A And E Setting

However, what some don’t know is that assaults on first responders are happening across the nation and many go unreported. Violence against EMS experts takes many forms. Most acts of brutality are not less than deadly. Statistics shows that the risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers a year; the national average is about 1.8 per 10,000 workers. The National Association of Emergency Medical Technicians (NAEMT) found 4/5 medics have experienced some form of injury as a result of the job. The U.S. Department of Labor reported that about 52 percent of EMTs operating in the field have been assaulted.

If those who witness horizontal violence taking place or if the nurse being targeted does not speak up, it can keep occurring until the situation starts to have a negative impact on the targeted nurse. The effects can start to show up in the nurse’s work and in patient satisfaction. It can also lead to the nurse leaving their hospital for a new hospital to work for and it can even lead to the nurse leaving the nursing profession for good. Some nurses deal with this type of stress by seeing it as a challenge that they must endure in order to be become hardy and resilient

Tony York, the chief operating officer for Healthcare Security Services in Denver, Colorado, which monitors security at hospitals throughout the nation, says there has been an “explosion of patient-generated violence” in the past several years – both from patients themselves and, often, the people accompanying them to the hospital. “Those are things that have driven this industry immensely,” York

According to Purpora and Blegen, approximately 60% of actual errors in patient care result from poor and ineffective communication (para. 3). Horizontal violence causes a decrease in effective communication between caregivers which places the patient’s safety in jeopardy. Horizontal violence decreases staff morale which leaves room for error in the workplace (Longo & Smith, 2011).

A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.

Horizontal violence is a hidden pattern of individual behavior in controlling other individual that risk health and safety (Hinchberger, 2009). According to Roche, Duffield and Catling-Paull, violence can be describe as emotional abuse, threat, or actual violence in any health care setting. Although the definition varies according to situations and practice settings, there is agreement that workplace violence has a negative impact on the health and wellbeing of nurses and the delivery of quality nursing care (Hinchberger, 2009). Violence mostly occur in any health care setting, However, it mostly occur in emergency department, waiting room, psychiatric ward and geriatric unit on which people involved psychological situations.

In reality, there are limited places that violence cannot happen, however, we are often surprised by some of the places violence does take place. One of the places many don’t expect violence to take place is in the hospital. Hospitals are designed to promote safety and provide medical care and nursing treatment for sick or injured people. Unfortunately, on January 12, 2016 a hospital security guard and a police officer endured near-fatal shootings by a drug-affected patient in Nepal. Rachel Olding, the author of an article written February 4, 2016 points out some concerns, thoughts, and ideas for improvement taken from hospital workers who have seen and experienced hospital violence firsthand. Hospitals need to be a place of safety for their patients, staff, and visitors.

In 3 articles, survivors of healthcare worker directed violence admitted to knowingly spending less time with their patients after the attack.(8, 12, 16) Quality of care is also reduced as survivors admit to being fearful of their patients as well as being reluctant to care for specific patients or any patients at all.(8, 17, 19, 25) After an incident of workplace violence, survivors stated that they have decreased communication with their patients, patient families, and coworkers.(12, 27) Survivors also admitted to having reduced interest in being a part of patient care, as well as being in their current position.(8, 12, 14, 19) One article found that physiotherapists often reduced their expectations for their patients after experiencing an incidence of workplace violence from a patient.(8) Survivors also found that they had reduced empathy and gave reduced emotional support to patients and their families after returning to work.(15) After an attack by a patient, survivors admitted to lacking concentration that led to missed medication administration, increased falls, and increased errors in administration of care.(10, 15, 17, 27)

Moreover, another type of violence which nurses experience is horizontal violence. Horizontal violence is described as “hostile, aggressive, and harmful behavior by a nurse or group of nurses toward a co-worker or group of nurses via attitudes, actions, words, and behaviors” (Becher & Visovsky, 2012, p. 210). Horizontal violence not only involves nurse-nurse violence but includes nurse-physician and nurse-supervisor violence. The perpetrator displays behaviors associated with horizontal violence which may include refusing to lend assistance, criticizing, intimidation, gossiping, name-calling, and ignoring (Becher & Visovsky, 2012). The American Nurses Association sets the expectations for nursing standards. According to the American Nurses

Violence and aggression refer to the manifestation of numerous behaviours (physical, verbal) that may cause injury or harm to others, (National Institute for Health and Care Excellence (NICE, 2015). The violent and aggressive behaviour are aimed towards themselves (patients), staff, properties, visitors and other service users. In England between 2013 and 2014, it was reported that 68,683 attacks took place on the staff, 69% in mental health settings, (NICE, 2015). To minimise dual diagnosis service users from

In today’s world violence can be expected anywhere at any time. This includes what was considered at one time a low risk area, the medical facility. Today the incidence of violence is increasing. There are two types of violence the first is lateral violence or aggression which is amongst hospital or medical personal. The other is external factors consisting of patients or visitors instituting violence or aggression among themselves or against healthcare workers. This is known as a code grey in my facility and all male staff not currently engaged in patient care are supposed to respond.

It was Saturday night while I was just starting on my shift and getting the handover report from the outgoing nurse, when the public address system announced a “Code Black”. A code black in the hospital setting means that there is an emergency situation involving personal threats to the safety of staff and the public including assaults, confrontation, hostage situation but mostly threats of personal injury or attack. The hospital is in partial lockdown and nobody can get in and out for fear of violent retribution from both the perpetrators and victims’ family; the patient being brought in the emergency room usually with stab injuries or gunshot wounds. It has been a fairly normal occurrence nowadays that nobody was unfazed with the announcement. We have seen recently on the news about the Orlando massacre where 49 people were killed and 53 injured due to gun violence influenced by a terrorist intent. If the congress will not do any substantial changes with the law and its implementation to curb this violent act of terrorist and mentally deranged individuals, then it wont be long before it will reach an epidemic proportion that it can happen to us in our own backyard. It is happening now in our community, sporadic incidence as it seems, it is very concerning and cannot be ignored. Because a lot of people, both men, women and children are dying everyday from gun violence, and the current

Health care workers in Canada face a vast amount of harassment in the workplace, and the safety of these employees are not being improved. The neglect of employee rights in the workplace is an example of employees rights not being respected. Many nurses and personal support workers have been experiencing abuse, sexual assault, and harassment because the government and hospital fail to implement laws to provide them a safe work environment. These assaults are carried out by their patients, for example, registered practical nurse, Dianne Paulin, was pinned against a door with a chair and was repeatedly assaulted by a patient. In addition to the harassment, awareness of this issue is being discouraged and it is said that nobody is allowed to talk about the issue because of the fear of the hospitals retaliation. Employees feel as if they cannot speak up

Suzanne Gordon’s book (2010), When Chicken Soup Isn’t Enough shares a personal experience of Registered Nurse Eleanor Geldard, titled, Intolerable Behaviour. When Geldard was working in South Africa, a nurse in her Intensive Care Unit (ICU) was verbally abused in front of patients and their families, by a doctor. Geldard could not stand this doctor’s

National Health Service (2014). Aggressive behavior at home Policy (Staff), University Hospitals of Leicester NHS trust:http://www.homeoffice.gov.uk/distributions/about-us/interviews/definitiondomestic-savagery/2014.