Violence In Nursing

VIOLENCE IN NURSING

WHAT IS VIOLENCE?

What is VIOLENCE? ╚>> any incident where an employee is abused, threatened or assaulted in circumstances arising out of, or in the course of, their employment.

What is VIOLENCE? ╚>> the intentional use of physical force or power, threatened or actual, against oneself, another person or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal development or deprivation (WHO, 2000)

What is VIOLENCE? ╚>> “THREAT” = a statement or behavior that causes a person to believe they are in danger of being physically attacked

What is VIOLENCE? ╚>> “PHYSICAL ATTACK” = direct or indirect application of force by a person to the body of, or clothing or equipment worn by, another person

WHAT ARE THE TYPES OF VIOLENCE?

TYPES of VIOLENCE VERBAL ABUSE

PSYCHOLOGI CAL ABUSE

PHYSICA L ABUSE

WHAT ARE THE EXAMPLES OF VIOLENCE?

EXAMPLES of VIOLENCE PUNCHIN G

PUSHING

YELLING

BITING

SEXUAL HARRASMEN T

THREAT S

THROWI NG OBJECTS

WHAT ARE THE CLASSIFICATIONS OF VIOLENCE?

Classification of violence A. CLIENT – INITIATED VIOLENCE = covers situations where a client or a client’s family member, friend, or guardian can be the source of the violence

Classification of violence B. INTERNAL VIOLENCE = covers situations where someone who works under the direction of an organization is the source of the behavior

Classification of violence C. EXTERNAL VIOLENCE = covers situations where violence is perpetrated by persons with no legitimate relationship to the organization

WHAT DO YOU NEED TO ASSESS IN ORDER TO KNOW IF THE CLIENT IS PRONE TO VIOLENCE?

INITIAL ASSESMENT 1. The patient’s mental status 2. The patient’s physical

status

3. The patient’s past history of violent behavior

INITIAL ASSESMENT 4. Signs and symptoms of current intoxication or use of mind altering drugs 5. The patient’s past history of criminal activity

INITIAL ASSESMENT 6. The patient’s financial 7. The patient’s coping mechanisms for stress and patterns of expressing anger

history

INITIAL ASSESMENT 8. The patient’s history of violence

family

9. If the client has made any sexual advances or communications directed toward the healthcare worker

INITIAL ASSESMENT 10. If the patient has access to any foreign object that could cause harm to the caregiver

WHAT CAN YOU DO TO DEFUSE A POTENTIALLY VIOLENT SITUATION?

10 Do’s and Don’ts

DO: 1. Watch for signs of escalation in the angry person. 2. Take control of the immediate environment.

10 Do’s and Don’ts

3. Project calmness. Speak quietly and move slowly. If standing, maintain a relaxed, a non-threatening posture, at right angles, not directly in front of the person. 4. Use empathetic listening skills.

10 Do’s and Don’ts

5. Manage the aftermath of a critical incident by debriefing with all staff members who were involved to discuss the incident, critique the action taken, and plan for future occurences.

10 Do’s and Don’ts

DON’T: 1. Ignore warning signs or your “gut” feelings. 2. Corner the person or allow yourself to be cornered.

10 Do’s and Don’ts

3. Interrupt, argue, or speak condescendingly. 4. Touch the person or allow them to touch you. 5. Try to be a hero if the person has a weapon.

WHAT ARE THE EMPLOYERS’ RESPONSIBILITIES TO PREVENT WORKPLACE VIOLENCE?

Employers’ Responsibilities ► Before hiring an individual, do intensive background checks ► Provide training for all employees ► Provide on the job counseling for employees

Employers’ Responsibilities ► Make the workplace the safest possible for all employees ► Make sure employees are told about a no tolerance level for any potential threatening situations that may occur in the workplace

WHAT DO THE CURRENT SURVEY RESULTS TELL US ABOUT WORKPLACE VIOLENCE?

SURVEY RESULTS Studies have shown that 35% and 80% of hospital staff has been physically assaulted at least once during their careers.

SURVEY RESULTS 36% of the Registered Nurses report having experienced episodes of violence in their workplace in the past five years.

SURVEY RESULTS 62% said that they or a co-worker had been verbally or physically assaulted at work – but 22% did not report the assault.

SURVEY RESULTS Registered Nurses in Emergency Departments (76%) and mental health units (67%) were mostly likely to experience an episode of work-related violence.

SURVEY RESULTS Assaults came from patients (38%); visitors (23%); even coworkers (18%), physicians (10%) and management (6%).

SURVEY RESULTS Almost half (48%) of all responding RNs said they had not received sufficient training on violence prevention strategies.

SURVEY RESULTS Almost half of the RNs also said there was a lack of adequate numbers of trained security personnel at their facility.

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