So, I’m still trying to wrap my head around the fact that nurses regularly endure the kind of verbal attacks and workplace violence that would have most of us hiring attorneys. And all this abuse comes at the hands of patients, no less!
As surly and uncouth as I am, I’ve never disrespected a nurse, so I reached out to column commenter and nurse, Heather Matthews, to ask her what kind of patient attacks a nurse. Here’s what she said:
“The kind high on drugs. The ones hallucinating from overdosing on benzodiazepines. The ones who are extremely confused after a traumatic brain injury. The ones who are not yet medically cleared to transfer to a psychiatric hospital. The ones at the psychiatric hospital who are refusing shots of medicine but have to get them because they are physically dangerous to themselves or others.
The old men with Alzheimer’s who were former boxers or vets who think you are the enemy in the war. People in extreme pain. People who feel their doctors aren’t listening to them. Parents who fear for their child’s life and fear the care isn’t happening fast enough. Parents furious when the charge nurse can’t get an IV on the first or second try (but the child’s veins have all collapsed because they are so sick). Teens in opposing gangs.
This is just a sample of what I’ve seen. But I’m a pediatric nurse. I’ve seen a lot less violence than nurses who care for adults.
The crazy part is that when I was a mental health counselor at an impatient psych hospital (before I was a nurse), I received multiple days of training every year on safe takedowns, body awareness in the room, safe restraint tactics, and verbal de-escalation techniques. We debriefed our techniques after every single code/takedown/escalation incident and gave each other feedback. Fortunately I was able to bring these skills with me to bedside care at the medical hospital. Most nurses don’t walk in with those skills.”
Like I said, yikes!
Despite the fact that most of these situations are eminently predictable, it would seem that our medical facilities are content to let nurses deal with this chronic abuse problem on their own.
Shortly after I spoke with Heather, former Aurora Township Highway Commissioner and registered nurse, John Shoemaker, reached out to describe some of his own experiences. The one that particularly caught my attention was when a patient hid in his room, and when John entered, he came after him with the call light he was twirling over his head like a morning star.
Thankfully he missed, but a struggle ensued until enough support staff arrived to subdue the attacker. John added that he “Currently work in corrections and it’s much safer than a hospital.”
I mistakenly thought that anything even mildly close to the Delnor hostage situation was a rarity, not a commonplace event in the workday lives of nurses everywhere. I understand that regularly dealing with certain medical issues carries a number of risks, but the solution to this kind of consistent and predictable violence is pretty straightforward.
As we discussed on Monday, Oswego State Rep Stephanie Kifowit is sponsoring a bill that would require all health care facilities that employ nurses to implement workplace violence prevention protocols overseen by a committee of nurses, doctors, security staff and administrators. HB 4100 also includes protections for any staffer who reports violence against a nurse.
So, I reached out to Stephanie to say, while I love her nurse-friendly initiative, considering everything I just learned, perhaps the bill needs to be a bit stronger. She replied that, since she expects hospital lobby opposition, there are limitations on what one can get passed. The point is to start with a basic bill and build on it going forward.
Our “non-profit” hospitals make money hand-over-fist and the basic steps Ms. Kifowit describes certainly won’t amount to any kind of major expense. Considering they know what kind of patients are most likely to become violent, just like it is with prisons, how difficult would it be to have roving support teams that act as nurse escorts whenever the situation warrants it.
Minimally, nurses should get the kind of training Heather received when she was a mental health counselor.
Of course, no one can predict every violent medical possibility, but it certainly seems that our medical facilities could do a heck of a lot more to protect their front line staff than simply saying something like “grin and bear it.”
No wonder we consistently hear about nursing shortages.
So please! This one’s a no-brainer. On behalf of nurses everywhere, call or email your State Rep to let them know you wholeheartedly support HB 4100. It’s a great start.