By Maureen Shawn Kennedy, AJN editor-in-chief
When I graduated from nursing school, my first job was as an ED nurse at Bellevue Hospital in New York City. We’re talking about the 1970s, when drugs were plentiful and plenty of young people used them, especially hallucinogenic drugs like LSD and mescaline. Many times these patients were violent because of “bad trips” or because as the drugs wore off, they “crashed.” Sometimes these patients were accompanied by friends who were just as stoned as they were. I often experienced situations in which patients or visitors became disruptive and sometimes violent, usually because they didn’t understand what was happening to them or because they were scared and paranoid. We had no strategy or guidelines for proceeding—it was pretty much trial and error. Sometimes reasoning worked, but often it didn’t, and then we called security.
Violence in the ED and hospital setting hasn’t gone away. In fact, I just learned from Dan Hartley, an epidemiologist with the National Institute for Occupational Safety and Health (NIOSH), that according to data from the Bureau of Labor Statistics, between 2003 and 2010 the health care and social assistance industry accounted for almost two-thirds of nonfatal occupational injuries and illnesses. I spoke with Dan (you can listen to the podcast here) about workplace violence and about a new educational program from NIOSH to help nurses deal with violence (physical as well as verbal and emotional abuse) in their work settings.
Hartley and Marilyn Ridenour, a nurse epidemiologist at NIOSH, led a team that developed an online CE course, Workplace Violence Prevention for Nurses, which is available for free. The course covers “the key elements of a comprehensive workplace violence prevention program, how organizational systems impact workplace violence, how to apply individual strategies, and develop skills for preventing and responding to workplace violence.”
More resources. The Emergency Nurses Association also offers a workplace violence toolkit specifically geared towards ED nurses. And the American Nurses Association’s Online Journal of Issues in Nursing (OJIN) published a series of articles on patient and visitor violence in its January 2013 issue.