors, a stethoscope, etc. Use the call bell in the patient’s room and if all else fails yell for help.

Being aware of your surroundings while taking care of your patient is vital. Observation is a key assessment with not just our patients, but our families too. Safety is a core value the Hartford Hospital lives by and that other institutions should also be mindful of.

Shenika Lynn Carroll, RN, MSN is an intensive care nurse and critical care instructor at Hartford Hospital in Connecticut.

References

1. U.S. Department of Labor & Occupational Safety and Health Administration (1996). Guidelines for preventing workplace violence for healthcare and social service workers. (No. OSHA 3148). Washington, DC: U.S. Department of Labor.

2. U.S. Department of Labor & Occupational Health Administration (2002). OSHA Factsheet: Workplace violence. www.osha.gov. Retrieved on Feb 10 2015.

3. McPhaul, K., Lipscomb, J., (September 30, 2004). Workplace Violence in Health Care: Recognized but not Regulated. Online Journal of Issues in Nursing. Vol.9 No.3, Manuscript 6. www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume92004/No3Sept04/ViolenceinHealthCare.aspx. Retrieved on Feb 10. 2015