If you are a nurse, I have to ask you if you really feel safe while at work? At any given moment you face people at their worse moment in life looking to vent their frustrations whether they are aware of what they are doing or not. Safety in the workplace is a hot issue in nursing and there is a damn good reason why!
Some surveys suggest up to 80% of nurses are attacked in some way while on the job! (Jacobson, 2014).
The sad truth to this according to Jacobson (2014) and as a personal witness to this belief is that is all a part of the job. People actually believe because we are nurses we must face the fact that we will be subject to attacks and assault. We go to college, learn how to get people better or keep them comfortable and oh yeah, take a class on how to take a beating. Well this is wrong! As a male in the nursing force for 20 years, I must say this goes double for us guys.
"Well your a guy, so it's better you take on the agitated, crazy lunatic in exam room 2!"
We have all recently witnessed horrible attacks in hospitals on healthcare workers. Whether it is a disgruntled ex-employee, patient, or family member, nurses are at risk everyday they punch in for the job.
Watch this video as Nurses are attacked by a patient with a metal rod!
What can be done to keep nurses and all healthcare workers safe while on the job? As an instructor for a deescalation program known as NAPPI, I must first turn to my attention to the entry way of the organization.
We have police security presence in airports, train stations, government building, and even schools. I can't even go visit my child without signing in at the office after the door is buzzed open. Not that I disagree with this, rather think it should be applied to healthcare building too. This can help slow down the violence from those entering the building on a mission to cause violence. Security must not only be at the entrance but throughout the buildings. Organizations must believe in this investment in order to keep their staff safe. SO many times I ave worked where the only security guard was tied up in the emergency room while I or another co-worker deal with a violent patient. HIRE MORE SECURITY GUARDS!
Now that i got that off my chest let me share some tips to keep safe. I must be careful in this section as I can't share specific techniques since the program I am an instructor for is a trademark and I am licensed only to teach employees. I will say that even when I teach these techniques I feel bad because deep down I know they don't always work. It's hard to have to follow protocols while the patient, family, or visitor does not. Fortunately assault on nurses and medical workers is a felony.
Tip # 1 - Always have each others back - In the ARMY we used the buddy system. You kept an eye on one another and had their back. Nurses must do the same. Watch out for one another.
I remember this night when a patient was admitted from the ED to the ICU. He was acting all fun and games in the room as the nurse tried to admit him. He had altered mental status and amnesia. He was young and looked physically fit. As the nurse working in the next room I kept a close eye on my co-worker. A few hours into the admission the patient snapped and grabbed her stethoscope around her neck and pulled it tightly around her throat. I ran into the room and yelled at him to let her go. He did and then grabbed me. I thought he was going to break my arms. A long story short, high on PCP and forever for security to arrive, I was lucky I wasn't injured.
Tip #2 - Have an escape plan - I tell people to always know how to escape and leave the area. Of course I am always asked "what about the patient?" or "what if they are confused and can't help it". This is always a case by case situation, however in order to avoid serious injury you may need to leave.
It was a late night, somewhere around 1 or 2 in the morning. I an two other nurses were on the floor. Suddenly my confused patient got out of bed and started boxing the wall in his room. I walked to him and he set eyes on me. "Oh shit!" was all I could think as he ran for me. I told the other nurses to leave the unit in fear they would get injured. They knew the exit. I kept this guys focus from other rooms as he continued after me. I will admit, I saw stars when he punched me in the face. Luckily he missed the second time and I was able to retrain him until the elderly security guard showed up. Thank god for IM injections!
Another time I ran into my office to stay safe! Hey, whatever works to keep you safe
Tip #3 - Less is more - The less you do sometimes the better. If a patient is agitated because of all the stuff we do to them while in the hospital, I suggest you don't do it. For example the agitated guy with dementia won't keep on his SCD's. Well take them off. I am sure he is moving his legs around so much blood clots are certainly not an issue. You on the other hand getting kicked in the face struggled to keep them on can be an issue. Do your best not to take it personal as you struggle to do what is best for the patient. Arguing with a family member on why you must turn their mother every hour to keep her skin from breaking down may not be the best solution when tempers are high. This leads to my last tip...
Tip #4 - Keep your emotions out of it - be strategic! - Keep your emotions in check in order from increasing the other's. This is hard to do, but practice makes perfect. Sometimes expecting others to be rude and unappreciative, allows you to not care much and remain calm. Keep your emotions in check as your only goal is keeping the person calm with the goal of a mutual understanding. I tell people Q-TIP QUIT TAKING IT PERSONALLY
I was working in the early evening in the ICU. The family of this now stable patient were quite involved in the young girls care. I didn't mind until they started asking me to do things that were not safe. For example, could I move the vented girl into a new bed because the one she was in made a noise when you elevated the head of bed. Not worth the risk as the evening grew into night and I did not have the resources. The family, not happy with my decision, criticized my every move while in the room. I wasn't labeling tubing correctly or giving enough sedation even though she was on a weaning protocol for early am extubation. I thought I had control until dad walked into the room and stuck his finger into my chest. As he scolded me, telling me I was the one wanting to change the bed and was giving his wife and sister a hard time, my internal anger and emotions began to bubble. "Who the hell does this guy think he is?" I kept them in check and excused myself from being the nurse in that room. I walked into the unit the next day to see the girl up and awake and fine, regardless of my reckless care. I ddin't say a word and kept to my business. I overheard the nurse with the family making statements about me and that "he is just a traveler who doen't know much."
I'm the first to say, it's hard! I wanted to say a few things but decided not to. My strategy was to finish this assignment and move on. This facility did not support it's staff and chose to go along with the abusive people rather request they be respectful to staff. I knew it wouldn't have mattered if I spoke up or got worked up.
IN Summary! Have each others back, work for a place that takes your safety seriously and learn as much as possible on safety. Have a plan and a way out in order to keep any injuries as minimal as possible. I am not naive either. I just shared stories with you where I could have been hurt. Just stay alert and stay diligent. Don't run into a violent situation unless someone needs you immediately. Play it safe and call the police if you have too. I have seen this used many times and it works. I have been scared to enter rooms in the ER. The police were called and stood in the room so I could work. Sometimes it has to be that way to be safe. If your facility does not support this I say encourage it to or get out. Stay safe. Nurses aren't really safe out there.